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Li H, Huang H, Huang W, Du M, Long D, Xu G, Mei W, Huang K. Hepatitis C virus subtype diversity and transmission clusters characteristics among drug users in Zhuhai, South China. BMC Infect Dis 2024; 24:451. [PMID: 38685009 PMCID: PMC11057121 DOI: 10.1186/s12879-024-09323-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection poses a major public health challenge globally, especially among injecting drug users. China has the world's largest burden of HCV infections. However, little is known about the characteristics of transmission networks among drug user populations. This study aims to investigate the molecular epidemiology and transmission characteristics of HCV infections among drug users in Zhuhai, a bustling port city connecting Mainland China and its Special Administrative Regions. METHODS Participants enrolled in this study were drug users incarcerated at Zhuhai's drug rehabilitation center in 2015. Their sociodemographic and behavioral information, including gender, promiscuity, drug use method, and so forth, was collected using a standardized questionnaire. Plasmas separated from venous blood were analyzed for HCV infection through ELISA and RT-PCR methods to detect anti-HCV antibodies and HCV RNA. The 5'UTR fragment of the HCV genome was amplified and further sequenced for subtype identifications and phylogenetic analysis. The phylogenetic tree was inferred using the Maximum Likelihood method based on the Tamura-Nei model, and the transmission cluster network was constructed using Cytoscape3.8.0 software with a threshold of 0.015. Binary logistic regression models were employed to assess the factors associated with HCV infection. RESULTS The overall prevalence of HCV infection among drug users was 44.37%, with approximately 19.69% appearing to clear the HCV virus successfully. Binary logistic regression analysis revealed that those aged over 40, engaging in injecting drug use, and being native residents were at heightened risk for HCV infection among drug user cohorts. The predominant HCV subtypes circulating among those drug users were 6a (60.26%), followed by 3b (16.7%), 3a (12.8%), 1b (6.41%) and 1a (3.85%), respectively. Molecular transmission network analysis unveiled the presence of six transmission clusters, with the largest propagation cluster consisting of 41 individuals infected with HCV subtype 6a. Furthermore, distinct transmission clusters involved eight individuals infected with subtype 3b and seven with subtype 3a were also observed. CONCLUSION The genetic transmission networks revealed a complex transmission pattern among drug users in Zhuhai, emphasizing the imperative for a targeted and effective intervention strategy to mitigate HCV dissemination. These insights are pivotal for shaping future national policies on HCV screening, treatment, and prevention in port cities.
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Affiliation(s)
- Hongxia Li
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
- School of Public Health, Jinan University, Guangzhou, Guangdong, China
| | - Huitao Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Wenyan Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Man Du
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Dongling Long
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Guangxian Xu
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong, China.
| | - Wenhua Mei
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China.
- School of Public Health, Jinan University, Guangzhou, Guangdong, China.
| | - Kaisong Huang
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong, China.
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Christensen KT, Pierard F, Bonsall D, Bowden R, Barnes E, Florence E, Ansari MA, Nguyen D, de Cesare M, Nevens F, Robaeys G, Schrooten Y, Busschots D, Simmonds P, Vandamme AM, Van Wijngaerden E, Dierckx T, Cuypers L, Van Laethem K. Phylogenetic Analysis of Hepatitis C Virus Infections in a Large Belgian Cohort Using Next-Generation Sequencing of Full-Length Genomes. Viruses 2023; 15:2391. [PMID: 38140632 PMCID: PMC10747466 DOI: 10.3390/v15122391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 12/24/2023] Open
Abstract
The hepatitis C virus (HCV) epidemic in Western countries is primarily perpetuated by the sub-populations of men who have sex with men (MSM) and people who inject drugs (PWID). Understanding the dynamics of transmission in these communities is crucial for removing the remaining hurdles towards HCV elimination. We sequenced 269 annotated HCV plasma samples using probe enrichment and next-generation sequencing, obtaining 224 open reading frames of HCV (OR497849-OR498072). Maximum likelihood phylogenies were generated on the four most prevalent subtypes in this study (HCV1a, 1b, 3a, 4d) with a subsequent transmission cluster analysis. The highest rate of clustering was observed for HCV4d samples (13/17 (76.47%)). The second highest rate of clustering was observed in HCV1a samples (42/78 (53.85%)) with significant association with HIV-positive MSM. HCV1b and HCV3a had very low rates of clustering (2/83 (2.41%) and (0/29)). The spread of the prevalent subtype HCV1b appears to have been largely curtailed, and we demonstrate the onwards transmission of HCV1a and HCV4d in the HIV-positive MSM population across municipal borders. More systematic data collection and sequencing is needed to allow a better understanding of the HCV transmission among the community of PWID and overcome the remaining barriers for HCV elimination in Belgium.
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Affiliation(s)
- Kasper T. Christensen
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, 3000 Leuven, Belgium; (F.P.); (Y.S.); (A.-M.V.); (T.D.); (L.C.); (K.V.L.)
| | - Florian Pierard
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, 3000 Leuven, Belgium; (F.P.); (Y.S.); (A.-M.V.); (T.D.); (L.C.); (K.V.L.)
| | - David Bonsall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LF, UK;
- The Wellcome Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK; (R.B.); (D.N.); (M.d.C.)
| | - Rory Bowden
- The Wellcome Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK; (R.B.); (D.N.); (M.d.C.)
| | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford OX1 3SY, UK;
- Translational Gastroenterology Unit, University of Oxford, Oxford OX3 9DU, UK
- Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford OX3 9DU, UK
| | - Eric Florence
- Department of General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, 2650 Edegem, Belgium;
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - M. Azim Ansari
- Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK;
| | - Dung Nguyen
- The Wellcome Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK; (R.B.); (D.N.); (M.d.C.)
| | - Mariateresa de Cesare
- The Wellcome Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK; (R.B.); (D.N.); (M.d.C.)
| | - Frederik Nevens
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, 3000 Leuven, Belgium; (F.N.); (G.R.)
| | - Geert Robaeys
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, 3000 Leuven, Belgium; (F.N.); (G.R.)
- Faculty of Medicine and Life Sciences—LCRC, UHasselt, Agoralaan, 3590 Diepenbeek, Belgium;
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
| | - Yoeri Schrooten
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, 3000 Leuven, Belgium; (F.P.); (Y.S.); (A.-M.V.); (T.D.); (L.C.); (K.V.L.)
- Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Dana Busschots
- Faculty of Medicine and Life Sciences—LCRC, UHasselt, Agoralaan, 3590 Diepenbeek, Belgium;
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
| | - Peter Simmonds
- Henry Wellcome Building for Molecular Physiology, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford OX3 7BN, UK;
| | - Anne-Mieke Vandamme
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, 3000 Leuven, Belgium; (F.P.); (Y.S.); (A.-M.V.); (T.D.); (L.C.); (K.V.L.)
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Eric Van Wijngaerden
- Department of General Internal Medicine, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Tim Dierckx
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, 3000 Leuven, Belgium; (F.P.); (Y.S.); (A.-M.V.); (T.D.); (L.C.); (K.V.L.)
| | - Lize Cuypers
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, 3000 Leuven, Belgium; (F.P.); (Y.S.); (A.-M.V.); (T.D.); (L.C.); (K.V.L.)
- Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Kristel Van Laethem
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, 3000 Leuven, Belgium; (F.P.); (Y.S.); (A.-M.V.); (T.D.); (L.C.); (K.V.L.)
- Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
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Eisen L, Mor Z, Madar M, Rabinovitch R, Dadon Y, Sheffer R, Kaliner E, Goldstein L. Hepatitis C Virus Elimination Program among Prison Inmates, Israel. Emerg Infect Dis 2023; 29:2358-2361. [PMID: 37877627 PMCID: PMC10617329 DOI: 10.3201/eid2911.230728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
The Israeli Prison Services implemented a hepatitis C virus (HCV) elimination program in 2020. Inmates considered high risk for HCV were offered serology; HCV-seropositive participants were offered HCV RNA testing. Among participants, 7.0% had detectable HCV RNA and were offered antiviral drug therapy. This program reduced HCV burden among incarcerated persons.
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Affiliation(s)
| | | | - Miriam Madar
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Ron Rabinovitch
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Yuval Dadon
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Rivka Sheffer
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Ehud Kaliner
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Liav Goldstein
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
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Spaulding AC, Kennedy SS, Osei J, Sidibeh E, Batina IV, Chhatwal J, Akiyama MJ, Strick LB. Estimates of Hepatitis C Seroprevalence and Viremia in State Prison Populations in the United States. J Infect Dis 2023; 228:S160-S167. [PMID: 37703336 DOI: 10.1093/infdis/jiad227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Prior studies demonstrate that eliminating hepatitis C virus (HCV) in the United States (US) heavily depends on treating incarcerated persons. Knowing the scope of the carceral HCV epidemic by state will help guide national elimination efforts. METHODS Between 2019 and 2023, all state prison systems received surveys requesting data on hepatitis C antibody and viremic prevalence. We supplemented survey information with publicly available HCV data to corroborate responses and fill in data gaps. RESULTS Weighting HCV prevalence by state prison population size, we estimate that 15.2% of the US prison population is HCV seropositive and 8.7% is viremic; 54.9% of seropositive persons have detectable RNA. Applying prevalence estimates to the total prison population at year-end 2021, 91 090 persons with HCV infection resided in a state prison. CONCLUSIONS With updated and more complete HCV data from all 50 states, HCV prevalence in state prisons is nearly 9-fold higher than the US general population. The heterogeneity in HCV prevalence by state prison system may reflect variable exposure before arrest and/or differences in treatment availability during incarceration. Elimination of HCV in the country depends on addressing the carceral epidemic, and one of the first steps is understanding the size of the problem.
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Affiliation(s)
- Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Shanika S Kennedy
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jeffery Osei
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ebrima Sidibeh
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Isabella V Batina
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jagpreet Chhatwal
- Massachusetts General Hospital Institute for Technology Assessment, Harvard Medical School, Boston
| | - Matthew J Akiyama
- Department of Medicine, Albert Einstein College of Medicine
- Department of Medicine, Montefiore Medical Center, New York, New York
| | - Lara B Strick
- Department of Medicine, University of Washington, Seattle
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