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Inferring transmission heterogeneity using virus genealogies: Estimation and targeted prevention.

ABSTRACT: Spread of HIV typically involves uneven transmission patterns where some individuals spread to a large number of individuals while others to only a few or none. Such transmission heterogeneity can impact how fast and how much an epidemic spreads. Further, more efficient interventions may be achieved by taking such transmission heterogeneity into account. To address these issues, we developed two phylogenetic methods based on virus sequence data: 1) to generally detect if significant transmission heterogeneity is present, and 2) to pinpoint where in a phylogeny high-level spread is occurring. We derive inference procedures to estimate model parameters, including the amount of transmission heterogeneity, in a sampled epidemic. We show that it is possible to detect transmission heterogeneity under a wide range of simulated situations, including incomplete sampling, varying levels of heterogeneity, and including within-host genetic diversity. When evaluating real HIV-1 data from different epidemic scenarios, we found a lower level of transmission heterogeneity in slowly spreading situations and a higher level of heterogeneity in data that included a rapid outbreak, while R0 and Sackin's index (overall tree shape statistic) were similar in the two scenarios, suggesting that our new method is able to detect transmission heterogeneity in real data. We then show by simulations that targeted prevention, where we pinpoint high-level spread using a coalescence measurement, is efficient when sequence data are collected in an ongoing surveillance system. Such phylogeny-guided prevention is efficient under both single-step contact tracing as well as iterative contact tracing as compared to random intervention.

SUBMITTER: Zhang Y

PROVIDER: S-EPMC7494101 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Multispecies occupancy models can estimate species richness from spatially replicated multispecies detection/non-detection survey data, while accounting for imperfect detection. A model extension using data augmentation allows inferring the total number of species in the community, including those completely missed by sampling (i.e., not detected in any survey, at any site). Here we investigate the robustness of these estimates. We review key model assumptions and test performance via simulations, under a range of scenarios of species characteristics and sampling regimes, exploring sensitivity to the Bayesian priors used for model fitting. We run tests when assumptions are perfectly met and when violated. We apply the model to a real dataset and contrast estimates obtained with and without predictors, and for different subsets of data. We find that, even with model assumptions perfectly met, estimation of the total number of species can be poor in scenarios where many species are missed (>15%-20%) and that commonly used priors can accentuate overestimation. Our tests show that estimation can often be robust to violations of assumptions about the statistical distributions describing variation of occupancy and detectability among species, but lower-tail deviations can result in large biases. We obtain substantially different estimates from alternative analyses of our real dataset, with results suggesting that missing relevant predictors in the model can result in richness underestimation. In summary, estimates of total richness are sensitive to model structure and often uncertain. Appropriate selection of priors, testing of assumptions, and model refinement are all important to enhance estimator performance. Yet, these do not guarantee accurate estimation, particularly when many species remain undetected. While statistical models can provide useful insights, expectations about accuracy in this challenging prediction task should be realistic. Where knowledge about species numbers is considered truly critical for management or policy, survey effort should ideally be such that the chances of missing species altogether are low.

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Inferring transmission heterogeneity using virus genealogies: Estimation and targeted prevention.

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