TY - JOUR
T1 - Persistent transmission of HCV among men who have sex with men despite widespread screening and treatment with direct-acting antivirals
AU - Popping, Stephanie
AU - Cuypers, Lize
AU - Claassen, Mark A. A.
AU - van den Berk, Guido E.
AU - De Weggheleire, Anja
AU - Arends, Joop E.
AU - Boerekamps, Anne
AU - Molenkamp, Richard
AU - Koopmans, Marion P. G.
AU - Verbon, Annelies
AU - Boucher, Charles A. B.
AU - Rijnders, Bart
AU - van de Vijver, David A. M. C.
N1 - FTX; DOAJ; (CC BY 4.0)
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Antiviral Agents/therapeutic use
KW - HIV Infections/drug therapy
KW - Hepacivirus/genetics
KW - Hepatitis C, Chronic/drug therapy
KW - Hepatitis C/drug therapy
KW - Homosexuality, Male
KW - Humans
KW - Male
KW - Phylogeny
KW - Sexual and Gender Minorities
U2 - 10.3390/v14091953
DO - 10.3390/v14091953
M3 - A1: Web of Science-article
C2 - 36146760
SN - 1999-4915
VL - 14
JO - Viruses-Basel
JF - Viruses-Basel
IS - 9
M1 - 1953
ER -