Universität zu Köln

Stecher, Melanie, Hoenigl, Martin ORCID: 0000-0002-1653-2824, Eis-Hubinger, Anna Maria, Lehmann, Clara, Faetkenheuer, Gerd, Wasmuth, Jan-Christian, Knops, Elena, Vehreschild, Joerg Janne, Mehta, Sanjay and Chaillon, Antoine (2019). Hotspots of Transmission Driving the Local Human Immunodeficiency Virus Epidemic in the Cologne-Bonn Region, Germany. Clin. Infect. Dis., 68 (9). S. 1539 - 1547. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

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Abstract

Background. Geographical allocation of interventions focusing on hotspots of human immunodeficiency virus (HIV) transmission has the potential to improve efficiency. We used phylogeographic analyses to identify hotspots of the HIV transmission in Cologne-Bonn, Germany. Methods. We included 714 HIV-1 infected individuals, followed up at the University Hospitals Cologne and Bonn. Distance-based molecular network analyses were performed to infer putative relationships. Characteristics of genetically linked individuals and assortativity (shared characteristics) were analyzed. Geospatial diffusion (ie, viral gene flow) was evaluated using a Slatkin-Maddison approach. Geospatial dispersal was determined by calculating the average distance between the residences of linked individuals (centroids of 3-digit zip code). Results. In sum, 217/714 (30.4%) sequences had a putative genetic linkage, forming 77 clusters (size range: 2-8). Linked individuals were more likely to live in areas surrounding the city center (P = .043), <30 years of age (P = .009). and infected with HIV-1 subtype B (P = .002). Clustering individuals were nonassortative by area of residency (-.0026, P = .046). Geospatial analyses revealed a median distance between genetically linked individuals of 23.4 kilometers (km), lower than expected (P < .001). Slatkin-Maddison analyses revealed increased gene flow from central Cologne toward the surrounding areas (P < .001). Conclusion. Phylogeographic analysis suggests that central Cologne may be a significant driver of the regional epidemic. Although clustering individuals lived closer than unlinked individuals, they were less likely to be linked to others from their same zip code. These results could help public health entities better understand transmission dynamics, facilitating allocation of resources to areas of greatest need.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stecher, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoenigl, Martin UNSPECIFIED orcid.org/0000-0002-1653-2824 UNSPECIFIED Eis-Hubinger, Anna Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Clara UNSPECIFIED UNSPECIFIED UNSPECIFIED Faetkenheuer, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Wasmuth, Jan-Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Knops, Elena UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Joerg Janne UNSPECIFIED UNSPECIFIED UNSPECIFIED Mehta, Sanjay UNSPECIFIED UNSPECIFIED UNSPECIFIED Chaillon, Antoine UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-148694
DOI:	10.1093/cid/ciy744
Journal or Publication Title:	Clin. Infect. Dis.
Volume:	68
Number:	9
Page Range:	S. 1539 - 1547
Date:	2019
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1537-6591
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RISK BEHAVIOR; GAY MEN; SEX; INFECTION; IMPACT; APPS; DNA Multiple languages Immunology; Infectious Diseases; Microbiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14869