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Spatiotemporal Phylodynamics of Hepatitis C Among People Who Inject Drugs in India.
Clipman, Steven J; Mehta, Shruti H; Rodgers, Mary A; Duggal, Priya; Srikrishnan, Aylur K; Saravanan, Shanmugam; Balakrishnan, Pachamuthu; Vasudevan, Canjeevaran K; Ray, Stuart C; Kumar, Muniratnam S; Quinn, Thomas C; Cloherty, Gavin A; Lucas, Gregory M; Solomon, Sunil S.
Afiliação
  • Clipman SJ; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Mehta SH; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Rodgers MA; Abbott Diagnostics, Infectious Disease Research, Abbott Park, IL.
  • Duggal P; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Srikrishnan AK; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Saravanan S; YR Gaitonde Centre for AIDS Research and Education (YRGCARE), Chennai, India.
  • Balakrishnan P; YR Gaitonde Centre for AIDS Research and Education (YRGCARE), Chennai, India.
  • Vasudevan CK; YR Gaitonde Centre for AIDS Research and Education (YRGCARE), Chennai, India.
  • Ray SC; YR Gaitonde Centre for AIDS Research and Education (YRGCARE), Chennai, India.
  • Kumar MS; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Quinn TC; YR Gaitonde Centre for AIDS Research and Education (YRGCARE), Chennai, India.
  • Cloherty GA; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Lucas GM; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
  • Solomon SS; Abbott Diagnostics, Infectious Disease Research, Abbott Park, IL.
Hepatology ; 74(4): 1782-1794, 2021 10.
Article em En | MEDLINE | ID: mdl-34008172
BACKGROUND AND AIMS: Implementing effective interventions for HCV requires a detailed understanding of local transmission dynamics and geospatial spread. Little is known about HCV phylodynamics, particularly among high-burden populations, such as people who inject drugs (PWID). APPROACH AND RESULTS: We used 483 HCV sequences and detailed individual-level data from PWID across four Indian cities. Bayesian phylogeographic analyses were used to evaluate transmission hotspots and geospatial diffusion of the virus. Phylogenetic cluster analysis was performed to infer epidemiologic links and factors associated with clustering. A total of 492 HIV sequences were used to draw comparisons within the same population and, in the case of coinfections, evaluate molecular evidence for shared transmission pathways. Overall, 139/483 (28.8%) of HCV sequences clustered with a median cluster size of 3 individuals. Genetically linked participants with HCV were significantly younger and more likely to be infected with HCV subtype 3b as well as to live and inject close to one another. Phylogenetic evidence suggests likely ongoing HCV infection/reinfection with limited support for shared HIV/HCV transmission pathways. Phylogeographic analyses trace historic HCV spread back to Northeastern India and show diffusion patterns consistent with drug trafficking routes. CONCLUSIONS: This study characterizes HCV phylodynamics among PWID in a low and middle-income country setting. Heterogeneity and recent genetic linkage of HCV across geographically disparate Indian states suggest that targeted interventions could help prevent reimportation of virus through drug trafficking routes.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Limite: Adult / Female / Humans / Male País/Região como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Limite: Adult / Female / Humans / Male País/Região como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article