Global molecular epidemiology of HIV in 1990-2025
Professor Philippe Guerin, Nuffield Department of Medicine, University of Oxford
The HIV pandemic remains a major global public health problem, with 38.4 million people living with HIV in 2021. Global HIV genetic diversity forms a major challenge to the development of an HIV vaccine as well as diagnostic, drug resistance, and viral load assays, which are essential for antiretroviral therapy programmes. HIV diversity also impacts HIV transmission and pathogenicity.
We previously collected data on nearly 400,000 subtyped HIV samples from 116 countries for the period 1990-2015. This showed that the global distribution of HIV-1 subtypes and recombinants is extremely complex and dynamic. Sub-Saharan Africa accounts for two-thirds of all people living with HIV worldwide and has the greatest genetic diversity of HIV. The number and proportion of HIV recombinants is increasing, and country-level HIV diversity is increasing globally. Global HIV-1 genetic diversity surveillance therefore remains crucial in tackling the pandemic.
Hemelaar et al, Lancet Infectious Diseases,19(2):143-155(2019).
Hemelaar et al, Lancet HIV,7(11):e772-e781(2020).
Hemelaar et al, J Virology,95(2):e01580-20(2021).
Elangovan et al, Hemelaar J, Front Microbiol, 12: 690647(2021).
RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING
The project will involve collection of global HIV molecular epidemiology data for the period 2016-2025. This will include conducting a living systematic literature review to identify papers reporting on HIV subtype distribution in countries in 2016-2025. In addition, we will engage with an established WHO-UNAIDS network of >200 HIV molecular epidemiology experts to obtain unpublished data. Data will be assembled in an online REDCap database, which will facilitate downstream analyses.
Analyses may include, but are not limited to:
- Country-level, regional and global distribution of HIV subtypes and recombinants during 1990-2025.
- Linkage of global HIV diversity data to transport and accessibility models to investigate the role of infrastructure and human migration in the spread of HIV.
- Analysis of associations between HIV variants and transmission routes/key populations, markers of disease progression/control (CD4 counts/viral loads), and antiretroviral drug resistance.
- Analysis to assess the global need for subtype-specific HIV vaccines, including differential vaccination scenarios and cost-benefit analyses.
FIELD WORK, SECONDMENTS, INDUSTRY PLACEMENTS AND TRAINING
It is anticipated that the work will be conducted in Oxford and all necessary facilities, equipment and training, including database, analytic and statistical training, will be provided in Oxford.
A student with a background in medicine, infectious diseases, statistics or global/public health would be best suited to this project. Experience in statistics is essential. The project has a broad scope and candidates are encouraged to contact Dr Joris Hemelaar to work out a specific project proposal.