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
N1 - Publisher Copyright:
© 2019
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 - PWID
KW - Phylogenetic
UR - http://www.scopus.com/inward/record.url?scp=85074415130&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85074415130&partnerID=8YFLogxK
U2 - 10.1016/j.meegid.2019.104078
DO - 10.1016/j.meegid.2019.104078
M3 - Article
C2 - 31669367
AN - SCOPUS:85074415130
SN - 1567-1348
VL - 77
JO - Infection, Genetics and Evolution
JF - Infection, Genetics and Evolution
M1 - 104078
ER -