Widespread hepatitis C virus transmission network among people who inject drugs in Kenya

作者：Matthew J. Akiyama, Yury Khudyakov, Sumathi Ramachandran, Lindsey Riback, Maxwell Ackerman, Mercy Nyakowa, Leonard Arthur, John Lizcano, Josephine G. Walker, Peter Cherutich, Ann Kurth · 发表于：International Journal of Infectious Diseases · 年份：2024 · DOI：10.1016/j.ijid.2024.107215 · 被引用次数：4 · 研究领域：Hepatitis C virus research、HIV, Drug Use, Sexual Risk、Hepatitis B Virus Studies

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 and towns 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%), 4a (n = 72, 51.8%) and 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 sites. 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 clustered strains from Nairobi and Coast suggest successful introduction of two ancestral HCV/1a and HCV/4a strains to PWID and the existence of a widespread transmission network in the country. The disruption of this network is essential for HCV e...