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Using transmission networks for assessing and guiding prevention efforts in hiv

English title Using transmission networks for assessing and guiding prevention efforts in hiv
Applicant Kouyos Roger
Number 155851
Funding scheme SNSF Starting Grants
Research institution
Institution of higher education University of Zurich - ZH
Main discipline Infectious Diseases
Start/End 01.10.2015 - 30.09.2021
Approved amount 1'486'805.00
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Keywords (5)

Epidemiology; Prevention; Molecular Epidemiology; Human Immunodeficiency Virus; Network

Lay Summary (German)

Lead
Ziel dieses Forschungsprojektes ist es traditionelle epidemiologische Daten und Analysen in eine Analyse des Transmissionsnetzwerks von HIV zu integrieren. Die Epidemiologie untersucht die Verteilung und Ursachen von Gesundheits-relevanten Zuständen. Dabei werden normalerweise verschiedene Individuen als unabhängig betrachtet. Diese Annahme ist aber gerade bei Infektionskrankheiten problematisch, da sie die Ausbreitung eines Erregers nur ungenügend erfassen kann. Diese Ausbreitung ist durch das Transmissionsnetzwerk des Erregers gegeben, welches allerdings sehr schwierig zu bestimmen ist, aber dennoch eine zentrale Bedeutung für eine erfolgreiche Prävention hat. HIV und insbesondere die Schweizerische-HIV-Kohorten-Studie (SHKS) bieten ein ideales Fallbeispiel für die Kombination von Transmissionsnetzwerken und traditionellen epidemiologischen Daten und Analysen.
Lay summary

Ziel dieses Forschungsprojektes ist es traditionelle epidemiologische Daten und Analysen in eine Analyse des Transmissionsnetzwerks von HIV zu integrieren.  Die Epidemiologie untersucht die Verteilung und Ursachen von Gesundheits-relevanten Zuständen (z.B. Krankheiten, Expositionen). Dabei werden normalerweise verschiedene Individuen als unabhängig betrachtet. Diese Annahme ist aber gerade bei Infektionskrankheiten problematisch, da sie die Ausbreitung eines Erregers nur ungenügend erfassen kann. Diese Ausbreitung ist durch das Transmissionsnetzwerk des Erregers gegeben, welches allerdings sehr schwierig zu bestimmen ist, aber dennoch eine zentrale Bedeutung für eine erfolgreiche Prävention hat z.B. zur Identifikation von Transmissionsrouten oder von transmissionsfördernden Faktoren.  Zuletzt können auch die Ursachen von Komorbiditäten (d.h. Krankheiten die zusammen mit einer Infektion auftreten) besser erforscht werden wenn sie im Lichte des Transmissionsnetzwerks betrachtet werden können--- z.B. kann ein gehäuftes Auftreten in bestimmten Regionen des Transmissionsnetzwerks ein Hinweis auf besonders anfällige Populationen liefern.  HIV und insbesondere die Schweizerische-HIV-Kohorten-Studie (SHKS) bieten ein ideales Fallbeispiel  für die Kombination von Transmissionsnetzwerken und traditionellen epidemiologischen Daten und Analysen. Einerseits verfügt die SHKS sowohl über ausgezeichnete Virale Sequenzdaten mit welchen sich das Transmissionsnetzwerk beschreiben lässt als auch über einen einmaligen Reichtum an klinischen, demographischen und immunologischen Daten (inkl. Bio-Bank). Andererseits, ist ein besseres Verständnis der HIV Transmission von zentraler Relevanz für die Eindämmung von Neu-Infektionen und deshalb von hoher aktueller Relevanz. 

Direct link to Lay Summary Last update: 22.09.2015

Responsible applicant and co-applicants

Employees

Publications

Publication
Assessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study
Balakrishna Suraj A., Salazar-Vizcaya Luisa, Schmidt Axel, Kachalov Viacheslav, Kusejko Katharina, Thurnheer Maria Christine, Roth Jan F., Nicca Dunja, Cavassini Matthias D., Battegay Manuel, Schmid Patrick, Bernasconi Enos, Guenthard Huldrych, Rauch Andri, Kouyos Roger, Swiss H. I. V. Cohort Study Shcs (2021), Assessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study, in Plos Computational Biology, 17, 1.
Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19
Tepekule Burcu, Hauser Anthony, Kachalov Viacheslav N., Andresen Sara, Scheier Thomas, Schreiber Peter W., Guenthard Huldrych F., Kouyos Roger D. (2021), Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19, in Plos Computational Biology, 17, 1.
Data linkage to evaluate the long-term risk of HIV infection in individuals seeking post-exposure prophylaxis
Hovaguimian Frederique, Guenthard Huldrych F., Hauser Christoph, Conen Anna, Bernasconi Enos, Calmy Alexandra, Cavassini Matthias, Seneghini Marco, Marzel Alex, Heinrich Henriette, Scherrer Alexandra, Riou Julien, Spoerri Adrian, Schmidlin Kurt, Balakrishna Suraj, Braun Dominique L., Rampini Silvana K., Fehr Jan S., Kouyos Roger D., Swiss H. I. V. Cohort Study (2021), Data linkage to evaluate the long-term risk of HIV infection in individuals seeking post-exposure prophylaxis, in Nature Communications, 12, 1.
Identifying and Characterizing Trans women in the Swiss HIV Cohort Study as an Epidemiologically Distinct Risk Group
Nguyen H., Hampel B., Nuñez D. G., Battegay M., Hachfeld A., Bernasconi E., Calmy A., Cavassini M., Vernazza P., Fellay J., Rudolph H., Huber M., Leuzinger K., Perreau M., Scherrer A., Ramette A. N., Yerly S., Günthard H. F., Kouyos R. D., Kusejko K. (2021), Identifying and Characterizing Trans women in the Swiss HIV Cohort Study as an Epidemiologically Distinct Risk Group, in Clin Infect Dis, 1.
Identifying the drivers of multidrug-resistant Klebsiella pneumoniae at a European level
Kachalov Viacheslav N., Nguyen Huyen, Balakrishna Suraj, Salazar-Vizcaya Luisa, Sommerstein Rami, Kuster Stefan P., Hauser Anthony, zur Wiesch Pia Abel, Klein Eili, Kouyos Roger D. (2021), Identifying the drivers of multidrug-resistant Klebsiella pneumoniae at a European level, in Plos Computational Biology, 17, 1.
Increasing Frequency and Transmission of HIV-1 Non-B Subtypes among Men Who Have Sex with Men in the Swiss HIV Cohort Study
Duran Ramirez J. J., Ballouz T., Nguyen H., Kusejko K., Chaudron S. E., Huber M., Hirsch H. H., Perreau M., Ramette A., Yerly S., Cavassini M., Stöckle M., Furrer H., Vernazza P., Bernasconi E., Günthard H. F., Kouyos R. D. (2021), Increasing Frequency and Transmission of HIV-1 Non-B Subtypes among Men Who Have Sex with Men in the Swiss HIV Cohort Study, in J Infect Dis, 1.
Participation, retention and uptake in a multicentre pre-exposure prophylaxis cohort using online, smartphone-compatible data collection
Hovaguimian F., Martin E., Reinacher M., Rasi M., Schmidt A. J., Bernasconi E., El Amari E. B., Braun D. L., Calmy A., Darling K., Christinet V., Depmeier C., Hauser C., Laeuchli S., Notter J., Stoeckle M., Surial B., Vernazza P., Bruggmann P., Tarr P., Haerry D., Bize R., Low N., Lehner A., Boeni J., Kouyos R. D., Fehr J. S., Hampel B. (2021), Participation, retention and uptake in a multicentre pre-exposure prophylaxis cohort using online, smartphone-compatible data collection, in Hiv Medicine, 1.
Phylogenetic Cluster Analysis Identifies Virological and Behavioral Drivers of Human Immunodeficiency Virus Transmission in Men Who Have Sex With Men
Bachmann Nadine, Kusejko Katharina, Nguyen Huyen, Chaudron Sandra E., Kadelka Claus, Turk Teja, Boeni Jurg, Perreau Matthieu, Klimkait Thomas, Yerly Sabine, Battegay Manuel, Rauch Andri, Ramette Alban, Vernazza Pietro, Bernasconi Enos, Cavassini Matthias, Guenthard Huldrych F., Kouyos Roger D., Swiss H. I. V. Cohort Study (2021), Phylogenetic Cluster Analysis Identifies Virological and Behavioral Drivers of Human Immunodeficiency Virus Transmission in Men Who Have Sex With Men, in Clinical Infectious Diseases, 72, 2175-2183.
Systematic screening of viral and human genetic variation identifies antiretroviral resistance and immune escape link
Nguyen Huyen, Thorball Christian Wandell, Fellay Jacques, Boni Jurg, Yerly Sabine, Perreau Matthieu, Hirsch Hans H., Kusejko Katharina, Thurnheer Maria Christine, Battegay Manuel, Cavassini Matthias, Kahlert Christian R., Bernasconi Enos, Gunthard Huldrych F., Kouyos Roger D., Study Swiss Hiv Cohort (2021), Systematic screening of viral and human genetic variation identifies antiretroviral resistance and immune escape link, in Elife, 10, 1.
Bridging the gap between HIV epidemiology and antiretroviral resistance evolution: Modelling the spread of resistance in South Africa
Hauser Anthony, Kusejko Katharina, Johnson Leigh F., Wandeler Gilles, Riou Julien, Goldstein Fardo, Egger Matthias, Kouyos Roger D. (2020), Bridging the gap between HIV epidemiology and antiretroviral resistance evolution: Modelling the spread of resistance in South Africa, in Plos Computational Biology, 15, 1.
Chemsex drugs on the rise: a longitudinal analysis of the Swiss HIV Cohort Study from 2007 to 2017
Hampel B., Kusejko K., Kouyos R. D., Boni J., Flepp M., Stockle M., Conen A., Beguelin C., Kunzler-Heule P., Nicca D., Schmidt A. J., Nguyen H., Delaloye J., Rougemont M., Bernasconi E., Rauch A., Gunthard H. F., Braun D. L., Fehr J., Anagnostopoulos A., Battegay M., Bernasconi E., Bucher H. C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Fehr, Fellay J., Furrer H., Fux C. A., Haerry D., Hasse B., Hirsch H. H., Hoffmann M., Hosli I., Huber M., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kovari H., Ledergerber B., Martinetti G., de Tejada B. Martinez, Marzolini C., Metzner K. J., Muller N., Paioni P., Panlaleo G., Perreau M., Rudin C., Scherrer A. U., Schmid P., Speck R., Stockle M., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S., Swiss H. I. V. Cohort Study Grp (2020), Chemsex drugs on the rise: a longitudinal analysis of the Swiss HIV Cohort Study from 2007 to 2017, in Hiv Medicine, 21, 228-239.
Diagnosis of latent tuberculosis infection is associated with reduced HIV viral load and lower risk for opportunistic infections in people living with HIV
Kusejko Katharina, Gunthard Huldrych F., Olson Gregory S., Zens Kyra, Darling Katharine, Khanna Nina, Furrer Hansjakob, Vetter Pauline, Bernasconi Enos, Vernazza Pietro, Hoffmann Matthias, Kouyos Roger D., Nemeth Johannes, Swiss H. I. V. Cohort Study (2020), Diagnosis of latent tuberculosis infection is associated with reduced HIV viral load and lower risk for opportunistic infections in people living with HIV, in Plos Biology, 18, 1.
Differences in social and mental well-being of long-term survivors among people who inject drugs and other participants in the Swiss HIV Cohort Study: 1980-2018
Kusejko Katharina, Marzel Alex, Nguyen Huyen, Chaudron Sandra E., Bachmann Nadine, Weber Rainer, Bruggmann Philip, Roth Jan A., Bernasconi Enos, Calmy Alexandra, Cavassini Matthias, Bregenzer Andrea, Boeni Juerg, Yerly Sabine, Klimkait Thomas, Perreau Matthieu, Walti Laura N., Gunthard Huldrych F., Kouyos Roger D., Swiss H. I. V. Cohort Study (2020), Differences in social and mental well-being of long-term survivors among people who inject drugs and other participants in the Swiss HIV Cohort Study: 1980-2018, in Antiviral Therapy, 25, 43-54.
Emergence of Human Immunodeficiency Virus-1 Drug Resistance During the 3-Month World Health Organization-Recommended Enhanced Adherence Counseling Period in the CART-1 Cohort Study
Brown Jennifer A., Mbunkah Herbert A., Lejone Thabo I., Ringera Isaac, Cheleboi Molisana, Klimkait Thomas, Metzner Karin J., Guenthard Huldrych F., Labhardt Niklaus D., Kouyos Roger D., Tschumi Nadine (2020), Emergence of Human Immunodeficiency Virus-1 Drug Resistance During the 3-Month World Health Organization-Recommended Enhanced Adherence Counseling Period in the CART-1 Cohort Study, in Open Forum Infectious Diseases, 8, 1.
HCV Genetic Diversity Can Be Used to Infer Infection Recency and Time since Infection
Carlisle Louisa A., Turk Teja, Metzner Karin J., Mbunkah Herbert A., Shah Cyril, Boni Jurg, Huber Michael, Braun Dominique L., Fehr Jan, Salazar-Vizcaya Luisa, Rauch Andri, Yerly Sabine, Nguyen Aude, Cavassini Matthias, Stoeckle Marcel, Vernazza Pietro, Bernasconi Enos, Gunthard Huldrych F., Kouyos Roger D. (2020), HCV Genetic Diversity Can Be Used to Infer Infection Recency and Time since Infection, in Viruses-Basel, 12, 1.
Heritability of the HIV-1 reservoir size and decay under long-term suppressive ART
Wan Chenjie, Bachmann Nadine, Mitov Venelin, Blanquart Francois, Cespedes Susana Posada, Turk Teja, Neumann Kathrin, Beerenwinkel Niko, Bogojeska Jasmina, Fellay Jacques, Roth Volker, Boni Jurg, Perreau Matthieu, Klimkait Thomas, Yerly Sabine, Battegay Manuel, Walti Laura, Calmy Alexandra, Vernazza Pietro, Bernasconi Enos, Cavassini Matthias, Metzner Karin J., Gunthard Huldrych F., Kouyos Roger D., Swiss H. I. V. Cohort Study (2020), Heritability of the HIV-1 reservoir size and decay under long-term suppressive ART, in Nature Communications, 11, 1.
Host Genomics of the HIV-1 Reservoir Size and Its Decay Rate During Suppressive Antiretroviral Treatment
Thorball Christian W., Borghesi Alessandro, Bachmann Nadine, Von Siebenthal Chantal, Vongrad Valentina, Turk Teja, Neumann Kathrin, Beerenwinkel Niko, Bogojeska Jasmina, Roth Volker, Kok Yik Lim, Parbhoo Sonali, Wieser Mario, Boeni Juerg, Perreau Matthieu, Klimkait Thomas, Yerly Sabine, Battegay Manuel, Rauch Andri, Schmid Patrick, Bernasconi Enos, Cavassini Matthias, Kouyos Roger D., Guenthard Huldrych F., Metzner Karin J., Fellay Jacques, Swiss H. I. V. Cohort Study (2020), Host Genomics of the HIV-1 Reservoir Size and Its Decay Rate During Suppressive Antiretroviral Treatment, in Jaids-Journal of Acquired Immune Deficiency Syndromes, 85, 517-524.
Impact of scaling up dolutegravir on antiretroviral resistance in South Africa: A modeling study
Hauser Anthony, Kusejko Katharina, Johnson Leigh F., Guenthard Huldrych F., Riou Julien, Wandeler Gilles, Egger Matthias, Kouyos Roger D. (2020), Impact of scaling up dolutegravir on antiretroviral resistance in South Africa: A modeling study, in Plos Medicine, 17, 1.
Self-reported Neurocognitive Impairment in People Living With Human Immunodeficiency Virus (HIV): Characterizing Clusters of Patients With Similar Changes in Self-reported Neurocognitive Impairment, 2013-2017, in the Swiss HIV Cohort Study
Kusejko Katharina, Salazar-Vizcaya Luisa, Braun Dominique L., Tarr Philip E., Bernasconi Enos, Doco-Lecompte Thanh, Cavassini Matthias, Schmid Patrick, Du Pasquier Renaud, Hauser Christoph, Guenthard Huldrych F., Kouyos Roger D., Swiss H. I. V. Cohort Study (2020), Self-reported Neurocognitive Impairment in People Living With Human Immunodeficiency Virus (HIV): Characterizing Clusters of Patients With Similar Changes in Self-reported Neurocognitive Impairment, 2013-2017, in the Swiss HIV Cohort Study, in Clinical Infectious Diseases, 71, 637-644.
Using longitudinally sampled viral nucleotide sequences to characterize the drivers of HIV-1 transmission
Reichmuth M. L., Chaudron S. E., Bachmann N., Nguyen H., Boeni J., Metzner K. J., Perreau M., Klimkait T., Yerly S., Hirsch H. H., Hauser C., Ramette A., Vernazza P., Cavassini M., Bernasconi E., Guenthard H. F., Kusejko K., Kouyos R. D. (2020), Using longitudinally sampled viral nucleotide sequences to characterize the drivers of HIV-1 transmission, in Hiv Medicine, 22, 346-359.
A Systematic Phylogenetic Approach to Study the Interaction of HIV-1 With Coinfections, Noncommunicable Diseases, and Opportunistic
Bachmann Nadine, Chaudron Sandra E., Huyen Nguyen, Braun Dominique L., Hampel Benjamin, Battegay Manuel, Bernasconi Enos, Calmy Alexandra, Cavassini Matthias, Hoffmann Matthias, Boni Jurg, Yerly Sabine, Klimkait Thomas, Perreau Matthieu, Rauch Andri, Gunthard Huldrych F., Kouyos Roger D., Battegay M., Bernasconi E., Boni J., Braun D. L., Bucher H. C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fehr J., Fellay J., Furrer H., Fux C. A., Gunthard H. F., Haerry D., Hasse B., Hirsch H. H., Hoffmann M., Hosli I., Huber M., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kouyos R. D., Kovari H., Ledergerber B., Martinetti G., de Tejada Martinez B., Marzolini C., Metzner K. J., Mueller N., Nicca D., Paioni P., Pantaleo G., Perreau M., Rauch A., Rudin C., Scherrer A. U., Schmid P., Speck R., Stockle M., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S., Swiss H. I. V. Cohort Study, Kusejko Katharina (2019), A Systematic Phylogenetic Approach to Study the Interaction of HIV-1 With Coinfections, Noncommunicable Diseases, and Opportunistic, in Journal of Infectious Diseases, 220, 244-253.
Can Directionality of HIV Transmission be Predicted by Next-Generation Sequencing Data?
Gunthard Huldrych F., Kouyos Roger (2019), Can Directionality of HIV Transmission be Predicted by Next-Generation Sequencing Data?, in Journal of Infectious Diseases, 220, 1393-1395.
Changing Trends in International Versus Domestic HCV Transmission in HIV-Positive Men Who Have Sex With Men: A Perspective for the Direct-Acting Antiviral Scale-Up Era
Salazar-Vizcaya Luisa, Kouyos Roger D., Metzner Karin J., Cortes Kamila Caraballo, Boni Jurg, Shah Cyril, Fehr Jan, Braun Dominique L., Bernasconi Enos, Mbunkah Herbert A., Hoffmann Matthias, Labhardt Niklaus, Cavassini Matthias, Rougemont Mathieu, Gunthard Huldrych F., Keiser Olivia, Rauch Andri, Aubert V., Battegay M., Bernasconi E., Boni J., Braun D. L., Bucher H. C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fehr J., Fellay J., Furrer H., Fux C. A., Gunthard H. F., Haerry D., Hasse B., Hirsch H. H., Hoffmann M., Hosli I., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kouyos R. D., Kovari H., Ledergerber B., Martinetti G., de Tejada Martinez B., Marzolini C., Metzner K. J., Mueller N., Nicca D., Pantaleo G., Paioni P., Rauch A., Rudin C., Scherrer A. U., Schmid P., Speck R., Stockle M., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S., Swiss H. I. V. Cohort Study (2019), Changing Trends in International Versus Domestic HCV Transmission in HIV-Positive Men Who Have Sex With Men: A Perspective for the Direct-Acting Antiviral Scale-Up Era, in Journal of Infectious Diseases, 220, 91-99.
Clusters of Sexual Behavior in Human Immunodeficiency Virus-positive Men Who Have Sex With Men Reveal Highly Dissimilar Time Trends
Salazar-Vizcaya Luisa, Kusejko Katharina, Schmidt Axel J., Carrillo-Montoya German, Nicca Dunja, Wandeler Gilles, Braun Dominique L., Fehr Jan, Darling Katharine E. A., Bernasconi Enos, Schmid Patrick, Guenthard Huldrych F., Kouyos Roger D., Rauch Andri, Swiss H. I. V. Cohort Study (2019), Clusters of Sexual Behavior in Human Immunodeficiency Virus-positive Men Who Have Sex With Men Reveal Highly Dissimilar Time Trends, in Clinical Infectious Diseases, 70, 416-424.
Determinants of HIV-1 reservoir size and long-term dynamics during suppressive ART
Bachmann Nadine, von Siebenthal Chantal, Vongrad Valentina, Turk Teja, Neumann Kathrin, Beerenwinkel Niko, Bogojeska Jasmina, Fellay Jaques, Roth Volker, Kok Yik Lim, Thorball Christian W., Borghesi Alessandro, Parbhoo Sonali, Wieser Mario, Boni Jurg, Perreau Matthieu, Klimkait Thomas, Yerly Sabine, Battegay Manuel, Rauch Andri, Hoffmann Matthias, Bernasconi Enos, Cavassini Matthias, Kouyos Roger D., Gunthard Huldrych F., Metzner Karin J., Anagnostopoulos Alexia, Braun Dominique L., Bucher Heiner C., Calmy Alexandra, Ciuffi Angela, Dollenmaier Gunter, Egger Matthias, Elzi Luigia, Fehr Jan, Fellay Jacques, Furrer Hansjakob, Fux Christoph A., Haerry David, Hasse Barbara, Hirsch Hans H., Hosli Irene, Huber Michael, Kahlert Christian, Kaiser Laurent, Keiser Olivia, Kovari Helen, Ledergerber Bruno, Martinetti Gladys, de Tejada Begona Martinez, Marzolini Catia, Mueller Nicolas, Nicca Dunja, Paioni Paolo, Pantaleo Guiseppe, Rudin Christoph, Scherrer Alexandra U., Schmid Patrick, Speck Roberto, Stockle Marcel, Tarr Philip, Trkola Alexandra, Vernazza Pietro, Wandeler Gilles, Webers Rainer, Swiss H. I. V. Cohort Study (2019), Determinants of HIV-1 reservoir size and long-term dynamics during suppressive ART, in Nature Communications, 10, 1.
High Cure Rates With Grazoprevir-Elbasvir With or Without Ribavirin Guided by Genotypic Resistance Testing Among Human Immunodeficiency Virus/Hepatitis C Virus-coinfected Men Who Have Sex With Men
Braun Dominique L., Hampel Benjamin, Kouyos Roger, Huyen Nguyen, Shah Cyril, Flepp Markus, Stockle Marcel, Conen Anna, Beguelin Charles, Kunzler-Heule Patrizia, Nicca Dunja, Schmid Patrick, Delaloye Julie, Rougemont Mathieu, Bernasconi Enos, Rauch Andri, Gunthard Huldrych F., Boni Jurg, Fehr Jan S., Anagnostopoulos A., Battegay M., Bucher H. C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fellay J., Furrer H., Fux C. A., Haerry D., Hasse B., Hirsch H. H., Hoffmann M., Hosli I., Huber M., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kovari H., Ledergerber B., Martinetti G., de Tejada B. Martinez, Marzolini C., Metzner K. J., Mueller N., Paioni P., Pantaleo G., Perreau M., Rudin C., Scherrer A. U., Speck R., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S., Swiss H. I. V. Cohort Study (2019), High Cure Rates With Grazoprevir-Elbasvir With or Without Ribavirin Guided by Genotypic Resistance Testing Among Human Immunodeficiency Virus/Hepatitis C Virus-coinfected Men Who Have Sex With Men, in Clinical Infectious Diseases, 68, 569-576.
High Number of Potential Transmitters Revealed in a Population-based Systematic Hepatitis C Virus RNA Screening Among Human Immunodeficiency Virus-infected Men Who Have Sex With Men
Braun Dominique L., Hampel Benjamin, Martin Eileen, Kouyos Roger, Kusejko Katharina, Grube Christina, Flepp Markus, Stockle Marcel, Conen Anna, Beguelin Charles, Schmid Patrick, Delaloye Julie, Rougemont Mathieu, Bernasconi Enos, Rauch Andri, Gunthard Huldrych F., Boni Jurg, Fehr Jan S., Anagnostopoulos A., Battegay M., Bucher H. C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fellay J., Furrer H., Fux C. A., Haerry D., Hasse B., Hirsch H. H., Hoffmann M., Hosli I., Huber M., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kovari H., Ledergerber B., Martinetti G., de Tejada B. Martinez, Marzolini C., Marzolini C., Metzner K. J., Mueller N., Nicca D., Paioni P., Pantaleo G., Perreau M., Rudin C., Scherrer A. U., Speck R., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S., Swiss H. I. V. Cohort Study (2019), High Number of Potential Transmitters Revealed in a Population-based Systematic Hepatitis C Virus RNA Screening Among Human Immunodeficiency Virus-infected Men Who Have Sex With Men, in Clinical Infectious Diseases, 68, 561-568.
HIV Transmission Chains Exhibit Greater HLA-B Homogeneity Than Randomly Expected
Huyen Nguyen, Thorball Christian W., Fellay Jacques, Boni Jurg, Yerly Sabine, Perreau Matthieu, Klimkait Thomas, Kusejko Katharina, Bachmann Nadine, Chaudron Sandra E., Paioni Paolo, Thurnheer Maria C., Battegay Manuel, Cavassini Matthias, Vernazza Pietro, Bernasconi Enos, Gunthard Huldrych F., Kouyos Roger, Anagnostopoulos A., Braun D. L., Bucher H. C., Calmy A., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fehr J., Furrer H., Fux C. A., Haerry D., Hasse B., Hirsch H. H., Hoffmann M., Hosli I., Huber M., Kahlert C., Kaiser L., Keiser O., Kouyos R. D., Kovari H., Ledergerber B., Martinetti G., de Tejada B. Martinez, Marzolini C., Metzner K. J., Mueller N., Nicca D., Pantaleo G., Rauch A., Rudin C., Scherrer A. U., Schmid P., Speck R., Stockle M., Tarr P., Trkola A., Wandeler G., Weber R., Swiss H. I. V. Cohort Study (2019), HIV Transmission Chains Exhibit Greater HLA-B Homogeneity Than Randomly Expected, in Jaids-Journal of Acquired Immune Deficiency Syndromes, 81, 508-515.
Impact of the M184V/I Mutation on the Efficacy of Abacavir/Lamivudine/Dolutegravir Therapy in HIV Treatment-Experienced Patients
Olearo Flaminia, Huyen Nguyen, Bonnet Fabrice, Yerly Sabine, Wandeler Gilles, Stoeckle Marcel, Cavassini Matthias, Scherrer Alexandra, Costagiola Dominique, Schmid Patrick, Gunthard Huldrych F., Bernasconi Enos, Boeni Jurg, Monforte Antonella D'Arminio, Zazzi Maurizio, Rossetti Barbara, Neau Didier, Bellecave Pantxika, Rijnders Bart, Reiss Peter, Wit Ferdinand, Kouyos Roger, Calmy Alexandra (2019), Impact of the M184V/I Mutation on the Efficacy of Abacavir/Lamivudine/Dolutegravir Therapy in HIV Treatment-Experienced Patients, in Open Forum Infectious Diseases, 6, 1.
Importance of routine viral load monitoring: higher levels of resistance at ART failure in Uganda and Lesotho compared with Switzerland
Bachmann Nadine, von Braun Amrei, Labhardt Niklaus D., Kadelka Claus, Gunthard Huldrych F., Sekaggya-Wiltshire Christine, Castelnuovo Barbara, Kambugu Andrew, Lejone Thabo I., Boni Jurg, Yerly Sabine, Perreau Matthieu, Klimkait Thomas, Kouyos Roger D., Fehr Jan, Anagnostopoulos A., Battegay M., Bernasconi E., Boni J., Braun D. L., Bucher H. C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fehr J., Fellay J., Furrer H., Fux C. A., Gunthard H. F., Haerry D., Hasse B., Hirsch H. H., Hoffmann M., Hosli I., Huber M., Kahlert C. R., Kaiser L., Keiser O., Klimkait T., Kouyos R. D., Kovari H., Ledergerber B., Martinetti G., de Tejada Martinez B., Marzolini C., Metzner K. J., Mueller N., Nicca D., Paioni P., Pantaleo G., Perreau M., Rauch A., Rudin C., Scherrer A. U., Schmid P., Speck R., Stockle M., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S., Swiss H. I. V. Cohort Study (2019), Importance of routine viral load monitoring: higher levels of resistance at ART failure in Uganda and Lesotho compared with Switzerland, in Journal of Antimicrobial Chemotherapy, 74, 468-472.
Lower Broadly Neutralizing Antibody Responses in Female Versus Male HIV-1 Infected Injecting Drug Users
Euler Zelda, Van den Kerkhof Tom L., Kouyos Roger D., Tully Damien C., Allen Todd M., Trkola Alexandra, Sanders Rogier W., Schuitemaker Hanneke, Van Gils Marit J. (2019), Lower Broadly Neutralizing Antibody Responses in Female Versus Male HIV-1 Infected Injecting Drug Users, in Viruses-Basel, 11, 1.
Noninferiority of Simplified Dolutegravir Monotherapy Compared to Continued Combination Antiretroviral Therapy That Was Initiated During Primary Human Immunodeficiency Virus Infection: A Randomized, Controlled, Multisite, Open-label, Noninferiority Trial
Braun Dominique L., Turk Teja, Tschumi Fabian, Grube Christina, Hampel Benjamin, Depmeier Carsten, Schreiber Peter W., Brugger Silvio D., Greiner Michael, Steffens Daniela, De Torrente-Bayard Cornelia, Courlet Perrine, Neumann Kathrin, Kuster Herbert, Flepp Markus, Bertisch Barbara, Decosterd Laurent, Boeni Juerg, Metzner Karin J., Kouyos Roger D., Guenthard Huldrych F. (2019), Noninferiority of Simplified Dolutegravir Monotherapy Compared to Continued Combination Antiretroviral Therapy That Was Initiated During Primary Human Immunodeficiency Virus Infection: A Randomized, Controlled, Multisite, Open-label, Noninferiority Trial, in Clinical Infectious Diseases, 69, 1489-1497.
Viral Diversity Based on Next-Generation Sequencing of HIV-1 Provides Precise Estimates of Infection Recency and Time Since Infection
Carlisle Louisa A., Turk Teja, Kusejko Katharina, Metzner Karin J., Leemann Christine, Schenkel Corinne D., Bachmann Nadine, Posada Susana, Beerenwinkel Niko, Boni Jurg, Yerly Sabine, Klimkait Thomas, Perreau Matthieu, Braun Dominique L., Rauch Andri, Calmy Alexandra, Cavassini Matthias, Battegay Manuel, Vernazza Pietro, Bernasconi Enos, Gunthard Huldrych F., Kouyos Roger D., Anagnostopoulos A., Battegay M., Bernasconi E., Boni J., Braun D. L., Bucher H. C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fehr J., Fellay J., Furrer H., Fux C. A., Gunthard H. F., Haerry D., Hasse B., Hirsch H. H., Hoffmann M., Hosli I., Huber M., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kouyos R. D., Kovari H., Ledergerber B., Martinetti G., de Tejada B. Martinez, Marzolini C., Metzner K. J., Mueller N., Nicca D., Paioni P., Pantaleo G., Perreau M., Rauch A., Rudin C., Scherrer A. U., Schmid P., Speck R., Stockle M., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S., Swiss H. I. V. Cohort Study (2019), Viral Diversity Based on Next-Generation Sequencing of HIV-1 Provides Precise Estimates of Infection Recency and Time Since Infection, in Journal of Infectious Diseases, 220, 254-265.
Antibacterial effects of antiretrovirals, potential implications for microbiome studies in HIV
Shilaih Mohaned, Angst Daniel C., Marzel Alex, Bonhoeffer Sebastian, Gunthard Huldrych F., Kouyos Roger D. (2018), Antibacterial effects of antiretrovirals, potential implications for microbiome studies in HIV, in Antiviral Therapy, 23, 91-94.
Development of a high-throughput bead based assay system to measure HIV-1 specific immune signatures in clinical samples
Liechti Thomas, Kadelka Claus, Ebner Hanna, Friedrich Nikolas, Kouyos Roger D., Guenthard Huldrych F., Trkola Alexandra (2018), Development of a high-throughput bead based assay system to measure HIV-1 specific immune signatures in clinical samples, in Journal of Immunological Methods, 454, 48-58.
Distinct, IgG1-driven antibody response landscapes demarcate individuals with broadly HIV-1 neutralizing activity
Kadelka Claus, Liechti Thomas, Ebner Hanna, Schanz Merle, Rusert Peter, Friedrich Nikolas, Stiegeler Emanuel, Braun Dominique L., Huber Michael, Scherrer Alexandra U., Weber Jacqueline, Uhr Therese, Kuster Herbert, Misselwitz Benjamin, Cavassini Matthias, Bernasconi Enos, Hoffmann Matthias, Calmy Alexandra, Battegay Manuel, Rauch Andri, Yerly Sabine, Aubert Vincent, Klimkait Thomas, Boeni Jurg, Kouyos Roger D., Guenthard Huldrych F., Trkola Alexandra, Swiss H. I. V. Cohort Study (2018), Distinct, IgG1-driven antibody response landscapes demarcate individuals with broadly HIV-1 neutralizing activity, in Journal of Experimental Medicine, 215, 1589-1608.
High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection
Braun Dominique L., Marzel Alex, Steffens Daniela, Schreiber Peter W., Grube Christina, Scherrer Alexandra U., Kouyos Roger D., Gunthard Huldrych F., Swiss H. I. V. Cohort Study (2018), High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection, in Clinical Infectious Diseases, 66, 735-742.
Inferring the age difference in HIV transmission pairs by applying phylogenetic methods on the HIV transmission network of the Swiss HIV Cohort Study
Kusejko Katharina, Kadelka Claus, Marzel Alex, Battegay Manuel, Bernasconi Enos, Calmy Alexandra, Cavassini Matthias, Hoffmann Matthias, Boni Jurg, Yerly Sabine, Klimkait Thomas, Perreau Matthieu, Rauch Andri, Gunthard Huldrych F., Kouyos Roger D., Scherrer Alexandra, Wild Susanne, Traytel Anna, Perraudin Daniele, Minichiello Mirjam, Anagnostopoulos A., Battegay M., Bernasconi E., Boni J., Braun D. L., Bucher H. C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fehr J., Fellay J., Furrer H., Fux C. A., Gunthard H. F., Haerry D., Hasse B., Hirsch H. H., Hoffmann M., Hosli I., Huber M., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kouyos R. D., Kovari H., Ledergerber B., Martinetti G., de Tejada Martinez B., Marzolini C., Metzner K. J., Mueller N., Nicca D., Paioni P., Pantaleo G., Perreau M., Rauch A., Rudin C., Scherrer A. U., Schmid P., Speck R., Stockle M., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S., Swiss H. I. V. Cohort Study (2018), Inferring the age difference in HIV transmission pairs by applying phylogenetic methods on the HIV transmission network of the Swiss HIV Cohort Study, in Virus Evolution, 4, 1.
Quantifying the drivers of HIV transmission and prevention in men who have sex with men: a population model-based analysis in Switzerland
Kusejko K., Marzel A., Hampel B., Bachmann N., Nguyen H., Fehr J., Braun D. L., Battegay M., Bernasconi E., Calmy A., Cavassini M., Hoffmann M., Boeni J., Yerly S., Klimkait T., Perreau M., Rauch A., Guenthard H. F., Kouyos R. D., Swiss H. I. V. Cohort Study (2018), Quantifying the drivers of HIV transmission and prevention in men who have sex with men: a population model-based analysis in Switzerland, in Hiv Medicine, 19, 688-697.
Quantifying the fitness cost of HIV-1 drug resistance mutations through phylodynamics
Kuhnert Denise, Kouyos Roger, Shirreff George, Pecerska Julija, Scherrer Alexandra U., Bonl Jurg, Yerly Sabine, Klimkait Thomas, Aubert Vincent, Gunthard Huldrych F., Stadler Tanja, Bonhoeffer Sebastian, Swiss H. I. V. Cohort Study (2018), Quantifying the fitness cost of HIV-1 drug resistance mutations through phylodynamics, in Plos Pathogens, 14, 1.
The Cumulative Impact of Harm Reduction on the Swiss HIV Epidemic: Cohort Study, Mathematical Model, and Phylogenetic Analysis
Marzel Alex, Kusejko Katharina, Weber Rainer, Bruggmann Philip, Rauch Andri, Roth Jan A., Bernasconi Enos, Calmy Alexandra, Cavassini Matthias, Hoffmann Matthias, Boni Jurg, Yerly Sabine, Klimkait Thomas, Perreau Matthieu, Gunthard Huldrych F., Kouyos Roger D., Swiss H. I. V. Cohort Study (2018), The Cumulative Impact of Harm Reduction on the Swiss HIV Epidemic: Cohort Study, Mathematical Model, and Phylogenetic Analysis, in Open Forum Infectious Diseases, 5, 1.
Tracing HIV-1 strains that imprint broadly neutralizing antibody responses
Kouyos Roger D., Rusert Peter, Kadelka Claus, Huber Michael, Marzel Alex, Ebner Hanna, Schanz Merle, Liechti Thomas, Friedrich Nikolas, Braun Dominique L., Scherrer Alexandra U., Weber Jacqueline, Uhr Therese, Baumann Nicolas S., Leemann Christine, Kuster Herbert, Chave Jean-Philippe, Cavassini Matthias, Bernasconi Enos, Hoffmann Matthias, Calmy Alexandra, Battegay Manuel, Rauch Andri, Yerly Sabine, Aubert Vincent, Klimkait Thomas, Boni Jurg, Metzner Karin J., Gunthard Huldrych F., Trkola Alexandra, Swiss H. I. V. Cohort Study (2018), Tracing HIV-1 strains that imprint broadly neutralizing antibody responses, in Nature, 561, 406-406.
Dissecting HIV Virulence: Heritability of Setpoint Viral Load, CD4+T-Cell Decline, and Per-Parasite Pathogenicity
Bertels Frederic, Marzel Alex, Leventhal Gabriel, Mitov Venelin, Fellay Jacques, Gunthard Huldrych F., Boni Jurg, Yerly Sabine, Klimkait Thomas, Aubert Vincent, Battegay Manuel, Rauch Andri, Cavassini Matthias, Calmy Alexandra, Bernasconi Enos, Schmid Patrick, Scherrer Alexandra U., Muller Viktor, Bonhoeffer Sebastian, Kouyos Roger, Regoes Roland R., Swiss H. I. V. Cohort Study (2017), Dissecting HIV Virulence: Heritability of Setpoint Viral Load, CD4+T-Cell Decline, and Per-Parasite Pathogenicity, in Molecular Biology and Evolution, 35, 27-37.
Evaluation of the Predictive Potential of the Short Acute Retroviral Syndrome Severity Score for HIV-1 Disease Progression in Individuals With Acute HIV Infection
Hoenigl Martin, Braun Dominique L., Kouyos Roger, Guenthard Huldrych F., Little Susan J. (2017), Evaluation of the Predictive Potential of the Short Acute Retroviral Syndrome Severity Score for HIV-1 Disease Progression in Individuals With Acute HIV Infection, in Jaids-Journal of Acquired Immune Deficiency Syndromes, 74, 114-117.
Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals
Shilaih Mohaned, Marzel Alex, Braun Dominique L., Scherrer Alexandra U., Kovari Helen, Young Jim, Calmy Alexandra, Darling Katharine, Battegay Manuel, Hoffmann Matthias, Bernasconi Enos, Thurnheer Maria C., Gunthard Huldrych F., Kouyos Roger D., Swiss H. I. V. Cohort Study (2017), Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals, in Medicine, 96, 1.
Mining for pairs: shared clinic visit dates identify steady HIV-positive partnerships
Marzel A., Shilaih M., Turk T., Campbell N. K., Yang W. L., Boni J., Yerly S., Klimkait T., Aubert V., Furrer H., Calmy A., Battegay M., Cavassini M., Bernasconi E., Schmid P., Metzner K. J., Guenthard H. F., Kouyos R. D., Shcs (2017), Mining for pairs: shared clinic visit dates identify steady HIV-positive partnerships, in Hiv Medicine, 18, 667-676.
Parent-offspring regression to estimate the heritability of an HIV-1 trait in a realistic setup
Bachmann Nadine, Turk Teja, Kadelka Claus, Marzel Alex, Shilaih Mohaned, Boni Jurg, Aubert Vincent, Klimkait Thomas, Leventhal Gabriel E., Gunthard Huldrych F., Kouyos Roger, Swiss H. I. V. Cohort Study (2017), Parent-offspring regression to estimate the heritability of an HIV-1 trait in a realistic setup, in Retrovirology, 14, 1.
Phylodynamics on local sexual contact networks
Rasmussen David A., Kouyos Roger, Gunthard Huldrych F., Stadler Tanja (2017), Phylodynamics on local sexual contact networks, in Plos Computational Biology, 13, 1.
Viral genetic variation accounts for a third of variability in HIV-1 set-point viral load in Europe
Blanquart Francois, Wymant Chris, Cornelissen Marion, Gall Astrid, Bakker Margreet, Bezemer Daniela, Hall Matthew, Hillebregt Mariska, Ong Swee Hoe, Albert Jan, Bannert Norbert, Fellay Jacques, Fransen Katrien, Gourlay Annabelle J., Grabowski M. Kate, Gunsenheimer-Bartmeyer Barbara, Guenthard Huldrych F., Kivela Pia, Kouyos Roger, Laeyendecker Oliver, Liitsola Kirsi, Meyer Laurence, Porter Kholoud, Ristola Matti, van Sighem Ard, Vanham Guido, Berkhout Ben, Kellam Paul, Reiss Peter, Fraser Christophe, Beehive Collaboartion (2017), Viral genetic variation accounts for a third of variability in HIV-1 set-point viral load in Europe, in Plos Biology, 15, 1.
Determinants of HIV-1 broadly neutralizing antibody induction
Rusert Peter, Kouyos Roger D., Kadelka Claus, Ebner Hanna, Schanz Merle, Huber Michael, Braun Dominique L., Hoze Nathanael, Scherrer Alexandra, Magnus Carsten, Weber Jacqueline, Uhr Therese, Cippa Valentina, Thorball Christian W., Kuster Herbert, Cavassini Matthias, Bernasconi Enos, Hoffmann Matthias, Calmy Alexandra, Battegay Manuel, Rauch Andri, Yerly Sabine, Aubert Vincent, Klimkait Thomas, Boni Jurg, Fellay Jacques, Regoes Roland R., Gunthard Huldrych F., Trkola Alexandra, Swiss H. I. V. Cohort Studys (2016), Determinants of HIV-1 broadly neutralizing antibody induction, in Nature Medicine, 22, 1260-1267.
Dually Active HIV/HBV Antiretrovirals as Protection Against Incident Hepatitis B Infections: Potential for Prophylaxis
Shilaih Mohaned, Marzel Alex, Scherrer Alexandra U., Braun Dominique L., Kovari Helen, Rougemont Mathieu, Darling Katharine, Battegay Manuel, Hoffmann Matthias, Bernasconi Enos, Hirzel Cedric, Gunthard Huldrych F., Kouyos Roger D., Swiss H. I. V. Cohort Study (2016), Dually Active HIV/HBV Antiretrovirals as Protection Against Incident Hepatitis B Infections: Potential for Prophylaxis, in Journal of Infectious Diseases, 214, 599-606.
Genotypic Resistance Tests Sequences Reveal the Role of Marginalized Populations in HIV-1 Transmission in Switzerland
Shilaih Mohaned, Marzel Alex, Yang Wan Lin, Scherrer Alexandra U., Schupbach Jorg, Boni Jurg, Yerly Sabine, Hirsch Hans H., Aubert Vincent, Cavassini Matthias, Klimkait Thomas, Vernazza Pietro L., Bernasconi Enos, Furrer Hansjakob, Gunthard Huldrych F., Kouyos Roger, Swiss H. I. V. Cohort Study (2016), Genotypic Resistance Tests Sequences Reveal the Role of Marginalized Populations in HIV-1 Transmission in Switzerland, in Scientific Reports, 6, 1.

Communication with the public

Communication Title Media Place Year
Talks/events/exhibitions Scientifica 2017 German-speaking Switzerland 2017

Awards

Title Year
Götz Preis 2015

Associated projects

Number Title Start Funding scheme
142411 Combining molecular epidemiology approaches and mathematical models for the spread of HIV and its coinfections 01.10.2012 Ambizione

Abstract

Integrating traditional epidemiological approaches with a transmission-network perspective is of key importance for understanding and preventing the spread of infectious diseases. HIV is a case in point for this: the wealth of sequence, clinical, and behavioral data have made such an integration feasible, and key questions in HIV prevention require a consideration of both transmission-network and traditional-epidemiological factors. We aim to apply such an integrative approach to the unique data from the Swiss HIV Cohort Study to address the following central issues in HIV prevention:Aim A: For men having sex with men, where antiretroviral treatment has not led to a substantial decrease in HIV incidence, we will quantify the impact of risk-compensation and of high-risk networks in the failure of treatment as prevention. Aim B: For heterosexuals, where HIV transmission is governed by imported infections, we will employ a stuttering-transmission-chain methodology to determine whether increases in risk behavior are driving the epidemic towards a self-sustained state.Aim C: For Intravenous Drug Users, where needle exchange could virtually eliminate HIV transmission in Switzerland, we will estimate the number of infections these efforts prevented in both IDUs and in the linked general population. Aim D: We will use targeted retrospective sequencing of stored plasma samples to obtain a representative HIV transmission history for Switzerland and in particular to assess how many infections could have been prevented by early treatment. Aim E: We will use the clustering patterns of a wide range of comorbidities/coinfections on the HIV transmission network as an exploratory tool to investigate their origin, pathogenesis and socio-demographic determinants. We will adapt this tool to assess for example the impact of serosorter networks on the spread sexually transmitted coinfections or the impact of viral genetic factors in non-infectious comorbidities.Overall this work will address key issues in the prevention of HIV transmission and will thereby not only contribute to optimize public health interventions but also provide an ideal case study for the role of transmission networks in infectious diseases and in particular for the crucial importance of integrating clinical, epidemiological, and network approaches.
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