Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals

被引:5
作者
Popping, Stephanie [1 ,2 ]
Cuypers, Lize [3 ,4 ]
Claassen, Mark A. A. [5 ]
van den Berk, Guido E. [6 ]
De Weggheleire, Anja [7 ]
Arends, Joop E. [8 ]
Boerekamps, Anne [2 ]
Molenkamp, Richard [1 ]
Koopmans, Marion P. G. [1 ]
Verbon, Annelies [2 ,8 ]
Boucher, Charles A. B. [1 ]
Rijnders, Bart [2 ]
van de Vijver, David A. M. C. [1 ]
机构
[1] Erasmus MC, Dept Virosci, NL-3015 CA Rotterdam, Netherlands
[2] Erasmus MC, Dept Med Microbiol & Infect Dis, NL-3015 CA Rotterdam, Netherlands
[3] Katholieke Univ Leuven, Dept Microbiol Immunol & Transplantat, Lab Clin & Epidemiol Virol, Rega Inst Med Res, B-3000 Leuven, Belgium
[4] Univ Hosp Leuven, Dept Lab Med, B-3000 Leuven, Belgium
[5] Rijnstate Ziekenhuis, Dept Internal Med & Infect Dis, NL-6815 AD Arnhem, Netherlands
[6] OLVG, Dept Internal Med & Infect Dis, NL-1091 AC Amsterdam, Netherlands
[7] Inst Trop Med Antwerp, Dept Clin Sci, B-2000 Antwerp, Belgium
[8] Univ Utrecht, Univ Med Ctr Utrecht, Dept Internal Med & Infect Dis, NL-3584 CX Utrecht, Netherlands
来源
VIRUSES-BASEL | 2022年 / 14卷 / 09期
关键词
hepatitis c; transmission dynamics; phylogenetic analysis; HIV-infected Men-who-have-sex-with-men; hepatitis C elimination; HIV-POSITIVE MEN; HEPATITIS-C; DRUG-USERS; REINFECTION; AMSTERDAM;
D O I
10.3390/v14091953
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Background: In the Netherlands, unrestricted access to direct-acting antivirals (DAAs) halved the incidence of acute hepatitis C virus (HCV) infections among HIV-infected men who have sex with men (MSM). To develop strategies that can further reduce the spread of HCV, it is important to understand the transmission dynamics of HCV. We used phylogenetic analysis of a dense sample of MSM to provide insight into the impact of unrestricted access to DAAs on HCV transmission in the Netherlands and in Belgium. Methods: We included 89 MSM that were recently infected with HCV genotype 1a in ten Dutch and one Belgian HIV treatment centers. Sequences were generated using next gene sequencing and Sanger sequencing. Maximum likelihood phylogenetic analysis (general time reversible model) was performed on concatenated NS5A and NS5B sequences and a reference set of 389 highly similar control sequences selected from GenBank. A cluster was based on a minimum bootstrap support of 90% and a 3% genetic distance threshold. Results: We found that 78 (88%) of individuals were part of seven major clusters. All clusters included individuals from across the study region, however, different cities were part of different clusters. In three clusters, HIV-negative MSM clustered with sequences from HIV-positive MSM. All clusters that were observed before the introduction of DAAs persisted after unrestricted access to DAAs became available. Conclusion: Recently acquired HCV infections among MSM in the Netherlands and Belgium are strongly clustered and therefore highly suitable for targeted prevention strategies, such as contact tracing and partner notification. Importantly, despite an HCV incidence reduction after high DAA uptake and continuously monitoring, HCV transmission persisted in the same clusters.
引用
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页数:8
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