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The Power and Pitfalls of HIV Phylogenetics in Public Health

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Abstract

Phylogenetics is the application of comparative studies of genetic sequences in order to infer evolutionary relationships among organisms. This tool can be used as a form of molecular epidemiology to enhance traditional population-level communicable disease surveillance. Phylogenetic study has resulted in new paradigms being created in the field of communicable diseases and this commentary aims to provide the reader with an explanation of how phylogenetics can be used in tracking infectious diseases. Special emphasis will be placed upon the application of phylogenetics as a tool to help elucidate HIV transmission patterns and the limitations to these methods when applied to forensic analysis. Understanding infectious disease epidemiology in order to prevent new transmissions is the sine qua non of public health. However, with increasing epidemiological resolution, there may be an associated potential loss of privacy to the individual. It is within this context that we aim to promote the discussion on how to use phylogenetics to achieve important public health goals, while at the same time protecting the rights of the individual.

Résumé

La phylogénie est l’application d’études comparatives de séquences génétiques afin d’inférer des liens évolutionnaires entre des organismes. Cet outil peut être utilisé comme une forme d’épidémiologie moléculaire pour améliorer la surveillance classique des maladies transmissibles dans la population. Des études phylogénétiques ont donné lieu à la création de nouveaux paradigmes dans le domaine des maladies transmissibles, et notre commentaire vise à expliquer l’utilisation possible de la phylogénie pour retracer des maladies infectieuses. Nous insistons surtout sur l’application de la phylogénie en tant qu’outil pour élucider les grandes tendances de transmission du VIH et sur les contraintes de ces méthodes lorsqu’elles sont appliquées à l’analyse médico-légale. En santé publique, il est indispensable de comprendre l’épidémiologie des maladies infectieuses pour prévenir les nouvelles transmissions. Toutefois, l’augmentation de la résolution épidémiologique pourrait s’accompagner d’une perte de confidentialité pour les particuliers. Dans ce contexte, nous voulons lancer un débat sur l’utilisation de la phylogénie pour atteindre d’importants objectifs de santé publique tout en protégeant les droits des particuliers.

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Correspondence to James I. Brooks MD, FRCPC.

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Conflict of Interest: None to declare.

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Brooks, J.I., Sandstrom, P.A. The Power and Pitfalls of HIV Phylogenetics in Public Health. Can J Public Health 104, e348–e350 (2013). https://doi.org/10.17269/cjph.104.3830

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  • DOI: https://doi.org/10.17269/cjph.104.3830

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