Clustering of HCV coinfections on HIV phylogeny indicates domestic and sexual transmission of HCV

• Published in: International journal of epidemiology Vol. 43; no. 3; pp. 887 - 896
• Main Authors: KOUYOS, Roger D, RAUCH, Andri, BATTEGAY, Manuel, VERNAZZA, Pietro L, BERNASCONI, Enos, LEDERGERBER, Bruno, GÜNTHARD, Huldrych F, BÖNI, Jürg, YERLY, Sabine, SHAH, Cyril, AUBERT, Vincent, KLIMKAIT, Thomas, KOVARI, Helen, CALMY, Alexandra, CAVASSINI, Matthias
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.06.2014
• Subjects: Biological and medical sciences; Codon; Cohort Studies; Coinfection - epidemiology; Coinfection - genetics; Coinfection - transmission; Epidemiology. Vaccinations; Female; General aspects; Hepacivirus - genetics; Hepatitis C - epidemiology; Hepatitis C - genetics; Hepatitis C - transmission; HIV Infections - epidemiology; HIV Infections - genetics; HIV Infections - transmission; HIV-1 - genetics; Homosexuality, Male - statistics & numerical data; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Miscellaneous; Molecular Epidemiology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral - genetics; Substance Abuse, Intravenous - epidemiology; Switzerland; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Switzerland; Europe; Human; Immunopathology; sexual transmission of HCV; Mixed infection; HIV-HCV coinfection; Retroviridae; Genotype; AIDS; Phylogeny; genotypic resistance testing; Medical screening; Immune deficiency; Lentivirus; Infection; Virus; Sexually transmitted disease; Viral disease; Molecular epidemiology; Human immunodeficiency virus; Flaviviridae; Hepatitis C virus; Hepacivirus; Public health; molecular epidemiology
• ISSN: 0300-5771; 1464-3685
• DOI: 10.1093/ije/dyt276

HCV coinfection remains a major cause of morbidity and mortality among HIV-infected individuals and its incidence has increased dramatically in HIV-infected men who have sex with men(MSM). Hepatitis C virus (HCV) coinfection in the Swiss HIV Cohort Study(SHCS) was studied by combining clinical data with HIV-1 pol-sequences from the SHCS Drug Resistance Database(DRDB). We inferred maximum-likelihood phylogenetic trees, determined Swiss HIV-transmission pairs as monophyletic patient pairs, and then considered the distribution of HCV on those pairs. Among the 9748 patients in the SHCS-DRDB with known HCV status, 2768(28%) were HCV-positive. Focusing on subtype B(7644 patients), we identified 1555 potential HIV-1 transmission pairs. There, we found that, even after controlling for transmission group, calendar year, age and sex, the odds for an HCV coinfection were increased by an odds ratio (OR) of 3.2 [95% confidence interval (CI) 2.2, 4.7) if a patient clustered with another HCV-positive case. This strong association persisted if transmission groups of intravenous drug users (IDUs), MSMs and heterosexuals (HETs) were considered separately(in all cases OR>2). Finally we found that HCV incidence was increased by a hazard ratio of 2.1 (1.1, 3.8) for individuals paired with an HCV-positive partner. Patients whose HIV virus is closely related to the HIV virus of HIV/HCV-coinfected patients have a higher risk for carrying or acquiring HCV themselves. This indicates the occurrence of domestic and sexual HCV transmission and allows the identification of patients with a high HCV-infection risk.