A Phylogenetic Analysis of Hepatitis C Virus Transmission, Relapse, and Reinfection Among People Who Inject Drugs Receiving Opioid Agonist Therapy

Matthew J. Akiyama, Daniel Lipsey, Lilia Ganova-Raeva, Lili T. Punkova, Linda Agyemang, Amanda Sue, Sumathi Ramachandran, Yury Khudyakov, Alain H. Litwin

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Understanding hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is essential for HCV elimination. We aimed to differentiate reinfections from treatment failures and to identify transmission linkages and associated factors in a cohort of PWID receiving opioid agonist therapy (OAT). METHODS: We analyzed baseline and follow-up specimens from 150 PWID from 3 OAT clinics in the Bronx, New York. Next-generation sequencing data from the hypervariable region 1 of HCV were analyzed using Global Hepatitis Outbreak and Surveillance Technology. RESULTS: There were 3 transmission linkages between study participants. Sustained virologic response (SVR) was not achieved in 9 participants: 7 had follow-up specimens with similar sequences to baseline, and 2 died. In 4 additional participants, SVR was achieved but the participants were viremic at later follow-up: 2 were reinfected with different strains, 1 had a late treatment failure, and 1 was transiently viremic 17 months after treatment. All transmission linkages were from the same OAT clinic and involved spousal or common-law partnerships. CONCLUSION: This study highlights the use of next-generation sequencing as an important tool for identifying viral transmission and to help distinguish relapse and reinfection among PWID. Results reinforce the need for harm reduction interventions among couples and those who report ongoing risk factors after SVR.

Original languageEnglish (US)
Pages (from-to)488-498
Number of pages11
JournalThe Journal of infectious diseases
Volume222
Issue number3
DOIs
StatePublished - Jul 6 2020

Keywords

  • HCV
  • hepatitis C
  • IDU
  • next generation sequencing
  • OAT
  • phylogenetic
  • PWID
  • transmission network

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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