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Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals

Background: In the Netherlands, unrestricted access to direct-acting antivirals (DAAs) halved the incidence of acute hepatitis C virus (HCV) infections among HIV-infected men who have sex with men (MSM). To develop strategies that can further reduce the spread of HCV, it is important to understand t...

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Autores principales: Popping, Stephanie, Cuypers, Lize, Claassen, Mark A. A., van den Berk, Guido E., De Weggheleire, Anja, Arends, Joop E., Boerekamps, Anne, Molenkamp, Richard, Koopmans, Marion P. G., Verbon, Annelies, Boucher, Charles A. B., Rijnders, Bart, van de Vijver, David A. M. C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9502248/
https://www.ncbi.nlm.nih.gov/pubmed/36146760
http://dx.doi.org/10.3390/v14091953
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author Popping, Stephanie
Cuypers, Lize
Claassen, Mark A. A.
van den Berk, Guido E.
De Weggheleire, Anja
Arends, Joop E.
Boerekamps, Anne
Molenkamp, Richard
Koopmans, Marion P. G.
Verbon, Annelies
Boucher, Charles A. B.
Rijnders, Bart
van de Vijver, David A. M. C.
author_facet Popping, Stephanie
Cuypers, Lize
Claassen, Mark A. A.
van den Berk, Guido E.
De Weggheleire, Anja
Arends, Joop E.
Boerekamps, Anne
Molenkamp, Richard
Koopmans, Marion P. G.
Verbon, Annelies
Boucher, Charles A. B.
Rijnders, Bart
van de Vijver, David A. M. C.
author_sort Popping, Stephanie
collection PubMed
description Background: In the Netherlands, unrestricted access to direct-acting antivirals (DAAs) halved the incidence of acute hepatitis C virus (HCV) infections among HIV-infected men who have sex with men (MSM). To develop strategies that can further reduce the spread of HCV, it is important to understand the transmission dynamics of HCV. We used phylogenetic analysis of a dense sample of MSM to provide insight into the impact of unrestricted access to DAAs on HCV transmission in the Netherlands and in Belgium. Methods: We included 89 MSM that were recently infected with HCV genotype 1a in ten Dutch and one Belgian HIV treatment centers. Sequences were generated using next gene sequencing and Sanger sequencing. Maximum likelihood phylogenetic analysis (general time reversible model) was performed on concatenated NS5A and NS5B sequences and a reference set of 389 highly similar control sequences selected from GenBank. A cluster was based on a minimum bootstrap support of 90% and a 3% genetic distance threshold. Results: We found that 78 (88%) of individuals were part of seven major clusters. All clusters included individuals from across the study region, however, different cities were part of different clusters. In three clusters, HIV-negative MSM clustered with sequences from HIV-positive MSM. All clusters that were observed before the introduction of DAAs persisted after unrestricted access to DAAs became available. Conclusion: Recently acquired HCV infections among MSM in the Netherlands and Belgium are strongly clustered and therefore highly suitable for targeted prevention strategies, such as contact tracing and partner notification. Importantly, despite an HCV incidence reduction after high DAA uptake and continuously monitoring, HCV transmission persisted in the same clusters.
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spelling pubmed-95022482022-09-24 Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals Popping, Stephanie Cuypers, Lize Claassen, Mark A. A. van den Berk, Guido E. De Weggheleire, Anja Arends, Joop E. Boerekamps, Anne Molenkamp, Richard Koopmans, Marion P. G. Verbon, Annelies Boucher, Charles A. B. Rijnders, Bart van de Vijver, David A. M. C. Viruses Article Background: In the Netherlands, unrestricted access to direct-acting antivirals (DAAs) halved the incidence of acute hepatitis C virus (HCV) infections among HIV-infected men who have sex with men (MSM). To develop strategies that can further reduce the spread of HCV, it is important to understand the transmission dynamics of HCV. We used phylogenetic analysis of a dense sample of MSM to provide insight into the impact of unrestricted access to DAAs on HCV transmission in the Netherlands and in Belgium. Methods: We included 89 MSM that were recently infected with HCV genotype 1a in ten Dutch and one Belgian HIV treatment centers. Sequences were generated using next gene sequencing and Sanger sequencing. Maximum likelihood phylogenetic analysis (general time reversible model) was performed on concatenated NS5A and NS5B sequences and a reference set of 389 highly similar control sequences selected from GenBank. A cluster was based on a minimum bootstrap support of 90% and a 3% genetic distance threshold. Results: We found that 78 (88%) of individuals were part of seven major clusters. All clusters included individuals from across the study region, however, different cities were part of different clusters. In three clusters, HIV-negative MSM clustered with sequences from HIV-positive MSM. All clusters that were observed before the introduction of DAAs persisted after unrestricted access to DAAs became available. Conclusion: Recently acquired HCV infections among MSM in the Netherlands and Belgium are strongly clustered and therefore highly suitable for targeted prevention strategies, such as contact tracing and partner notification. Importantly, despite an HCV incidence reduction after high DAA uptake and continuously monitoring, HCV transmission persisted in the same clusters. MDPI 2022-09-02 /pmc/articles/PMC9502248/ /pubmed/36146760 http://dx.doi.org/10.3390/v14091953 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Popping, Stephanie
Cuypers, Lize
Claassen, Mark A. A.
van den Berk, Guido E.
De Weggheleire, Anja
Arends, Joop E.
Boerekamps, Anne
Molenkamp, Richard
Koopmans, Marion P. G.
Verbon, Annelies
Boucher, Charles A. B.
Rijnders, Bart
van de Vijver, David A. M. C.
Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals
title Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals
title_full Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals
title_fullStr Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals
title_full_unstemmed Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals
title_short Persistent Transmission of HCV among Men Who Have Sex with Men despite Widespread Screening and Treatment with Direct-Acting Antivirals
title_sort persistent transmission of hcv among men who have sex with men despite widespread screening and treatment with direct-acting antivirals
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9502248/
https://www.ncbi.nlm.nih.gov/pubmed/36146760
http://dx.doi.org/10.3390/v14091953
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