Identifying Clusters of Recent and Rapid HIV Transmission Through Analysis of Molecular Surveillance Data.

摘要: BACKGROUND Detecting recent and rapid spread of HIV can help prioritize prevention early treatment for those at highest risk transmission. genetic sequence data identify transmission clusters, but previous approaches have not distinguished clusters recent, We assessed an analytic approach to such in the United States. METHODS analyzed 156,553 partial HIV-1 polymerase sequences reported National Surveillance System inferred using 2 distance thresholds (0.5% 1.5%) periods diagnoses (all years 2013-2015, ie, diagnoses). For rapidly growing (with ≥5 during 2015), molecular clock phylogenetic analysis estimated time most common ancestor all divergence events within cluster. Cluster rates were these phylogenies. RESULTS A threshold 1.5% identified 103 73 diagnoses; 0.5%, 15 13 diagnoses. Molecular that 0.5% had been diversifying a median 4.7 years, compared with 6.5-13.2 other approaches. The rate 33/100 person-years, national estimates 4/100 person-years. CONCLUSIONS Our 8 times estimates. This method groups involved programs effectively direct limited public health resources.