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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Recent epidemic of acute hepatitis C virus in HIV-positive men who have sex with men linked to high-risk sexual behaviours
AIDS, Volume 21, No. 8, Year 2007
Notification
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Description
OBJECTIVE: To characterize the mode of hepatitis C virus (HCV) transmission in a recent epidemic of acute HCV in HIV-infected individuals using linked molecular and clinical epidemiological studies. DESIGN: Individuals diagnosed with acute HCV between 1999 and 2005 at three urban HIV units in the UK were enrolled into a phylogenetic and case-control study. Phylogenetic trees were constructed from the amplified sequences of the E1/E2 region of the HCV genome and were used to compare cases with unrelated sequences. A questionnaire-based, case-control study using matched controls recruited from each HIV unit identified putative transmission factors. RESULTS: One hundred and eleven HIV-positive men who have sex with men with acute HCV (genotype 1: 84%) were enrolled. Phylogenetic analysis of 93 E1/E2 sequences revealed seven monophyletic clusters signifying multiple independent HCV lineages co-circulating in the HIV-positive population. Permucosal rather than percutaneous transmission factors were associated with case/control status. Cases (n = 60) had more sexual partners, increased levels of high-risk sexual behaviour and were more likely to have shared drugs via a nasal or anal route in the preceding year in comparison with controls (n = 130). Sex in a group of more than two people was the strongest predictor of case/control status; odds ratios associated with participation in two or at least three types of high-risk sexual behaviour in a group were 9.16 (95% confidence interval, 3.51-23.90) and 23.50 (95% confidence interval, 9.47-58.33), respectively. CONCLUSION: The identified co-circulating HCV lineages belong to different subtypes and genotypes, implying that rather than viral change, the epidemic is due to permucosal transmission factors that should be the focus of public health interventions. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Brown, David J.C.
United Kingdom, London
University College London
Bhagani, Sanjay R.
United Kingdom, London
Ucl Medical School
Pybus, Oliver George
United Kingdom, Oxford
University of Oxford
Sabin, Caroline Anne
United Kingdom, London
Ucl Medical School
Nelson, Mark Richard
United Kingdom, London
Chelsea and Westminster Hospital
Fisher, Martin J.
United Kingdom, Worthing
University Hospitals Sussex Nhs Foundation Trust
Johnson, Anne M.
United Kingdom, London
Ucl Medical School
Dusheiko, Geoffrey M.
United Kingdom, London
University College London
Statistics
Citations: 500
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1097/QAD.0b013e3281053a0c
ISSN:
02699370
Research Areas
Genetics And Genomics
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Case-Control Study
Participants Gender
Male