Hepatitis C virus phylogenetic clustering is associated with the social-injecting network in a cohort of people who inject drugs

PLoS One. 2012;7(10):e47335. doi: 10.1371/journal.pone.0047335. Epub 2012 Oct 26.

Abstract

It is hypothesized that social networks facilitate transmission of the hepatitis C virus (HCV). We tested for association between HCV phylogeny and reported injecting relationships using longitudinal data from a social network design study. People who inject drugs were recruited from street drug markets in Melbourne, Australia. Interviews and blood tests took place three monthly (during 2005-2008), with participants asked to nominate up to five injecting partners at each interview. The HCV core region of individual isolates was then sequenced and phylogenetic trees were constructed. Genetic clusters were identified using bootstrapping (cut-off: 70%). An adjusted Jaccard similarity coefficient was used to measure the association between the reported injecting relationships and relationships defined by clustering in the phylogenetic analysis (statistical significance assessed using the quadratic assignment procedure). 402 participants consented to participate; 244 HCV infections were observed in 238 individuals. 26 genetic clusters were identified, with 2-7 infections per cluster. Newly acquired infection (AOR = 2.03, 95% CI: 1.04-3.96, p = 0.037, and HCV genotype 3 (vs. genotype 1, AOR = 2.72, 95% CI: 1.48-4.99) were independent predictors of being in a cluster. 54% of participants whose infections were part of a cluster in the phylogenetic analysis reported injecting with at least one other participant in that cluster during the study. Overall, 16% of participants who were infected at study entry and 40% of participants with newly acquired infections had molecular evidence of related infections with at least one injecting partner. Likely transmission clusters identified in phylogenetic analysis correlated with reported injecting relationships (adjusted Jaccard coefficient: 0.300; p<0.001). This is the first study to show that HCV phylogeny is associated with the injecting network, highlighting the importance of the injecting network in HCV transmission.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Genotype
  • Hepacivirus / classification
  • Hepacivirus / genetics*
  • Hepatitis C / transmission
  • Humans
  • Male
  • Phylogeny
  • Risk Factors
  • Substance Abuse, Intravenous / virology*
  • Young Adult

Grants and funding

This work was supported by Australia's National Health and Medical Research Council [project grant 331312, postgraduate scholarship to RSD, training fellowship to PH, Senior Research Fellowship to MH, http://www.nhmrc.gov.au/]; the Victorian Department of Health [public health research grant 2008–09, http://www.health.vic.gov.au/]; the Australian Centre for HIV and Hepatitis Virology Research [ACH2, http://www.hiv.edu.au/]; the Victorian Operational Infrastructure Support Program [http://www.business.vic.gov.au/BUSVIC/STANDARD/PC_60698.html]; the Burnet Institute [http://www.burnet.edu.au]; the Centre for Research Excellence into Injecting Drug Use [top-up postgraduate scholarship to RSD, http://www.creidu.edu.au]; and the Australian Research Council [Discovery project grant 0987730, http://www.arc.gov.au/ncgp/dp/dp_default.htm]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.