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Transmission patterns of HIV and hepatitis C virus among networks of people who inject drugs.

Pilon R, Leonard L, Kim J, Vallee D, De Rubeis E, Jolly AM, Wylie J, Pelude L, Sandstrom P - PLoS ONE (2011)

Bottom Line: Thirty-six percent of HCV sequences were associated with clusters, compared to 67% of HIV sequences.Four (16.7%) of the 24 HCV clusters contained membership separated by 2 or fewer recruitment cycles, compared to 10 (41.6%) derived from more than one recruitment component.However, among the complete cohort, a higher degree of HIV clustering indicates many are recent infections originating from within current social networks, whereas a larger proportion of HCV infections may have occurred earlier in injecting history and in the context of a different social environment.

View Article: PubMed Central - PubMed

Affiliation: National HIV and Retrovirology Laboratories, Public Health Agency of Canada, Ottawa, Ontario, Canada.

ABSTRACT

Background: The risk-related behaviours and practices associated with injection drug use remain a driver of HIV and hepatitis C virus (HCV) transmission throughout the world. Here we evaluated HIV and HCV transmission patterns in the context of social networks of injection drug users (IDU) recruited from a higher incidence region in order to better understand factors that contribute to ongoing transmission among IDU.

Methods: IDU recruited through a chain-referral method provided biological specimens for analysis. HIV and HCV positive specimens were sequenced and analyzed using phylogenetic methods (Neighbour-joining and bayesian) and transmission patterns of HIV and HCV evaluated in the context of the recruitment networks.

Results: Among the 407 recruited IDU, HCV and HIV prevalence were 60.6% and 10.1%, respectively; 98% of HIV positive individuals were co-infected with HCV. Thirty-six percent of HCV sequences were associated with clusters, compared to 67% of HIV sequences. Four (16.7%) of the 24 HCV clusters contained membership separated by 2 or fewer recruitment cycles, compared to 10 (41.6%) derived from more than one recruitment component. Two (28.6%) of the 7 HIV clusters contained membership separated by 2 or fewer recruitment cycles while 6 (85.7%) were composed of inter component membership.

Conclusions: Few HIV and HCV transmissions coincided with the recruitment networks, suggesting that they occurred in a different social context or a context not captured by the recruitment network. However, among the complete cohort, a higher degree of HIV clustering indicates many are recent infections originating from within current social networks, whereas a larger proportion of HCV infections may have occurred earlier in injecting history and in the context of a different social environment.

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Phylogenetic analysis.A. Neighbour Joining analysis of all HIV-1 pol sequences generated. B. Analysis of all clustered HCV core sequences. In each tree, bootstrap values greater than 80% are indicated. In situations where HCV clusters based on core analysis (5, 9 & 20) fell below the 80% bootstrap cut off, similar analysis of NS5B (not shown) resolved clusters with bootstrap values above 80%.
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pone-0022245-g002: Phylogenetic analysis.A. Neighbour Joining analysis of all HIV-1 pol sequences generated. B. Analysis of all clustered HCV core sequences. In each tree, bootstrap values greater than 80% are indicated. In situations where HCV clusters based on core analysis (5, 9 & 20) fell below the 80% bootstrap cut off, similar analysis of NS5B (not shown) resolved clusters with bootstrap values above 80%.

Mentions: Separate phylogenetic analysis of 176 core and 166 NS5B sequences revealed that 58 (32%) of the HCV specimens with amplifiable RNA were related to at least one other HCV infection within the recruitment networks. In all, 24 HCV infection clusters were identified in at least one of the two regions analyzed, with cluster size ranging from 2 to 7 participants [Figure 2A and Table 3]. Similar phylogenetic analysis of HIV sequences revealed that 18 (62%) of the 29 specimens for which HIV sequence data was obtained fell within 7 distinct transmission clusters ranging in size from 2 to 4 participants (Figure 2B). Of the 24 HCV clusters, only 4 (16.7%) contained membership separated by 2 or fewer recruitment cycles, in contrast to 10 (41.6%) clusters that were derived from more than one recruitment component. Two (28.6%) of the 7 unique HIV clusters, contained membership separated by 2 or fewer recruitment cycles while 6 clusters (85.7%) were composed of inter component membership.


Transmission patterns of HIV and hepatitis C virus among networks of people who inject drugs.

Pilon R, Leonard L, Kim J, Vallee D, De Rubeis E, Jolly AM, Wylie J, Pelude L, Sandstrom P - PLoS ONE (2011)

Phylogenetic analysis.A. Neighbour Joining analysis of all HIV-1 pol sequences generated. B. Analysis of all clustered HCV core sequences. In each tree, bootstrap values greater than 80% are indicated. In situations where HCV clusters based on core analysis (5, 9 & 20) fell below the 80% bootstrap cut off, similar analysis of NS5B (not shown) resolved clusters with bootstrap values above 80%.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3140499&req=5

pone-0022245-g002: Phylogenetic analysis.A. Neighbour Joining analysis of all HIV-1 pol sequences generated. B. Analysis of all clustered HCV core sequences. In each tree, bootstrap values greater than 80% are indicated. In situations where HCV clusters based on core analysis (5, 9 & 20) fell below the 80% bootstrap cut off, similar analysis of NS5B (not shown) resolved clusters with bootstrap values above 80%.
Mentions: Separate phylogenetic analysis of 176 core and 166 NS5B sequences revealed that 58 (32%) of the HCV specimens with amplifiable RNA were related to at least one other HCV infection within the recruitment networks. In all, 24 HCV infection clusters were identified in at least one of the two regions analyzed, with cluster size ranging from 2 to 7 participants [Figure 2A and Table 3]. Similar phylogenetic analysis of HIV sequences revealed that 18 (62%) of the 29 specimens for which HIV sequence data was obtained fell within 7 distinct transmission clusters ranging in size from 2 to 4 participants (Figure 2B). Of the 24 HCV clusters, only 4 (16.7%) contained membership separated by 2 or fewer recruitment cycles, in contrast to 10 (41.6%) clusters that were derived from more than one recruitment component. Two (28.6%) of the 7 unique HIV clusters, contained membership separated by 2 or fewer recruitment cycles while 6 clusters (85.7%) were composed of inter component membership.

Bottom Line: Thirty-six percent of HCV sequences were associated with clusters, compared to 67% of HIV sequences.Four (16.7%) of the 24 HCV clusters contained membership separated by 2 or fewer recruitment cycles, compared to 10 (41.6%) derived from more than one recruitment component.However, among the complete cohort, a higher degree of HIV clustering indicates many are recent infections originating from within current social networks, whereas a larger proportion of HCV infections may have occurred earlier in injecting history and in the context of a different social environment.

View Article: PubMed Central - PubMed

Affiliation: National HIV and Retrovirology Laboratories, Public Health Agency of Canada, Ottawa, Ontario, Canada.

ABSTRACT

Background: The risk-related behaviours and practices associated with injection drug use remain a driver of HIV and hepatitis C virus (HCV) transmission throughout the world. Here we evaluated HIV and HCV transmission patterns in the context of social networks of injection drug users (IDU) recruited from a higher incidence region in order to better understand factors that contribute to ongoing transmission among IDU.

Methods: IDU recruited through a chain-referral method provided biological specimens for analysis. HIV and HCV positive specimens were sequenced and analyzed using phylogenetic methods (Neighbour-joining and bayesian) and transmission patterns of HIV and HCV evaluated in the context of the recruitment networks.

Results: Among the 407 recruited IDU, HCV and HIV prevalence were 60.6% and 10.1%, respectively; 98% of HIV positive individuals were co-infected with HCV. Thirty-six percent of HCV sequences were associated with clusters, compared to 67% of HIV sequences. Four (16.7%) of the 24 HCV clusters contained membership separated by 2 or fewer recruitment cycles, compared to 10 (41.6%) derived from more than one recruitment component. Two (28.6%) of the 7 HIV clusters contained membership separated by 2 or fewer recruitment cycles while 6 (85.7%) were composed of inter component membership.

Conclusions: Few HIV and HCV transmissions coincided with the recruitment networks, suggesting that they occurred in a different social context or a context not captured by the recruitment network. However, among the complete cohort, a higher degree of HIV clustering indicates many are recent infections originating from within current social networks, whereas a larger proportion of HCV infections may have occurred earlier in injecting history and in the context of a different social environment.

Show MeSH
Related in: MedlinePlus