Assessing the danger of self-sustained HIV epidemics in heterosexuals by population based phylogenetic cluster analysis
- University Hospital Zurich, Switzerland
- University of Hospital Zurich, Switzerland
- University of Zurich, Switzerland
- Geneva University Hospitals, Switzerland
- University Hospital Lausanne, Switzerland
- University of Basel, Switzerland
- University Hospital Basel, Switzerland
- Regional Hospital of Lugano, Switzerland
- Geneva University Hospital, Switzerland
- Lausanne University Hospital, Switzerland
- University of Bern, Switzerland
- Cantonal Hospital St. Gallen, Switzerland
- University Hospital Zürich, Switzerland
Abstract
Assessing the danger of transition of HIV transmission from a concentrated to a generalized epidemic is of major importance for public health. In this study, we develop a phylogeny-based statistical approach to address this question. As a case study, we use this to investigate the trends and determinants of HIV transmission among Swiss heterosexuals. We extract the corresponding transmission clusters from a phylogenetic tree. To capture the incomplete sampling, the delayed introduction of imported infections to Switzerland, and potential factors associated with basic reproductive number R0, we extend the branching process model to infer transmission parameters. Overall, the R0 is estimated to be 0.44 (95%-confidence interval 0.42-0.46) and it is decreasing by 11% per 10 years (4%-17%). Our findings indicate rather diminishing HIV transmission among Swiss heterosexuals far below the epidemic threshold. Generally, our approach allows to assess the danger of self-sustained epidemics from any viral sequence data.
Article and author information
Author details
Funding
Swiss National Science Foundation (33CS30-148522 and 159868)
- Huldrych F Günthard
Swiss National Science Foundation (PZ00P3-142411)
- Roger D Kouyos
Yvonne-Jacob Foundation
- Huldrych F Günthard
University of Zurich's Clinical Research Priority Program's ZPHI
- Huldrych F Günthard
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Reviewing Editor
- Ryosuke Omori
Ethics
Human subjects: The SHCS was approved by the ethics committees of the participating institutions (Kantonale Ethikkommission Bern, Ethikkommission des Kantons St. Gallen, Comite Departemental d'Ethique des Specialites Medicales et de Medicine Communataire et de Premier Recours, Kantonale Ethikkommission Zürich, Repubblica e Cantone Ticino-Comitato Ethico Cantonale, Commission Cantonale d'Étique de la Recherche sur l'Être Humain, Ethikkommission beiderBasel; all approvals are available on http://www.shcs.ch/206-ethic-committee-approval-and-informed-consent), and written informed consent was obtained from all participants.
Version history
- Received: May 17, 2017
- Accepted: August 28, 2017
- Accepted Manuscript published: September 12, 2017 (version 1)
- Version of Record published: October 20, 2017 (version 2)
Copyright
© 2017, Turk et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Assessing the danger of self-sustained HIV epidemics in heterosexuals by population based phylogenetic cluster analysis
eLife 6:e28721.
https://doi.org/10.7554/eLife.28721
Further reading
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- Epidemiology and Global Health
Background:
Circulating omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) have been associated with various chronic diseases and mortality, but results are conflicting. Few studies examined the role of omega-6/omega-3 ratio in mortality.
Methods:
We investigated plasma omega-3 and omega-6 PUFAs and their ratio in relation to all-cause and cause-specific mortality in a large prospective cohort, the UK Biobank. Of 85,425 participants who had complete information on circulating PUFAs, 6461 died during follow-up, including 2794 from cancer and 1668 from cardiovascular disease (CVD). Associations were estimated by multivariable Cox proportional hazards regression with adjustment for relevant risk factors.
Results:
Risk for all three mortality outcomes increased as the ratio of omega-6/omega-3 PUFAs increased (all Ptrend <0.05). Comparing the highest to the lowest quintiles, individuals had 26% (95% CI, 15–38%) higher total mortality, 14% (95% CI, 0–31%) higher cancer mortality, and 31% (95% CI, 10–55%) higher CVD mortality. Moreover, omega-3 and omega-6 PUFAs in plasma were all inversely associated with all-cause, cancer, and CVD mortality, with omega-3 showing stronger effects.
Conclusions:
Using a population-based cohort in UK Biobank, our study revealed a strong association between the ratio of circulating omega-6/omega-3 PUFAs and the risk of all-cause, cancer, and CVD mortality.
Funding:
Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institute of Health under the award number R35GM143060 (KY). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
