Department of Molecular Virology and Pathogenesis, United States Military HIV Research Program (MHRP), Walter Reed Army Institute of Research, Silver Spring, MD, USA.
J Med Virol. 2013 Jul;85(7):1170-9. doi: 10.1002/jmv.23575.
Hepatitis C virus (HCV) prevalence is high among injecting drug users in Afghanistan, but transmission dynamics are poorly understood. Samples from HCV-infected injecting drug users were sequenced to determine circulating genotypes and potential transmission linkages. Serum samples were obtained from injecting drug user participants in Hirat, Jalalabad, and Mazar-i-Sharif between 2006 and 2008 with reactive anti-HCV rapid tests. Specimens with detected HCV viremia were amplified and underwent sequence analysis. Of 113 samples evaluated, 25 samples (35.2%) were only typeable in NS5B, nine samples (12.7%) were only typeable in CE1, and 37 samples (52.1%) were genotyped in both regions. Of those with typeable HCV, all were Afghan males with a mean age of 31.1 (standard deviation [SD] ± 8.0) years and mean duration of injecting of 3.9 (SD ± 4.3) years. Most reported residence outside Afghanistan in the last decade (90.1%) and prior incarceration (76.8%). HCV genotypes detected were: 1a, (35.2%, n = 25), 3a (62.0%, n = 44), and 1b (2.8%, n = 2). Cluster formation was detected in NS5B and CE1 and were generally from within the same city. All participants within clusters reported being a refugee in Iran compared to 93.5% of those outside clusters. Only 22.2% (4/11) of those within clusters had been refugees in Pakistan and these four individuals had also been refugees in Iran. Predominance of genotype 3a and the association between HCV viremia and having been a refugee in Iran potentially reflects migration between Afghanistan and Iran among IDUs from Mazar-i-Sharif and Hirat and carry implications for harm reduction programs for this migratory population.
在阿富汗，注射吸毒者中丙型肝炎病毒（HCV）的流行率很高，但传播动态知之甚少。对 HCV 感染的注射吸毒者的样本进行测序，以确定循环基因型和潜在的传播联系。2006 年至 2008 年间，在赫拉特、贾拉拉巴德和马扎里沙里夫从注射吸毒者参与者中获得血清样本，并进行了 HCV 快速检测。对检测到 HCV 病毒血症的标本进行扩增并进行序列分析。在评估的 113 个样本中，有 25 个样本（35.2%）仅在 NS5B 可测，9 个样本（12.7%）仅在 CE1 可测，37 个样本（52.1%）在两个区域均可测。在可测 HCV 样本中，均为阿富汗男性，平均年龄为 31.1（标准差 [SD] ± 8.0）岁，平均注射时间为 3.9（SD ± 4.3）年。大多数人在过去十年中报告居住在阿富汗境外（90.1%），且曾被监禁（76.8%）。检测到的 HCV 基因型有：1a（35.2%，n=25）、3a（62.0%，n=44）和 1b（2.8%，n=2）。在 NS5B 和 CE1 中检测到聚类形成，且通常来自同一城市。聚类内的所有参与者都报告曾在伊朗避难，而聚类外的参与者有 93.5%。仅 22.2%（4/11）的聚类内成员曾在巴基斯坦避难，这四人也曾在伊朗避难。基因型 3a 的优势以及 HCV 病毒血症与在伊朗避难之间的关联可能反映了来自马扎里沙里夫和赫拉特的 IDU 之间在阿富汗和伊朗之间的迁徙，并对针对这一迁徙人群的减少伤害方案具有影响。
