Federal University of Mato Grosso do Sul, Avenida Senador Filinto Mueller, s/n, Laboratório de Imunologia Clínica, FACFAN, Campo Grande, MS 79070-900, Brazil.
Centers for Disease Control and Prevention, 1600, Clifton Road NE, BlDG 18 MS-A33, Atlanta, GA 30330, USA.
Infect Genet Evol. 2020 Nov;85:104488. doi: 10.1016/j.meegid.2020.104488. Epub 2020 Jul 31.
In this study, the prevalence rate, associated risk factors and genetic diversity of hepatitis C virus (HCV) infection were determined among people who use crack from an international drug trafficking route in Central-West, Brazil. Blood samples were collected from 700 users of crack from Campo Grande and two border cities of Mato Grosso do Sul State and tested for HCV infection using serological and molecular testing methodologies. Anti-HCV was detected in 31/700 (4.5%, 95% CI: 2.9-6.0%) and HCV RNA in 26/31 (83.9%) of anti-HCV positive samples. Phylogenetic analysis of three HCV sub-genomic regions (5'UTR, NS5B and HVR-1) revealed the circulation of 1a (73.9%), 1b (8.7%) and 3a (17.4%) genotypes. Next-generation sequencing and phylogenetic analysis of intra-host viral populations of HCV HVR-1 showed a significant variation in intra-host genetic diversity among infected individuals, with 58.8% composed of more than one sub-population. Bayesian analysis estimated that the most recent common HCV ancestor for strains identified here was introduced to this region after 1975 following expansion of intravenous drug use in Brazil. Multivariate analyses showed that only 'ever having injected drugs' was independently associated with HCV infection. These results indicate an increasing spread of multiple HCV strains requiring public health intervention, such as harm reduction, testing services and treatment among crack users in this important border region of Central Brazil.
在这项研究中，我们确定了来自巴西中西部一条国际贩毒路线的可卡因使用者中丙型肝炎病毒（HCV）感染的流行率、相关危险因素和遗传多样性。从南马托格罗索州坎波格兰德和两个边境城市的 700 名可卡因使用者中采集血液样本，使用血清学和分子检测方法检测 HCV 感染。在 700 名可卡因使用者中，有 31 名（4.5%，95%置信区间：2.9-6.0%）抗 HCV 阳性，26 名（83.9%）抗 HCV 阳性样本中检测到 HCV RNA。对 HCV 三个亚基因组区域（5'UTR、NS5B 和 HVR-1）的三个部分进行系统进化分析，结果显示 1a（73.9%）、1b（8.7%）和 3a（17.4%）基因型在该地区流行。对 HCV HVR-1 病毒种群的下一代测序和系统进化分析显示，感染个体之间病毒遗传多样性存在显著差异，其中 58.8%由一个以上亚种群组成。贝叶斯分析估计，这里鉴定的病毒株的最近共同 HCV 祖先，是在巴西静脉吸毒扩张之后，于 1975 年之后引入该地区的。多变量分析表明，只有“曾经注射过毒品”与 HCV 感染独立相关。这些结果表明，在巴西这个重要的中部边境地区，需要采取公共卫生干预措施，如减少伤害、检测服务和治疗，以应对多种 HCV 株的传播。
