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Correlates of hepatitis C viral clustering among people who inject drugs in Baltimore.

ABSTRACT: 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.

SUBMITTER: Hackman J

PROVIDER: S-EPMC7460273 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Correlates of hepatitis C viral clustering among people who inject drugs in Baltimore.

Hackman Jada J Falade-Nwulia Oluwaseun O Patel Eshan U EU Mehta Shruti H SH Kirk Gregory D GD Astemborski Jacquie J Ray Stuart C SC Thomas David L DL Laeyendecker Oliver O

Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases 20191024

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 ...[more]

PMID: 31669367

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Project description:It is hypothesized that social networks facilitate transmission of the hepatitis C virus (HCV). We tested for association between HCV phylogeny and reported injecting relationships using longitudinal data from a social network design study. People who inject drugs were recruited from street drug markets in Melbourne, Australia. Interviews and blood tests took place three monthly (during 2005-2008), with participants asked to nominate up to five injecting partners at each interview. The HCV core region of individual isolates was then sequenced and phylogenetic trees were constructed. Genetic clusters were identified using bootstrapping (cut-off: 70%). An adjusted Jaccard similarity coefficient was used to measure the association between the reported injecting relationships and relationships defined by clustering in the phylogenetic analysis (statistical significance assessed using the quadratic assignment procedure). 402 participants consented to participate; 244 HCV infections were observed in 238 individuals. 26 genetic clusters were identified, with 2-7 infections per cluster. Newly acquired infection (AOR?=?2.03, 95% CI: 1.04-3.96, p?=?0.037, and HCV genotype 3 (vs. genotype 1, AOR?=?2.72, 95% CI: 1.48-4.99) were independent predictors of being in a cluster. 54% of participants whose infections were part of a cluster in the phylogenetic analysis reported injecting with at least one other participant in that cluster during the study. Overall, 16% of participants who were infected at study entry and 40% of participants with newly acquired infections had molecular evidence of related infections with at least one injecting partner. Likely transmission clusters identified in phylogenetic analysis correlated with reported injecting relationships (adjusted Jaccard coefficient: 0.300; p<0.001). This is the first study to show that HCV phylogeny is associated with the injecting network, highlighting the importance of the injecting network in HCV transmission.

Dataset Information

Correlates of hepatitis C viral clustering among people who inject drugs in Baltimore.

Publications

Correlates of hepatitis C viral clustering among people who inject drugs in Baltimore.

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