Frequent HCV reinfection and superinfection in a cohort of injecting drug users in Amsterdam
Frequent HCV reinfection and superinfection in a cohort of injecting drug users in Amsterdam
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DOI：
10.1016/j.jhep.2009.05.027
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发表时间：
2009-10-01
影响因子：
25.7
通讯作者：
Bruisten, Sylvia M.
中科院分区：
文献类型：
--
作者：
van de Laar, Thijs J. W.;Molenkamp, Richard;Bruisten, Sylvia M.
背景/目的：本研究调查了 1985 年至 2005 年参与阿姆斯特丹队列研究的 HCV 血清转化者中 HCV 再次感染和重复感染的发生情况。方法：在五个不同时间点对 HCV 血清转化者 (n = 59) 进行 HCV RNA 检测：血清转化前的最后一次就诊 (t = -1)、血清转化后的第一次就诊 (t = 1)、血清转化后六个月 (t = 2) 和一年后 (t = 3)，以及最后一次访视在 2005 年 11 月之前 (t = 4)。如果存在 HCV RNA，则部分 NS5B 区域会被扩增并测序。进行了额外的系统发育分析和克隆以确定 HCV 再感染和重复感染。结果：在 23/59 (39%) 血清转化者中检测到多重 HCV 感染； 7 例 HCV 再感染，14 例二重感染，2 例再感染后二重感染。在 HCV 再次感染时，7/9 的血清转化者为 HIV 阴性：在 HIV 阳性病例和 4/7 HIV 阴性病例中均出现持续性 HCV 再感染。我们总共鉴定了 93 种不同的 HCV 感染，每个血清转化者有 1 到 4 种感染。在有自发 HCV 清除的 10/24 血清转化者中观察到多重 HCV 感染（11 例再感染，3 例重复感染），在 13/35 例无病毒清除的血清转化者中观察到多种 HCV 感染（20 例重复感染）。结论：HCV 再感染和重复感染在主动注射吸毒者中很常见。这可能会使有效丙型肝炎病毒疫苗的开发进一步复杂化。 (C) 2009 年欧洲肝脏研究协会。由 Elsevier B.V. 出版。保留所有权利。
Background/Aims:This study investigates the occurrence of HCV reinfection and superinfection among HCV seroconverters participating in the Amsterdam Cohort Studies among drug users from 1985 through 2005.Methods: HCV seroconverters (n = 59) were tested for HCV RNA at five different time points: the last visit before seroconversion (t = -1), the first visit after seroconversion (t = 1), six months after (t = 2) and one year after (t = 3) seroconversion, and the last visit prior to November 2005 (t = 4). If HCV RNA was present, part of the NS5B region was amplified and sequenced. Additional phylogenetic analysis and cloning was performed to establish HCV reinfection and superinfection.Results: Multiple HCV infections were detected in 23/59 (39%) seroconverters; 7 had HCV reinfections, 14 were superinfected, and 2 had reinfection followed by superinfection. At the moment of HCV reinfection, 7/9 seroconverters were HIV-negative: persistent HCV reinfection developed in both HIV-positive cases but also in 4/7 HIV-negative cases. In total, we identified 93 different HCV infections, varying from 1 to 4 infections per seroconverter. Multiple HCV infections were observed in 10/24 seroconverters with spontaneous HCV clearance (11 reinfections, 3 superinfections) and in 13/35 seroconverters without viral clearance (20 superinfections).Conclusions: HCV reinfection and superinfection are common among actively injecting drug users. This might further complicate the development of an effective HCV vaccine. (C) 2009 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.