Matthew J. Akiyama , Yury Khudyakov , Sumathi Ramachandran , Lindsey R. Riback , Maxwell Ackerman , Mercy Nyakowa , Leonard Arthur , John Lizcano , Josephine Walker , Peter Cherutich , Ann Kurth
{"title":"Widespread hepatitis C virus transmission network among people who inject drugs in Kenya","authors":"Matthew J. Akiyama , Yury Khudyakov , Sumathi Ramachandran , Lindsey R. Riback , Maxwell Ackerman , Mercy Nyakowa , Leonard Arthur , John Lizcano , Josephine Walker , Peter Cherutich , Ann Kurth","doi":"10.1016/j.ijid.2024.107215","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>Hepatitis C virus (HCV) disproportionately affects people who inject drugs (PWID) worldwide. Despite carrying a high HCV burden, little is known about transmission dynamics in low- and middle-income countries.</p></div><div><h3>Methods</h3><p>We recruited PWID from Nairobi and coastal cities of Mombasa, Kilifi, and Malindi in Kenya at needle and syringe programs. Next-generation sequencing data from HCV hypervariable region 1 were analyzed using Global Hepatitis Outbreak and Surveillance Technology to identify transmission clusters.</p></div><div><h3>Results</h3><p>HCV strains belonged to genotype 1a (n = 64, 46.0%) and 4a (n = 72, 51.8%) and were mixed HCV/1a/4a (n = 3, 2.2%). HCV/1a was dominant (61.2%) in Nairobi, whereas HCV/4a was dominant in Malindi (85.7%) and Kilifi (60.9%), and both genotypes were evenly identified in Mombasa (45.3% for HCV/1a and 50.9% for HCV/4a). Global Hepatitis Outbreak and Surveillance Technology identified 11 transmission clusters involving 90 cases. Strains in the two largest clusters (n = 38 predominantly HCV/4a and n = 32 HCV/1a) were sampled from all four cities.</p></div><div><h3>Conclusions</h3><p>Transmission clusters involving 64.7% of cases indicate an effective sampling of major HCV strains circulating among PWID. Large clusters involving 77.8% of strains from Nairobi and Coast suggest successful introduction of two ancestral HCV/1a and HCV/4a strains to PWID, with widely spread progeny. The disruption of the country-wide transmission network is essential for HCV elimination.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"147 ","pages":"Article 107215"},"PeriodicalIF":4.8000,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002868/pdfft?md5=d5b933ca9ff3e33169f89f87934f5697&pid=1-s2.0-S1201971224002868-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1201971224002868","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
Hepatitis C virus (HCV) disproportionately affects people who inject drugs (PWID) worldwide. Despite carrying a high HCV burden, little is known about transmission dynamics in low- and middle-income countries.
Methods
We recruited PWID from Nairobi and coastal cities of Mombasa, Kilifi, and Malindi in Kenya at needle and syringe programs. Next-generation sequencing data from HCV hypervariable region 1 were analyzed using Global Hepatitis Outbreak and Surveillance Technology to identify transmission clusters.
Results
HCV strains belonged to genotype 1a (n = 64, 46.0%) and 4a (n = 72, 51.8%) and were mixed HCV/1a/4a (n = 3, 2.2%). HCV/1a was dominant (61.2%) in Nairobi, whereas HCV/4a was dominant in Malindi (85.7%) and Kilifi (60.9%), and both genotypes were evenly identified in Mombasa (45.3% for HCV/1a and 50.9% for HCV/4a). Global Hepatitis Outbreak and Surveillance Technology identified 11 transmission clusters involving 90 cases. Strains in the two largest clusters (n = 38 predominantly HCV/4a and n = 32 HCV/1a) were sampled from all four cities.
Conclusions
Transmission clusters involving 64.7% of cases indicate an effective sampling of major HCV strains circulating among PWID. Large clusters involving 77.8% of strains from Nairobi and Coast suggest successful introduction of two ancestral HCV/1a and HCV/4a strains to PWID, with widely spread progeny. The disruption of the country-wide transmission network is essential for HCV elimination.
期刊介绍:
International Journal of Infectious Diseases (IJID)
Publisher: International Society for Infectious Diseases
Publication Frequency: Monthly
Type: Peer-reviewed, Open Access
Scope:
Publishes original clinical and laboratory-based research.
Reports clinical trials, reviews, and some case reports.
Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases.
Emphasizes diseases common in under-resourced countries.