巴黎 HIV 阳性男性患者中急性 HCV 感染的高度聚集和相关性传播感染的高发生率。

High clustering of acute HCV infections and high rate of associated STIs among Parisian HIV-positive male patients.

机构信息

Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, Paris, France.

Cerballiance Laboratory, Paris, France.

出版信息

Int J Antimicrob Agents. 2019 May;53(5):678-681. doi: 10.1016/j.ijantimicag.2019.02.002. Epub 2019 Feb 8.

DOI:10.1016/j.ijantimicag.2019.02.002

PMID:30742957

Abstract

BACKGROUND

Increasing incidence of hepatitis C virus (HCV) infection in human immunodeficiency virus (HIV)-positive men having sex with men (MSM) has been described in recent years. Phylogenetic analyses of acute HCV infections were undertaken to characterize the dynamics during the epidemic in Paris, and associated sexually transmitted infections (STIs) were evaluated.

METHODS

Sanger sequencing of polymerase gene was performed. Maximum likelihood phylogenies were reconstructed using FastTree 2.1 under a GTR+CAT model. Transmission chains were defined as clades with a branch probability ≥0.80 and intraclade genetic distances <0.02 nucleotide substitutions per sites. STIs detected ≤1 month before HCV diagnosis were considered.

RESULTS

Among the 85 studied patients, at least 81.2% were MSM. Respectively, 47.6%, 39.0%, 11.0% and 2.4% were infected with genotypes 1a, 4d, 3a and 2k. At least 91.8% were co-infected with HIV. HCV re-infection was evidenced for 24.7% of patients and STIs for 20.0% of patients. Twenty-two transmission chains were identified, including 52 acute hepatitis C (11 pairs and 11 clusters from three to seven patients).

CONCLUSIONS

These results revealed strong clustering of acute HCV infections. Thus, rapid treatment of both chronic and acute infections is needed among this population to decrease the prevalence of HCV, in combination with preventive behavioural interventions.

摘要

背景

近年来，男男性行为人群（MSM）中人类免疫缺陷病毒（HIV）阳性者的丙型肝炎病毒（HCV）感染发病率不断上升。对急性 HCV 感染进行系统发育分析，以描述巴黎流行期间的动态，并评估相关的性传播感染（STIs）。

方法

对聚合酶基因进行 Sanger 测序。使用 FastTree 2.1 在 GTR+CAT 模型下重建最大似然系统发育树。传播链定义为分支概率≥0.80 且聚类内遗传距离<0.02 个核苷酸取代/位的聚类。将 HCV 诊断前≤1 个月检测到的 STIs 视为相关感染。

结果

在所研究的 85 例患者中，至少 81.2%为 MSM。分别有 47.6%、39.0%、11.0%和 2.4%感染了 1a、4d、3a 和 2k 基因型。至少 91.8%的患者同时感染了 HIV。24.7%的患者出现 HCV 再感染，20.0%的患者出现 STIs。共鉴定出 22 条传播链，包括 52 例急性丙型肝炎（11 对和 11 个从三个到七个患者的聚类）。