Clustering of HCV coinfections on HIV phylogeny indicates domestic and sexual transmission of HCV
Clustering of HCV coinfections on HIV phylogeny indicates domestic and sexual transmission of HCV
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DOI：
10.1093/ije/dyt276
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发表时间：
2014-06-01
影响因子：
7.7
通讯作者：
Guenthard, Huldrych F.
中科院分区：
文献类型：
--
作者：
Kouyos, Roger D.;Rauch, Andri;Guenthard, Huldrych F.
背景：HCV 合并感染仍然是 HIV 感染者发病和死亡的主要原因，其发病率在男男性行为者 (MSM) 的 HIV 感染男性中急剧增加。方法：通过结合临床数据和 SHCS 耐药数据库 (DRDB) 中的 HIV-1 pol 序列，对瑞士 HIV 队列研究 (SHCS) 中的丙型肝炎病毒 (HCV) 合并感染进行了研究。我们推断了最大似然系统发育树，将瑞士 HIV 传播对确定为单系患者对，然后考虑这些对上的 HCV 分布。 结果：在 SHCS-DRDB 中已知 HCV 状况的 9748 名患者中，2768 名（28%）为 HCV 阳性。针对 B 亚型（7644 名患者），我们确定了 1555 个潜在的 HIV-1 传播对。在那里，我们发现，即使在控制了传播群体、日历年、年龄和性别后，如果一名患者与另一名 HCV 阳性病例聚集在一起，HCV 合并感染的几率也会增加 3.2 的比值比 (OR) [95% 置信区间 (CI) 2.2, 4.7]。如果单独考虑静脉吸毒者 (IDU)、MSM 和异性恋者 (HET) 的传播群体（在所有情况下 OR > 2），这种强相关性仍然存在。最后我们发现，与 HCV 阳性伴侣配对的个体，HCV 发病率增加了 2.1（1.1，3.8）的风险比。结论：HIV 病毒与 HIV/HCV 合并感染患者的 HIV 病毒密切相关的患者自身携带或感染 HCV 的风险较高。这表明存在家庭和性 HCV 传播，并可以识别 HCV 感染高风险的患者。
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).Methods: Hepatitis C virus (HCV) coinfection in the Swiss HIV Cohort Study(SHCS) was studied by combining clinical data with HIV-1 pol-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 distribution 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.