Document text
Principal Investigator: Julie Parsonnet
Organization: STANFORD UNIVERSITY
Fiscal Year: 2024
Award: $193,000
Funding agency: National Institute of Allergy and Infectious Diseases
PROJECT SUMMARY
At the start of the COVID-19 pandemic in late 2019, an estimated 1.2 million people—including 158,500
(13%) with undiagnosed infection—were living with HIV in the United States. Since then, HIV control
efforts have been complicated by disruptions to HIV testing, care-related services, and case surveillance
activities in state and local jurisdictions. However, the full impact of the COVID-19 pandemic on HIV
transmission, incidence and outcomes has been difficult to quantify.
Wastewater-based epidemiology (WBE) is a non-invasive and unbiased surveillance approach that can be
used to estimate infectious disease occurrence in the population by detecting pathogen DNA or RNA in
pooled community samples of wastewater. Here we propose to apply a novel WBE HIV surveillance
method to measure HIV-1 nucleic acids in wastewater to estimate HIV incidence in sewersheds during the
COVID-19 pandemic. This research study will pursue three specific aims: (1) to develop and validate a
quantification method for HIV-1 nucleic acids (RNA and DNA) in urine, feces and wastewater settled
solids, (2) in 30 people living with HIV, to c orrelate HIV nucleic acid (RNA and DNA) shedding in urine and
feces with plasma viral load, and (3) using archived samples of wastewater rom Santa Clara and San
Francisco Counties during the COVID pandemic, to determine trends in wastewater HIV-1 nucleic acid
levels and compare findings with community case rates of HIV.
The overarching goal of this project is to establish an HIV quantification method for wastewater-based
surveillance using digital droplet, reverse transcription-PCR analysis that can be used to monitor HIV in
the community. We hypothesize that wastewater surveillance can identify populations disproportionately
affected by HIV, facilitating allocation of resources to those at highest risk, thereby maximizing HIV
control. Investigating rates of changes in HIV nucleic acid in wastewater in relation to COVID-19 may also
improve our understanding of how pandemic disease and its control strategies can impact HIV surveillance
and patient care. Knowledge gained from this project will help establish a framework for wastewater-based
surveillance for HIV in the US and globally that can reduce health disparities, improve health outcomes
and prevent HIV transmission.
Terms: <2019 novel corona virus><2019 novel coronavirus><2019-nCoV><AIDS Virus><AIDS prevention><AIDS test><AIDS/HIV><AIDS/HIV test><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Acute Poliomyelitis><Affect><Anti-HIV Positivity><Assay><Bioassay><Biological Assay><Blood Plasma><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 pandemic affected><COVID-19 pandemic consequence><COVID-19 pandemic effects><COVID-19 pandemic impact><COVID-19 pandemic impacted><COVID-19 period><COVID-19 public health crisis><COVID-19 virus><COVID-19 years><COVID19 virus><CV-19><California><Caring><Clinical><CoV-2><CoV2><Communicable Diseases><Communities><Complement><Complement Proteins><Coronavirus Infectious Disease 2019><County><DNA><Decrease health disparities><Deoxyribonucleic Acid><Disease><Disease Surveillance><Disorder><Ensure><Feces><Goals><HIV><HIV Infections><HIV Positive><HIV Positivity><HIV Prevention><HIV Seroconversion><HIV Seropositivity><HIV antibody positive><HIV diagnosis><HIV test><HIV-1><HIV-1 test><HIV-2 test><HIV-I><HIV/AIDS><HIV/AIDS prevention><HIV1><HTLV-III Infections><HTLV-III Seroconversion><HTLV-III Seropositivity><HTLV-III-LAV Infections><Health><Health disparity mitigation><Health disparity reduction><Hospital Admission><Hospitalization><Human><Human Immunodeficiency Virus Type 1><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Human immunodeficiency virus 1><Human immunodeficiency virus test><Incidence><Individual><Infection><Infectious Disease Pathway><Infectious Diseases><Infectious Disorder><Knowledge><LAV-HTLV-III><Lower health disparities><Lymphadenopathy-Associated Virus><Measurement><Measures><Medical><Methods><Mitigate health disparities><Modeling><Modern Man><Monitor><Monkey Pox><Monkeypox><NIAID><National Institute of Allergy and Infectious Disease><Non-Polyadenylated RNA><Nucleic Acids><Outcome><Pathogen detection><Patient Care><Patient Care Delivery><Persons><Plasma><Plasma Serum><Polio><Poliomyelitis><Population><Prevalence><Public Health><RNA><RNA Gene Products><RT-PCR><RTPCR><Reduce health disparities><Reporting><Research Specimen><Resource Allocation><Reticuloendothelial System, Serum, Plasma><Reverse Transcriptase Polymerase Chain Reaction><Reverse Transcription><Ribonucleic Acid><Risk Assessment><SARS corona virus 2><SARS-CO-V2><SARS-COVID-2><SARS-CoV-2><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-CoV2><SARS-associated corona virus 2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><SARS-related corona virus 2><SARS-related coronavirus 2><SARSCoV2><Sampling><San Francisco><Services><Severe Acute Respiratory Coronavirus 2><Severe Acute Respiratory Distress 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