Journal
INFECTION GENETICS AND EVOLUTION
Volume 77, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.meegid.2019.104078
Keywords
Hepatitis C virus; 1CE; Phylogenetic; Molecular epidemiology; PWID; Injection drug use
Categories
Funding
- National Institutes of Health (NIH) [U01 DA036297, R01 DA12568, K23 DA041294, UM1 AI068613, R01D048063]
- Division of Intramural Research, National Insitute of Allergy and Infectious Diseases, NIH [T32AI102623]
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [ZIAAI000361] Funding Source: NIH RePORTER
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This study examines correlates of hepatitis C virus (HCV) genetic clustering among community-recruited people who inject drugs enrolled in the AIDS Linked to the IntraVenous Experience cohort in Baltimore between 1988 and 1989. HCV RNA was extracted and the core/envelope-1 region was sequenced. Clusters were identified from maximum likelihood trees with 1000 bootstrap replicates using a 70% aLRT and a 4% genetic-distance threshold in Cluster Picker. Overall, 46% of participants were in a cluster, including 122 genotype-1a and 36 genotype-1b clusters with an average of 2-3 genetically linked HCV infections. The largest cluster consists of 9 participants. In univariable analysis, black race (PR= 1.66 [95% CI: 1.12-2.45]), age < 35 years (PR= 1.18 [95% CI: 1.02-1.37]), and injection drug use of cocaine alone (PR= 1.30 [95% CI: 1.02-1.65]) were significantly associated with being in a cluster. Conversely, a history of medication-associated treatment (MAT) was negatively associated with being in a cluster (PR= 0.82 [95% CI: 0.71-0.95]). In multivariable analysis, black race (APR = 1.62 [95% CI: 1.11-2.38]) remained independently associated being in a cluster while MAT (APR = 0.85 [95% CI: 0.74-0.99]) remained negatively associated with clustering. Our findings suggest strong locally-propagated transmission networks during the early epidemic that was driven by younger PWID. In light of the current opioid epidemic in the US, these findings suggest an urgent need for preventive interventions to mitigate the growth of large HCV transmission networks.
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