Wastewater analysis offers novel approach to track HIV burden
Researchers at Baylor College of Medicine and collaborators developed a hybrid-capture genetic sequencing method to detect HIV-1 in wastewater, finding strong correlations between viral signals and known HIV cases in communities. The study, published in *Nature Communications*, suggests wastewater analysis could help identify untreated HIV infections and guide public health resource allocation, particularly in underserved areas.
Baylor College of Medicine researchers, alongside collaborators, have introduced a novel wastewater-based approach to track HIV-1 using hybrid-capture genetic sequencing. Published in *Nature Communications*, the study analyzed wastewater from 40 sites across 15 Texas cities between mid-2022 and late 2024, revealing consistent yet low-level HIV genetic material in over 2,000 samples. The findings align with clinical data, showing wastewater signals correspond to known HIV prevalence in communities, offering a potential tool to identify untreated infections. The method builds on Baylor’s prior work in wastewater surveillance, including tracking poliovirus and SARS-CoV-2 during the COVID-19 pandemic. Dr. Thomas Giordano, co-corresponding author and section chief of infectious diseases, emphasized that while HIV genetic traces appear in wastewater, they are unlikely to represent infectious virus due to decontamination processes. Co-author Dr. Anthony Maresso, professor of molecular virology, highlighted the urgent need for complementary surveillance strategies to detect undiagnosed or untreated HIV, which accounts for 80% of new transmissions globally. The Texas Wastewater and Environmental Biomonitoring (TexWEB) group, which implemented this approach, has previously detected over 400 viruses in wastewater, including avian influenza, mpox, and measles. First author Dr. Justin Clark, assistant professor of molecular virology, noted the advanced sequencing technique allowed detailed HIV genome analysis, distinguishing viral signals from lab strains. The study suggests wastewater surveillance could help pinpoint geographic hotspots for HIV prevention and treatment efforts. Globally, HIV-1 has infected 90 million people and caused over 40 million deaths, with 1.3 million new diagnoses in 2023. Current surveillance relies on clinical diagnoses, leaving undiagnosed individuals invisible to public health systems. The researchers propose wastewater analysis as a scalable, population-level tool to complement existing methods, particularly in areas with limited healthcare access. The findings align with broader public health goals to reduce HIV transmission by identifying untreated infections early. Baylor’s wastewater surveillance dashboard, used for tracking other viruses, could be adapted for HIV monitoring, providing real-time data for targeted interventions. The study underscores the potential of wastewater epidemiology to address gaps in infectious disease surveillance.
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