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

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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.

Original languageEnglish (US)
Article number104078
JournalInfection, Genetics and Evolution
Volume77
DOIs
StatePublished - Jan 2020

Fingerprint

hepatitis C
Baltimore
hepatitis
Hepatitis C virus
Hepatitis C
Hepacivirus
Cluster Analysis
virus
drug
drugs
Pharmaceutical Preparations
drug therapy
genotype
Genotype
drug injection
cocaine
virus transmission
narcotics
acquired immune deficiency syndrome
Virus Diseases

Keywords

  • 1CE
  • Hepatitis C virus
  • Injection drug use
  • Molecular epidemiology
  • Phylogenetic
  • PWID

ASJC Scopus subject areas

  • Microbiology
  • Ecology, Evolution, Behavior and Systematics
  • Molecular Biology
  • Genetics
  • Microbiology (medical)
  • Infectious Diseases

Cite this

@article{a16d6ebaeaf240d4b2368f8af6b6a532,
title = "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.",
keywords = "1CE, Hepatitis C virus, Injection drug use, Molecular epidemiology, Phylogenetic, PWID",
author = "Jada Hackman and Oluwaseun Falade-Nwulia and Patel, {Eshan U.} and Mehta, {Shruti H.} and Kirk, {Gregory D.} and Jacquie Astemborski and Ray, {Stuart C.} and Thomas, {David L.} and Oliver Laeyendecker",
year = "2020",
month = "1",
doi = "10.1016/j.meegid.2019.104078",
language = "English (US)",
volume = "77",
journal = "Infection, Genetics and Evolution",
issn = "1567-1348",
publisher = "Elsevier",

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TY - JOUR

T1 - Correlates of hepatitis C viral clustering among people who inject drugs in Baltimore

AU - Hackman, Jada

AU - Falade-Nwulia, Oluwaseun

AU - Patel, Eshan U.

AU - Mehta, Shruti H.

AU - Kirk, Gregory D.

AU - Astemborski, Jacquie

AU - Ray, Stuart C.

AU - Thomas, David L.

AU - Laeyendecker, Oliver

PY - 2020/1

Y1 - 2020/1

N2 - 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.

AB - 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.

KW - 1CE

KW - Hepatitis C virus

KW - Injection drug use

KW - Molecular epidemiology

KW - Phylogenetic

KW - PWID

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DO - 10.1016/j.meegid.2019.104078

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JO - Infection, Genetics and Evolution

JF - Infection, Genetics and Evolution

SN - 1567-1348

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