ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Massive Iatrogenic Outbreak of Human Immunodeficiency Virus Type 1 in Rural Cambodia, 2014-2015.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic Review of Reported HIV Outbreaks, Pakistan, 2000-2019.Emerging infectious diseases · 2021Pooled it
- Hepatitis C virus and HIV transmission: parenteral (including percutaneous) routes are still relevant and must receive due attention.Frontiers in public health · 2026Article
- Community-based versus facility-based services to improve hepatitis C screening in Cambodia: a cluster randomized controlled trial (ANRS 12384 Cam-C study).The Lancet regional health. Western Pacific · 2025Article
- HIV Drug Resistance Mutations and Subtype Profiles among Pregnant Women of Ho Chi Minh City, South Vietnam.Viruses · 2023Article
- Enhanced TLR3 responsiveness in hepatitis C virus resistant women from the Irish anti-D cohort.Cell reports. Medicine · 2022Article
- Article
- Prevalence and genotype distribution of viral hepatitis B in Cambodia between 1990 and 2020: a systematic review and meta-analysis.Archives of public health = Archives belges de sante publique · 2022Review
- Phylogenetic Analysis of Spread of Hepatitis C Virus Identified during HIV Outbreak Investigation, Unnao, India.Emerging infectious diseases · 2022Review
- Hepatitis C seroprevalence among people living with HIV/AIDS and pregnant women in four provinces in Cambodia: an integrated bio-behavioral survey.BMC infectious diseases · 2022Article
- Exploring the Evolutionary History and Phylodynamics of Human Immunodeficiency Virus Type 1 Outbreak From Unnao, India Using Phylogenetic Approach.Frontiers in microbiology · 2022Article
- Development of a risk score to guide targeted hepatitis C testing among human immunodeficiency virus patients in Cambodia.World journal of hepatology · 2021Article
- Article
- Article
- Improving injection safety practices of Cambodian healthcare workers through training.PloS one · 2020Article
- Phylogenetics applied to the human immunodeficiency virus type 1 (HIV-1): from the cross-species transmissions to the contact network inferences.Memorias do Instituto Oswaldo Cruz · 2020Article
- Regulation of nursing professionals in Cambodia and Vietnam: a review of the evolution and key influences.Human resources for health · 2019Review
- Molecular epidemiology of hepatitis C virus in Cambodia during 2016-2017.Scientific reports · 2019Observational
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26 authors.
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Abstract
Background: In 2014-2015, 242 individuals aged 2-89 years were newly diagnosed with human immunodeficiency virus type 1 (HIV-1) in Roka, a rural commune in Cambodia. A case-control study attributed the outbreak to unsafe injections. We aimed to reconstruct the likely transmission history of the outbreak. Methods: We assessed in 209 (86.4%) HIV-infected cases the presence of hepatitis C virus (HCV) and hepatitis B virus (HBV). We identified recent infections using antibody (Ab) avidity testing for HIV and HCV. We performed amplification, sequencing, and evolutionary phylogenetic analyses of viral strains. Geographical coordinates and parenteral exposure through medical services provided by an unlicensed healthcare practitioner were obtained from 193 cases and 1499 controls during interviews. Results: Cases were coinfected with HCV (78.5%) and HBV (12.9%). We identified 79 (37.8%) recent (<130 days) HIV infections. Phylogeny of 202 HIV env C2V3 sequences showed a 198-sample CRF01_AE strains cluster, with time to most recent common ancestor (tMRCA) in September 2013 (95% highest posterior density, August 2012-July 2014), and a peak of 15 infections/day in September 2014. Three geospatial HIV hotspots were discernible in Roka and correlated with high exposure to the practitioner (P = .04). Fifty-nine of 153 (38.6%) tested cases showed recent (<180 days) HCV infections. Ninety HCV NS5B sequences formed 3 main clades, 1 containing 34 subtypes 1b with tMRCA in 2012, and 2 with 51 subtypes 6e and tMRCAs in 2002-2003. Conclusions: Unsafe injections in Cambodia most likely led to an explosive iatrogenic spreading of HIV, associated with a long-standing and more genetically diverse HCV propagation.
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