Factors associated with phylogenetic clustering of hepatitis C among people who inject drugs in Baltimore

• Published in: BMC infectious diseases 2020-11, Vol.20 (1), p.815-9, Article 815
• Main Authors: Falade-Nwulia, Oluwaseun, Hackman, Jada, Mehta, Shruti H, McCormick, Sean D, Kirk, Gregory D, Sulkowski, Mark, Thomas, David, Latkin, Carl, Laeyendecker, Oliver, Ray, Stuart C
• Format: Article
• Language: English
• Subjects: Age; Aged; Aged, 80 and over; Analysis; Antibodies; Antiviral agents; Antiviral Agents - therapeutic use; Baltimore - epidemiology; Cluster Analysis; Clustering; Confidence intervals; Demographic aspects; Disease transmission; Distribution; Drug abuse; Drug use; Drugs; Epidemiology; Female; Follow-Up Studies; Genetic distance; Genomes; Genotype; Genotype & phenotype; Genotypes; Health aspects; Hepacivirus - genetics; Hepatitis; Hepatitis C; Hepatitis C - epidemiology; Hepatitis C - transmission; Hepatitis C - virology; HIV; HIV - genetics; HIV Infections - epidemiology; HIV Infections - transmission; HIV Infections - virology; Human immunodeficiency virus; Humans; Infections; Intravenous drug abuse; Male; Middle Aged; Molecular epidemiology; People who inject drugs; Phylogenetics; Phylogeny; Prevalence; Prevention; Prospective Studies; Public health; Regression analysis; Risk factors; Sex; Sex Factors; Sex ratio; Sexual Partners; Sexually transmitted diseases; Statistical analysis; STD; Substance Abuse, Intravenous - epidemiology; Viremia - epidemiology; Viruses; Women
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-020-05546-x

The availability of effective, oral direct acting antivirals (DAAs) for hepatitis C virus (HCV) treatment has put elimination of HCV as a public health challenge within reach. However, little is known about the characteristics of transmission networks of people who inject drugs (PWID). Sequencing of a segment of the HCV genome was performed on samples collected from a community-based cohort of PWID between August 2005 and December 2016. Phylogenetic trees were inferred, and clusters were identified (70% bootstrap threshold; 0.04 maximum genetic distance threshold). We describe sex, race, age difference, and HIV infection status of potential transmission partners. Logistic regression was used to assess factors associated with being in an HCV cluster. Of 508 HCV genotype 1 viremic PWID, 8% (n = 41) were grouped into 20 clusters, consisting of 19 pairs and 1 triad. In adjusted analyses, female sex (odds ratio [OR] 2.3 [95% confidence interval (CI) 1.2-4.5]) and HIV infection (OR 5.7 [CI 2.7-11.9]) remained independently associated with being in an HCV infection cluster. Molecular epidemiological analysis reveals that, in this cohort of PWID in Baltimore, HIV infection and female sex were associated with HCV clustering. Combination HCV prevention interventions targeting HIV infected PWID and addressing HCV infection prevention needs of women have potential to advance HCV elimination efforts.