Noelia Caro-Pérez1, María Martínez-Rebollar2, Josep Gregori3, Josep Quer4, Patricia González5, Martina Gambato6, Neris García-González7, Fernando González-Candelas8, Josep Costa9, Juan Ignacio Esteban10, Josep Mallolas11, Xavier Forns12, Montse Laguno13, Sofía Pérez-Del-Pulgar14. 1. Liver Unit, Hospital Clínic, IDIBAPS, CIBERehd, Universitat de Barcelona, Barcelona, Spain. Electronic address: caro@clinic.ub.es. 2. Infectious Diseases Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain. Electronic address: rebollar@clinic.ub.es. 3. Liver Unit, Vall d'Hebron Institut de Recerca-Hospital Universitari Vall d'Hebron, CIBERehd, Barcelona, Spain; Roche Diagnostics SL, Sant Cugat del Vallès, Barcelona, Spain. Electronic address: josep.gregori@vhir.org. 4. Liver Unit, Vall d'Hebron Institut de Recerca-Hospital Universitari Vall d'Hebron, CIBERehd, Barcelona, Spain. Electronic address: josep.quer@vhir.org. 5. Liver Unit, Hospital Clínic, IDIBAPS, CIBERehd, Universitat de Barcelona, Barcelona, Spain. Electronic address: pgonzale@clinic.ub.es. 6. Liver Unit, Hospital Clínic, IDIBAPS, CIBERehd, Universitat de Barcelona, Barcelona, Spain. Electronic address: gambato@clinic.ub.es. 7. Joint Research Unit Infección y Salud Pública, FISABIO-Universitat de València, I2SysBio, CIBERESP, Valencia, Spain. Electronic address: negargon@alumni.uv.es. 8. Joint Research Unit Infección y Salud Pública, FISABIO-Universitat de València, I2SysBio, CIBERESP, Valencia, Spain. Electronic address: fernando.gonzalez@uv.es. 9. Microbiology Department, Centre Diagnòstic Biomèdic, Hospital Clínic, CIBERehd, Barcelona, Spain. Electronic address: jcosta@clinic.ub.es. 10. Liver Unit, Vall d'Hebron Institut de Recerca-Hospital Universitari Vall d'Hebron, CIBERehd, Barcelona, Spain. Electronic address: jignacio.esteban@ciberehd.org. 11. Infectious Diseases Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain. Electronic address: mallolas@clinic.ub.es. 12. Liver Unit, Hospital Clínic, IDIBAPS, CIBERehd, Universitat de Barcelona, Barcelona, Spain. Electronic address: xforns@clinic.ub.es. 13. Infectious Diseases Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain. Electronic address: mlaguno@clinic.ub.es. 14. Liver Unit, Hospital Clínic, IDIBAPS, CIBERehd, Universitat de Barcelona, Barcelona, Spain. Electronic address: sofiapp@clinic.ub.es.
Abstract
BACKGROUND: The incidence of acute hepatitis C (AHC) among HIV-infected men who have sex with men (MSM) has increased significantly in the last 10 years. Several studies point to a social and sexual network of HIV-positive MSM that extends internationally. OBJECTIVES: The aim of our study was to investigate the dynamics of HCV transmission in an outbreak of AHC in HIV-infected MSM in Barcelona by ultra-deep pyrosequencing. STUDY DESIGN: Between 2008 and 2013, 113 cases of AHC in HIV-infected MSM were diagnosed in the Infectious Diseases Unit, Hospital Clínic, Barcelona. Massive sequencing was performed using the Roche 454 GS Junior platform. To define possible transmission networks, maximum likelihood phylogenetic trees were constructed, and levels of genetic diversity within and among patients were compared. RESULTS: Among the 70 cases analyzed, we have identified 16 potential clusters of transmission: 8 for genotype 1a (23 cases involved), 1 for genotype 1b (3 cases) and 7 for genotype 4d (27 cases). Although the initial phylogenetic reconstruction suggested a local transmission cluster of HCV gt4d, our approach based on low genetic differentiation did not corroborate it. Indeed, gt4d strains formed 4 independent groups related to patients from other countries. CONCLUSIONS: Frequent clustering of HIV-positive MSM shows that HCV infection has spread through a local network in Barcelona. This outbreak is related to a large international HCV transmission network among MSM. Public health efforts are needed to reduce HCV transmission among this high-risk group.
BACKGROUND: The incidence of acute hepatitis C (AHC) among HIV-infectedmen who have sex with men (MSM) has increased significantly in the last 10 years. Several studies point to a social and sexual network of HIV-positive MSM that extends internationally. OBJECTIVES: The aim of our study was to investigate the dynamics of HCV transmission in an outbreak of AHC in HIV-infected MSM in Barcelona by ultra-deep pyrosequencing. STUDY DESIGN: Between 2008 and 2013, 113 cases of AHC in HIV-infected MSM were diagnosed in the Infectious Diseases Unit, Hospital Clínic, Barcelona. Massive sequencing was performed using the Roche 454 GS Junior platform. To define possible transmission networks, maximum likelihood phylogenetic trees were constructed, and levels of genetic diversity within and among patients were compared. RESULTS: Among the 70 cases analyzed, we have identified 16 potential clusters of transmission: 8 for genotype 1a (23 cases involved), 1 for genotype 1b (3 cases) and 7 for genotype 4d (27 cases). Although the initial phylogenetic reconstruction suggested a local transmission cluster of HCV gt4d, our approach based on low genetic differentiation did not corroborate it. Indeed, gt4d strains formed 4 independent groups related to patients from other countries. CONCLUSIONS: Frequent clustering of HIV-positive MSM shows that HCV infection has spread through a local network in Barcelona. This outbreak is related to a large international HCV transmission network among MSM. Public health efforts are needed to reduce HCV transmission among this high-risk group.
Authors: Anna L McNaughton; Valentina D'Arienzo; M Azim Ansari; Sheila F Lumley; Margaret Littlejohn; Peter Revill; Jane A McKeating; Philippa C Matthews Journal: Gastroenterology Date: 2018-09-27 Impact factor: 22.682