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Clustering of HCV coinfections on HIV phylogeny indicates domestic and sexual transmission of HCV


Kouyos, Roger D; Rauch, Andri; Böni, Jürg; Yerli, Sabome; Shah, Cyril; Aubert, Vincent; Klimkait, Thomas; Kovari, Helen; Calmy, Alexandra; Cavassini, Matthias; Battegay, Manuel; Vernazza, Pietro L; Bernasconi, Enos; Ledergerber, Bruno; Gunthard, Huldrych F (2014). Clustering of HCV coinfections on HIV phylogeny indicates domestic and sexual transmission of HCV. International Journal of Epidemiology, 43(3):887-896.

Abstract

Background: HCV coinfection remains a major cause of morbidity and mortality among HIV-infected individuals and its incidence has increased dramatically in HIV-infected men who have sex with men(MSM). Hepatitis C virus (HCV) coinfection in the Swiss HIV Cohort Study(SHCS) was studied by combining clinical data with HIV-1pol-sequences from the SHCS Drug Resistance Database(DRDB). We inferred maximum-likelihood phylogenetic trees, determined Swiss HIV-transmission pairs as monophyletic patient pairs, and then considered the dis- tribution of HCV on those pairs. Results: Among the 9748 patients in the SHCS-DRDB with known HCV status, 2768(28%) were HCV-positive. Focusing on subtype B(7644 patients), we identified 1555 potential HIV-1 transmission pairs. There, we found that, even after controlling for transmission group, calendar year, age and sex, the odds for an HCV coinfection were increased by an odds ratio (OR) of 3.2 [95% confidence interval (CI) 2.2, 4.7) if a patient clustered with another HCV-positive case. This strong association persisted if transmission groups of intravenous drug users (IDUs), MSMs and heterosexuals (HETs) were considered separately (in all cases OR>2). Finally we found that HCV incidence was increased by a hazard ratio of 2.1 (1.1, 3.8) for individuals paired with an HCV-positive partner. Conclusions: Patients whose HIV virus is closely related to the HIV virus of HIV/HCV-coinfected patients have a higher risk for carrying or acquiring HCV themselves. This indicates the occurrence of domestic and sexual HCV transmission and allows the identification of patients with a high HCV-infection risk.

Abstract

Background: HCV coinfection remains a major cause of morbidity and mortality among HIV-infected individuals and its incidence has increased dramatically in HIV-infected men who have sex with men(MSM). Hepatitis C virus (HCV) coinfection in the Swiss HIV Cohort Study(SHCS) was studied by combining clinical data with HIV-1pol-sequences from the SHCS Drug Resistance Database(DRDB). We inferred maximum-likelihood phylogenetic trees, determined Swiss HIV-transmission pairs as monophyletic patient pairs, and then considered the dis- tribution of HCV on those pairs. Results: Among the 9748 patients in the SHCS-DRDB with known HCV status, 2768(28%) were HCV-positive. Focusing on subtype B(7644 patients), we identified 1555 potential HIV-1 transmission pairs. There, we found that, even after controlling for transmission group, calendar year, age and sex, the odds for an HCV coinfection were increased by an odds ratio (OR) of 3.2 [95% confidence interval (CI) 2.2, 4.7) if a patient clustered with another HCV-positive case. This strong association persisted if transmission groups of intravenous drug users (IDUs), MSMs and heterosexuals (HETs) were considered separately (in all cases OR>2). Finally we found that HCV incidence was increased by a hazard ratio of 2.1 (1.1, 3.8) for individuals paired with an HCV-positive partner. Conclusions: Patients whose HIV virus is closely related to the HIV virus of HIV/HCV-coinfected patients have a higher risk for carrying or acquiring HCV themselves. This indicates the occurrence of domestic and sexual HCV transmission and allows the identification of patients with a high HCV-infection risk.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Medical Virology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Uncontrolled Keywords:HIV-HCV coinfection, molecular epidemiology, genotypic resistance testing, sexual transmission of HCV
Language:English
Date:22 January 2014
Deposited On:28 Nov 2014 15:55
Last Modified:22 Jan 2017 06:16
Publisher:Oxford University Press
ISSN:0300-5771
Funders:Framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation (SNF grant #33CS30-134277 and -148522), SHCS projects #470, 528, 569, SHCS Research Foundation, the Swiss National Science Foundation (grant 324730-130865, to H.F.G.), Yvonne-Jacob Foundation (to H.F.G.), Research grant of the Union Bank of Switzerland, in the name of an anonymous donor to H.F.G., Unrestricted research grant from Gilead, Switzerland, to the SHCS research foundation, University of Zurich’s Clinical Research Priority Program (CRPP) ‘Viral infectious diseases: Zurich Primary HIV Infection Study’ (to H.F.G.), SNF #PZ00P3-142411 (to R.K.)
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/ije/dyt276
PubMed ID:24453237

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