BACKGROUND: The human immunodeficiency virus type 1 (HIV-1) pandemic was ignited in Léopoldville (now known as Kinshasa), in the former Belgian Congo. Factors that jump-started its early expansion remain unclear. Nonlethal hepatitis C virus (HCV) and human T-cell lymphotropic virus (HTLV-1) can be used to investigate past iatrogenic transmission. METHODS: We undertook a cross-sectional study of elderly inhabitants of Kinshasa, with serological assays, amplification, and sequencing. Risk factors were assessed through logistic regression. Phylogenetic methods reconstructed the genetic history of HCV. RESULTS: A total of 217 of 839 participants (25.9%) were HCV seropositive; 26 (3.1%) were HTLV-1-seropositive. Amplification products were obtained from 118 HCV-seropositive participants; subtypes 4k (in 47 participants) and 4r (in 38) were most common. Independent risk factors for HCV subtype 4r seropositivity were intramuscular tuberculosis therapy, intravenous injections at hospital A, intravenous injections before 1960, and injections at a colonial-era venereology clinic. Intravenous injections at hospital B and antimalarials were associated with HCV subtype 4k seropositivity. Risk factors for HTLV-1 seropositivity included intravenous injections at hospitals C or D and transfusions. Evolutionary analysis of viral sequences revealed independent exponential amplification of HCV subtypes 4r and 4k from the 1950s onward. CONCLUSIONS: Iatrogenic transmission of HCV and HTLV-1 occurred in mid-20th century Kinshasa, at the same time and place HIV-1 emerged. Iatrogenic routes may have contributed to the early establishment of the pandemic.
BACKGROUND: The human immunodeficiency virus type 1 (HIV-1) pandemic was ignited in Léopoldville (now known as Kinshasa), in the former Belgian Congo. Factors that jump-started its early expansion remain unclear. Nonlethal hepatitis C virus (HCV) and human T-cell lymphotropic virus (HTLV-1) can be used to investigate past iatrogenic transmission. METHODS: We undertook a cross-sectional study of elderly inhabitants of Kinshasa, with serological assays, amplification, and sequencing. Risk factors were assessed through logistic regression. Phylogenetic methods reconstructed the genetic history of HCV. RESULTS: A total of 217 of 839 participants (25.9%) were HCV seropositive; 26 (3.1%) were HTLV-1-seropositive. Amplification products were obtained from 118 HCV-seropositive participants; subtypes 4k (in 47 participants) and 4r (in 38) were most common. Independent risk factors for HCV subtype 4r seropositivity were intramuscular tuberculosis therapy, intravenous injections at hospital A, intravenous injections before 1960, and injections at a colonial-era venereology clinic. Intravenous injections at hospital B and antimalarials were associated with HCV subtype 4k seropositivity. Risk factors for HTLV-1 seropositivity included intravenous injections at hospitals C or D and transfusions. Evolutionary analysis of viral sequences revealed independent exponential amplification of HCV subtypes 4r and 4k from the 1950s onward. CONCLUSIONS: Iatrogenic transmission of HCV and HTLV-1 occurred in mid-20th century Kinshasa, at the same time and place HIV-1 emerged. Iatrogenic routes may have contributed to the early establishment of the pandemic.
Authors: Jonathan B Parr; Evans K Lodge; Vera Holzmayer; Jacques Pepin; Eric H Frost; Michael W Fried; David R McGivern; Stanley M Lemon; Corinna Keeler; Michael Emch; Kashamuka Mwandagalirwa; Antoinette Tshefu; Franck Fwamba; Jérémie Muwonga; Steven R Meshnick; Gavin Cloherty Journal: Clin Infect Dis Date: 2018-01-06 Impact factor: 9.079
Authors: Nuno R Faria; Nicole Vidal; José Lourenco; Jayna Raghwani; Kim C E Sigaloff; Andy J Tatem; David A M van de Vijver; Andrea-Clemencia Pineda-Peña; Rebecca Rose; Carole L Wallis; Steve Ahuka-Mundeke; Jean-Jacques Muyembe-Tamfum; Jérémie Muwonga; Marc A Suchard; Tobias F Rinke de Wit; Raph L Hamers; Nicaise Ndembi; Guy Baele; Martine Peeters; Oliver G Pybus; Philippe Lemey; Simon Dellicour Journal: PLoS Pathog Date: 2019-12-06 Impact factor: 6.823
Authors: Medhat K Shier; James C Iles; Mohammad S El-Wetidy; Hebatallah H Ali; Mohammad M Al Qattan Journal: PLoS One Date: 2017-09-01 Impact factor: 3.240
Authors: Chris Davis; George S Mgomella; Ana da Silva Filipe; Eric H Frost; Genevieve Giroux; Joseph Hughes; Catherine Hogan; Pontiano Kaleebu; Gershim Asiki; John McLauchlan; Marc Niebel; Ponsiano Ocama; Cristina Pomila; Oliver G Pybus; Jacques Pépin; Peter Simmonds; Joshua B Singer; Vattipally B Sreenu; Clara Wekesa; Elizabeth H Young; Donald G Murphy; Manj Sandhu; Emma C Thomson Journal: Hepatology Date: 2019-03-22 Impact factor: 17.425