Phylodynamics and migration data help describe HIV transmission dynamics in internally displaced people who inject drugs in Ukraine.

Autor:	Kovalenko G; Division of Virology, Department of Pathology, University of Cambridge, Cambridge CB2 0QN, UK.; Department of Biological Sciences, University of Alaska, Anchorage, AK 99508, USA., Yakovleva A; Medical Sciences Division, University of Oxford, Oxford OX3 9DU, UK., Smyrnov P; Alliance for Public Health, Kyiv 01601, Ukraine., Redlinger M; Department of Biological Sciences, University of Alaska, Anchorage, AK 99508, USA., Tymets O; Alliance for Public Health, Kyiv 01601, Ukraine., Korobchuk A; Alliance for Public Health, Kyiv 01601, Ukraine., Kolodiazieva A; Odesa Regional Virology Laboratory, Odesa 65000, Ukraine., Podolina A; Odesa Regional Virology Laboratory, Odesa 65000, Ukraine., Cherniavska S; Odesa Regional Virology Laboratory, Odesa 65000, Ukraine., Skaathun B; Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92093-0507, USA., Smith LR; Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92093-0507, USA., Strathdee SA; Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92093-0507, USA., Wertheim JO; Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92093-0507, USA., Friedman SR; Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA., Bortz E; Department of Biological Sciences, University of Alaska, Anchorage, AK 99508, USA., Goodfellow I; Division of Virology, Department of Pathology, University of Cambridge, Cambridge CB2 0QN, UK., Meredith L; Division of Virology, Department of Pathology, University of Cambridge, Cambridge CB2 0QN, UK., Vasylyeva TI; Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92093-0507, USA.
Jazyk:	angličtina
Zdroj:	PNAS nexus [PNAS Nexus] 2023 Jan 20; Vol. 2 (3), pp. pgad008. Date of Electronic Publication: 2023 Jan 20 (Print Publication: 2023).
DOI:	10.1093/pnasnexus/pgad008
Abstrakt:	Internally displaced persons are often excluded from HIV molecular epidemiology surveillance due to structural, behavioral, and social barriers in access to treatment. We test a field-based molecular epidemiology framework to study HIV transmission dynamics in a hard-to-reach and highly stigmatized group, internally displaced people who inject drugs (IDPWIDs). We inform the framework by Nanopore generated HIV pol sequences and IDPWID migration history. In June-September 2020, we recruited 164 IDPWID in Odesa, Ukraine, and obtained 34 HIV sequences from HIV-infected participants. We aligned them to publicly available sequences ( N = 359) from Odesa and IDPWID regions of origin and identified 7 phylogenetic clusters with at least 1 IDPWID. Using times to the most recent common ancestors of the identified clusters and times of IDPWID relocation to Odesa, we infer potential post-displacement transmission window when infections likely to happen to be between 10 and 21 months, not exceeding 4 years. Phylogeographic analysis of the sequence data shows that local people in Odesa disproportionally transmit HIV to the IDPWID community. Rapid transmissions post-displacement in the IDPWID community might be associated with slow progression along the HIV continuum of care: only 63% of IDPWID were aware of their status, 40% of those were in antiviral treatment, and 43% of those were virally suppressed. Such HIV molecular epidemiology investigations are feasible in transient and hard-to-reach communities and can help indicate best times for HIV preventive interventions. Our findings highlight the need to rapidly integrate Ukrainian IDPWID into prevention and treatment services following the dramatic escalation of the war in 2022. (© The Author(s) 2023. Published by Oxford University Press on behalf of National Academy of Sciences.)
Databáze:	MEDLINE
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