Characterising HIV-1 transmission in Victoria, Australia: a molecular epidemiological studyResearch in context

George Taiaroa; Doris Chibo; Sophie Herman; Mona L. Taouk; Megan Gooey; Jodie D'Costa; Rizmina Sameer; Nicole Richards; Elaine Lee; Lydya Macksabo; Nasra Higgins; David J. Price; Soo Jen Low; Eike Steinig; Genevieve E. Martin; Michael A. Moso; Leon Caly; Jacqueline Prestedge; Christopher K. Fairley; Eric P.F. Chow; Marcus Y. Chen; Sebastian Duchene; Jane S. Hocking; Sharon R. Lewin; Deborah A. Williamson

The Lancet Regional Health. Western Pacific (Jun 2024)

Characterising HIV-1 transmission in Victoria, Australia: a molecular epidemiological studyResearch in context

George Taiaroa,
Doris Chibo,
Sophie Herman,
Mona L. Taouk,
Megan Gooey,
Jodie D'Costa,
Rizmina Sameer,
Nicole Richards,
Elaine Lee,
Lydya Macksabo,
Nasra Higgins,
David J. Price,
Soo Jen Low,
Eike Steinig,
Genevieve E. Martin,
Michael A. Moso,
Leon Caly,
Jacqueline Prestedge,
Christopher K. Fairley,
Eric P.F. Chow,
Marcus Y. Chen,
Sebastian Duchene,
Jane S. Hocking,
Sharon R. Lewin,
Deborah A. Williamson

Affiliations

George Taiaroa: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Corresponding author. Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, 3000, VIC, Australia.
Doris Chibo: Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Sophie Herman: Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Mona L. Taouk: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Megan Gooey: Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Jodie D'Costa: Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Rizmina Sameer: Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Nicole Richards: Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Elaine Lee: Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Lydya Macksabo: Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Nasra Higgins: Victorian Department of Health, Melbourne, Victoria, Australia
David J. Price: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
Soo Jen Low: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Eike Steinig: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Genevieve E. Martin: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Michael A. Moso: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Leon Caly: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Jacqueline Prestedge: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Christopher K. Fairley: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; School of Translational Medicine, Monash University, Melbourne, Victoria
Eric P.F. Chow: Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; School of Translational Medicine, Monash University, Melbourne, Victoria
Marcus Y. Chen: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; School of Translational Medicine, Monash University, Melbourne, Victoria
Sebastian Duchene: Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Jane S. Hocking: Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
Sharon R. Lewin: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Victoria, Australia; Victorian Infectious Diseases Service, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Deborah A. Williamson: Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Corresponding author. Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, 3000, VIC, Australia.

Journal volume & issue: Vol. 47
p. 101103

Abstract

Read online

Summary: Background: In Australia the incidence of HIV has declined steadily, yet sustained reduction of HIV transmission in this setting requires improved public health responses. As enhanced public health responses and prioritisation of resources may be guided by molecular epidemiological data, here we aimed to assess the applicability of these approaches in Victoria, Australia. Methods: A comprehensive collection of HIV-1 pol sequences from individuals diagnosed with HIV in Victoria, Australia, between January 1st 2000 and December 31st 2020 were deidentified and used as the basis of our assessment. These sequences were subtyped and surveillance drug resistance mutations (SDRMs) identified, before definition of transmission groups was performed using HIV-TRACE (0.4.4). Phylodynamic methods were applied using BEAST (2.6.6), assessing effective reproductive numbers for large groups, and additional demographic data were integrated to provide a high resolution view of HIV transmission in Victoria on a decadal time scale. Findings: Based on standard settings for HIV-TRACE, 70% (2438/3507) of analysed HIV-1 pol sequences were readily assigned to a transmission group. Individuals in transmission groups were more commonly males (aOR 1.50), those born in Australia (aOR 2.13), those with probable place of acquisition as Victoria (aOR 6.73), and/or those reporting injectable drug use (aOR 2.13). SDRMs were identified in 375 patients (10.7%), with sustained transmission of these limited to a subset of smaller groups. Informative patterns of epidemic growth, stabilisation, and decline were observed; many transmission groups showed effective reproductive numbers (Re) values reaching greater than 4.0, representing considerable epidemic growth, while others maintained low Re values. Interpretation: This study provides a high resolution view of HIV transmission in Victoria, Australia, and highlights the potential of molecular epidemiology to guide and enhance public health responses in this setting. This informs ongoing discussions with community groups on the acceptability and place of molecular epidemiological approaches in Australia. Funding: National Health and Medical Research Council, Australian Research Council.

Published in The Lancet Regional Health. Western Pacific

ISSN: 2666-6065 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.thelancet.com/journals/lanwpc/home

About the journal

Abstract

Keywords