未经授权:在努力消除艾滋病毒感染者中的丙型肝炎病毒(HCV)感染,了解HCV传播模式可以为指导和评估干预措施提供见解。在这项研究中,我们评估了,在直接作用抗病毒时代,澳大利亚HIV/HCV共感染人群中与HCV系统发育聚集相关的因素。
UNASSIGNED:在CEASE队列研究中,从2014年至2018年收集的干血斑(DBS)样品中提取HCVRNA。通过聚合酶链反应扩增HCVCore-E2区并进行Sanger测序。使用最大似然系统发育树(1000个自举重复)来识别聚类模式(3%遗传距离阈值)。混合效应逻辑回归用于确定系统发育聚类的相关性。评估的因素是性危险行为,教育,注射吸毒,住房,employment,HIV病毒载量,年龄,性别,和性。
未经证实:为HCV亚型1a(n=139)和3a(n=63)序列重建了系统发育树,29%(58/202)在一对或一组中。总的来说(n=202),系统发育聚类与年龄较小(40岁以下;调整比值比[aOR]2.52,95%置信区间[CI]1.20-5.29)正相关,在同性恋和双性恋男性中(n=168),与年龄较小呈正相关(aOR2.61,95%CI1.10-6.19),高等教育(AOR2.58,95%CI1.09-6.13),并报告高危性行为(aOR3.94,95%CI1.31-11.84)。随访期间,观察到五次再感染,但没有一个是系统发育簇.
未经证实:这项研究发现了很大比例的系统发育亲缘关系,主要在年轻人和同性恋和双性恋男性报告高风险的性行为。尽管如此,很少观察到再感染,和再感染表明与已知的集群没有什么关系。这些发现强调了快速开始HCV治疗的重要性,以及系统发育的监测。
UNASSIGNED: In moving towards the elimination of hepatitis C virus (HCV) infection among people living with HIV, understanding HCV transmission patterns may provide insights to guide and evaluate interventions. In this study, we evaluated patterns of, and factors associated with HCV phylogenetic clustering among people living with HIV/HCV co-infection in Australia in the direct-acting antiviral era.
UNASSIGNED: HCV RNA was extracted from dried blood spot (DBS) samples collected between 2014 and 2018 in the CEASE cohort study. The HCV Core-E2 region was amplified by a polymerase chain reaction and Sanger sequenced. Maximum likelihood phylogenetic trees (1000 bootstrap replicates) were used to identify patterns of clustering (3% genetic distance threshold). Mixed-effects logistic regression was used to determine correlates of phylogenetic clustering. Factors assessed were sexual risk behavior, education, injecting drug use, housing, employment, HIV viral load, age, sex, and sexuality.
UNASSIGNED: Phylogenetic trees were reconstructed for HCV subtype 1a (n = 139) and 3a (n = 63) sequences, with 29% (58/202) in a pair or cluster. Overall (n = 202), phylogenetic clustering was positively associated with younger age (under 40; adjusted odds ratio [aOR] 2.52, 95% confidence interval [CI] 1.20-5.29), and among gay and bisexual men (n = 168), was positively associated with younger age (aOR 2.61, 95% CI 1.10-6.19), higher education (aOR 2.58, 95% CI 1.09-6.13), and reporting high-risk sexual behavior (aOR 3.94, 95% CI 1.31-11.84). During follow-up, five reinfections were observed, but none were in phylogenetic clusters.
UNASSIGNED: This study found a high proportion of phylogenetic relatedness, predominantly among younger people and gay and bisexual men reporting high-risk sexual behavior. Despite this, few reinfections were observed, and reinfections demonstrated little relationship with known clusters. These findings highlight the importance of rapid HCV treatment initiation, together with monitoring of the phylogeny.