A Phylogenetic Analysis of Hepatitis C Virus Transmission, Relapse, and Reinfection Among People Who Inject Drugs Receiving Opioid Agonist Therapy.
J Infect Dis
; 222(3): 488-498, 2020 07 06.
Article
en En
| MEDLINE
| ID: mdl-32150621
ABSTRACT
BACKGROUND:
Understanding hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is essential for HCV elimination. We aimed to differentiate reinfections from treatment failures and to identify transmission linkages and associated factors in a cohort of PWID receiving opioid agonist therapy (OAT).METHODS:
We analyzed baseline and follow-up specimens from 150 PWID from 3 OAT clinics in the Bronx, New York. Next-generation sequencing data from the hypervariable region 1 of HCV were analyzed using Global Hepatitis Outbreak and Surveillance Technology.RESULTS:
There were 3 transmission linkages between study participants. Sustained virologic response (SVR) was not achieved in 9participants:
7 had follow-up specimens with similar sequences to baseline, and 2 died. In 4 additional participants, SVR was achieved but the participants were viremic at later follow-up 2 were reinfected with different strains, 1 had a late treatment failure, and 1 was transiently viremic 17 months after treatment. All transmission linkages were from the same OAT clinic and involved spousal or common-law partnerships.CONCLUSION:
This study highlights the use of next-generation sequencing as an important tool for identifying viral transmission and to help distinguish relapse and reinfection among PWID. Results reinforce the need for harm reduction interventions among couples and those who report ongoing risk factors after SVR.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Antivirales
/
Preparaciones Farmacéuticas
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Abuso de Sustancias por Vía Intravenosa
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Hepatitis C
/
Analgésicos Opioides
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
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Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Infect Dis
Año:
2020
Tipo del documento:
Article