TY - JOUR
T1 - Prevalence and phylogenetic characterization of hepatitis C virus among indian men who have sex with men
T2 - Limited evidence for sexual transmission
AU - Clipman, Steven J.
AU - Duggal, Priya
AU - Srikrishnan, Aylur K.
AU - Saravanan, Shanmugam
AU - Balakrishnan, Pachamuthu
AU - Vasudevan, Canjeevaran K.
AU - Celentano, David D.
AU - Thomas, David L.
AU - Mehta, Shruti H.
AU - Solomon, Sunil S.
N1 - Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background: Data from high-income countries suggest increasing hepatitis C virus (HCV) prevalence/incidence among human immunodeficiency virus (HIV)–infected men who have sex with men (MSM), but limited data derive from low-and-middle-income countries. Methods: We recruited 4994 MSM from 5 states across India using respondent-driven sampling. Logistic regression incorporating respondent-driven sampling weights and machine learning feature selection were used to identify correlates of prevalent HCV, and Bayesian phylogenetic analysis was used to examine genetic clustering. Results: The median age was 25 years, the HIV prevalence was 7.2%, and 49.3% of participants reported recent unprotected anal intercourse. The HCV prevalence was 1.3% (95% confidence interval, 1.0%–1.6%; site range, 0.2%–3.4%) and was 3.1% in HIV-positive versus 1.1% among HIV-negative men. HCV infection was significantly associated with injection drug use (odds ratio, 177.1; 95% confidence interval, 72.7–431.5) and HIV infection (4.34; 1.88–10.05). Machine learning did not uncover any additional epidemiologic signal. Phylogenetic analysis revealed 3 clusters suggestive of linked transmission; each contained ≥1 individual reporting injection drug use. Conclusions: We observed a low HCV prevalence in this large sample of MSM despite a high prevalence of known risk factors, reflecting either the need for a threshold of HCV for sexual transmission and/or variability in sexual practices across settings.
AB - Background: Data from high-income countries suggest increasing hepatitis C virus (HCV) prevalence/incidence among human immunodeficiency virus (HIV)–infected men who have sex with men (MSM), but limited data derive from low-and-middle-income countries. Methods: We recruited 4994 MSM from 5 states across India using respondent-driven sampling. Logistic regression incorporating respondent-driven sampling weights and machine learning feature selection were used to identify correlates of prevalent HCV, and Bayesian phylogenetic analysis was used to examine genetic clustering. Results: The median age was 25 years, the HIV prevalence was 7.2%, and 49.3% of participants reported recent unprotected anal intercourse. The HCV prevalence was 1.3% (95% confidence interval, 1.0%–1.6%; site range, 0.2%–3.4%) and was 3.1% in HIV-positive versus 1.1% among HIV-negative men. HCV infection was significantly associated with injection drug use (odds ratio, 177.1; 95% confidence interval, 72.7–431.5) and HIV infection (4.34; 1.88–10.05). Machine learning did not uncover any additional epidemiologic signal. Phylogenetic analysis revealed 3 clusters suggestive of linked transmission; each contained ≥1 individual reporting injection drug use. Conclusions: We observed a low HCV prevalence in this large sample of MSM despite a high prevalence of known risk factors, reflecting either the need for a threshold of HCV for sexual transmission and/or variability in sexual practices across settings.
KW - HCV
KW - India
KW - MSM
KW - Machine learning
KW - Phylodynamics
KW - Phylogenetics
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U2 - 10.1093/INFDIS/JIAA006
DO - 10.1093/INFDIS/JIAA006
M3 - Article
C2 - 31917837
AN - SCOPUS:85084695486
SN - 0022-1899
VL - 221
SP - 1875
EP - 1883
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 11
ER -