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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Evidence of a Large, International Network of HCV Transmission in HIV-Positive Men Who Have Sex With Men
Gastroenterology, Volume 136, No. 5, Year 2009
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Description
Background & Aims: Since 2000, there has been a marked rise in acute hepatitis C virus (HCV) in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). We conducted an international phylogenetic study to investigate the existence of an HCV transmission network among MSM. Methods: HIV-positive MSM diagnosed with recent HCV (n = 226) in England (107), The Netherlands (58), France (12), Germany (25), and Australia (24) between 2000 and 2006 were enrolled into a molecular phylogenetic study. Using real-time polymerase chain reaction (PCR), the NS5B region of the HCV genome (436 base pair) was amplified, sequenced, and compared with unrelated NS5B sequences. Results: NS5B sequences were obtained from 200 (89%) cases. Circulating HCV genotypes were 1a (59%), 4d (23%), 3a (11%), 1b (5%), and 2b/c (3%). Phylogenetic analysis revealed 156 (78%) sequences that formed 11 clusters (bootstrap value > 70%) containing between 4 and 37 individual sequences. Country mixing was associated with larger cluster size (17 vs 4.5 sequences; P = .03). "Molecular clock" analysis indicated that the majority (85%) of transmissions occurred since 1996. Conclusions: Phylogenetic analysis revealed a large international network of HCV transmission among HIV-positive MSM. The rapid spread of HCV among neighboring countries is supported by the large proportion (74%) of European MSM infected with an HCV strain co-circulating in multiple European countries, the low evolutionary distances among HCV isolates from different countries, and the trend toward increased country mixing with increasing cluster size. Temporally, this epidemic coincides with the introduction of highly active antiretroviral therapy and associated increases in sexual risk behaviors. International collaborative public health efforts are needed to mitigate HCV transmission among this population. © 2009 AGA Institute.
Authors & Co-Authors
Pybus, Oliver George
United Kingdom, Oxford
University of Oxford
Bruisten, Sylvia Maria
Unknown Affiliation
Brown, David J.C.
United Kingdom, London
University College London
Nelson, Mark Richard
United Kingdom, London
Chelsea and Westminster Hospital
Bhagani, Sanjay R.
United Kingdom, London
Ucl Medical School
Chaix, Marie Laure
France, Paris
Hôpital Necker Enfants Malades
Fisher, Martin J.
United Kingdom, Worthing
University Hospitals Sussex Nhs Foundation Trust
Götz, Hannelore Martha
Unknown Affiliation
Matthews, Gail V.
Australia, Sydney
Unsw Sydney
White, Peter A.
Australia, Sydney
Unsw Sydney
Rawlinson, William D.
Australia, Sydney
Unsw Sydney
Pol, Stanislas
France, Paris
Université Paris Cité
Rockstroh, Jürgen Kurt
Germany, Bonn
Universität Bonn
Coutinho, Roel A.
Netherlands, Bilthoven
Rijksinstituut Voor Volksgezondheid en Milieu
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Dore, Gregory J.
Australia, Sydney
Unsw Sydney
Dusheiko, Geoffrey M.
United Kingdom, London
University College London
Statistics
Citations: 268
Authors: 16
Affiliations: 12
Identifiers
Doi:
10.1053/j.gastro.2009.02.006
ISSN:
00165085
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Participants Gender
Male