Quantifying and Predicting Ongoing Human Immunodeficiency Virus Type 1 Transmission Dynamics in Switzerland Using a Distance-Based Clustering Approach
Author:
Labarile Marco12ORCID, Loosli Tom12, Zeeb Marius12, Kusejko Katharina12ORCID, Huber Michael2, Hirsch Hans H34ORCID, Perreau Matthieu5, Ramette Alban6ORCID, Yerly Sabine7, Cavassini Matthias8ORCID, Battegay Manuel4, Rauch Andri9, Calmy Alexandra7, Notter Julia10, Bernasconi Enos11, Fux Christoph12, Günthard Huldrych F12, Pasin Chloé12, Kouyos Roger D12ORCID, Abela I, Aebi-Popp K, Anagnostopoulos A, Battegay M, Bernasconi E, Braun D L, Bucher H C, Calmy A, Cavassini M, Ciuffi A, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux C A, Günthard H F, Hachfeld A, Haerry D, Hasse B, Hirsch H H, Hoffmann M, Hösli I, Huber M, Kahlert C R, Kaiser L, Keiser O, Klimkait T, Kouyos R D, Kovari H, Kusejko K, Martinetti G, de Tejada B Martinez, Marzolini C, Metzner K J, Müller N, Nemeth J, Nicca D, Paioni P, Pantaleo G, Perreau M, Rauch A, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Wandeler G, Yerly S,
Affiliation:
1. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich , Zurich , Switzerland 2. Institute of Medical Virology, University of Zurich , Zurich , Switzerland 3. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel , Basel , Switzerland 4. Transplantation and Clinical Virology, Department of Biomedicine, University of Basel , Basel , Switzerland 5. Division of Immunology and Allergy, Lausanne University Hospital, University of Lausanne , Lausanne , Switzerland 6. Institute for Infectious Diseases, University of Bern , Bern , Switzerland 7. Laboratory of Virology and Division of Infectious Diseases, Geneva University Hospital, University of Geneva , Geneva , Switzerland 8. Division of Infectious Diseases, Lausanne University Hospital , Lausanne , Switzerland 9. Department of Infectious Diseases, Bern University Hospital, University of Bern , Bern , Switzerland 10. Division of Infectious Diseases, Cantonal Hospital St Gallen , St Gallen , Switzerland 11. Division of Infectious Diseases, Regional Hospital Lugano , Lugano , Switzerland 12. Department of Infectious Diseases, Kantonsspital Aarau , Aarau , Switzerland
Abstract
Abstract
Background
Despite effective prevention approaches, ongoing human immunodeficiency virus 1 (HIV-1) transmission remains a public health concern indicating a need for identifying its drivers.
Methods
We combined a network-based clustering method using evolutionary distances between viral sequences with statistical learning approaches to investigate the dynamics of HIV transmission in the Swiss HIV Cohort Study and to predict the drivers of ongoing transmission.
Results
We found that only a minority of clusters and patients acquired links to new infections between 2007 and 2020. While the growth of clusters and the probability of individual patients acquiring new links in the transmission network was associated with epidemiological, behavioral, and virological predictors, the strength of these associations decreased substantially when adjusting for network characteristics. Thus, these network characteristics can capture major heterogeneities beyond classical epidemiological parameters. When modeling the probability of a newly diagnosed patient being linked with future infections, we found that the best predictive performance (median area under the curve receiver operating characteristic AUCROC = 0.77) was achieved by models including characteristics of the network as predictors and that models excluding them performed substantially worse (median AUCROC = 0.54).
Conclusions
These results highlight the utility of molecular epidemiology-based network approaches for analyzing and predicting ongoing HIV transmission dynamics. This approach may serve for real-time prospective assessment of HIV transmission.
Funder
Swiss National Science Foundation Yvonne-Jacob Foundation University of Zurich Gilead Sciences
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Immunology and Allergy
Cited by
1 articles.
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