Epidemic dispersion of HIV and HCV in a population of co-infected Romanian injecting drug users

PLoS One. 2017 Oct 9;12(10):e0185866. doi: 10.1371/journal.pone.0185866. eCollection 2017.

Abstract

Co-infections with HIV and HCV are very frequent among people who inject drugs (PWID). However, very few studies comparatively reconstructed the transmission patterns of both viruses in the same population. We have recruited 117 co-infected PWID during a recent HIV outbreak in Romania. Phylogenetic analyses were performed on HIV and HCV sequences in order to characterize and compare transmission dynamics of the two viruses. Three large HIV clusters (2 subtype F1 and one CRF14_BG) and thirteen smaller HCV transmission networks (genotypes 1a, 1b, 3a, 4a and 4d) were identified. Eighty (65%) patients were both in HIV and HCV transmission chains and 70 of those shared the same HIV and HCV cluster with at least one other patient. Molecular clock analysis indicated that all identified HIV clusters originated around 2006, while the origin of the different HCV clusters ranged between 1980 (genotype 1b) and 2011 (genotypes 3a and 4d). HCV infection preceded HIV infection in 80.3% of cases. Coincidental transmission of HIV and HCV was estimated to be rather low (19.65%) and associated with an outbreak among PWID during detention in the same penitentiary. This study has reconstructed and compared the dispersion of these two viruses in a PWID population.

MeSH terms

  • Adult
  • Coinfection / epidemiology
  • Coinfection / genetics
  • Coinfection / transmission*
  • Coinfection / virology
  • Disease Outbreaks
  • Drug Users
  • Female
  • Genotype
  • HIV / genetics*
  • HIV / pathogenicity
  • HIV Infections / epidemiology
  • HIV Infections / genetics
  • HIV Infections / transmission*
  • HIV Infections / virology
  • Hepacivirus / genetics*
  • Hepacivirus / pathogenicity
  • Hepatitis C / epidemiology
  • Hepatitis C / genetics
  • Hepatitis C / transmission*
  • Hepatitis C / virology
  • Humans
  • Male
  • Phylogeny
  • Romania

Grants and funding

This study was supported by the Executive Agency for Higher Education, Research, Development and Innovation Funding (http://uefiscdi.gov.ro/) grant BEST-HOPE 4- 003/2012 (DO) and project HIV-ID 260/2015 (SP). The National Authority for Scientific Research (http://research.ro/en) partially supported this work, GreenVac project, 5SEE/2014 (DO) and POSCCE program CRCBABI project (642/2014). EN was supported by National Authority for Scientific Research(ANCS), grant POSDRU/1591/1.5/S/135760-CERO. PL was supported by PhD grant of the Fonds Wetenschappelijk Onderzoek – Vlaanderen. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.