ArticleEBioMedicine2018
A large HCV transmission network enabled a fast-growing HIV outbreak in rural Indiana, 2015.
Article in EBioMedicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.
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47 citing papers in PubMed, 71 citations in OpenAlex.
- Comparison of persons who died of drug overdoses with and without evidence of hepatitis C, United States, 2019-2024.Drug and alcohol dependence · 2026Article
- Informing the Equitable Implementation of Hepatitis C Interventions: Cost-Effectiveness Modeling in Rural Populations of People Who Inject Drugs.PharmacoEconomics · 2026Article
- Single cell RNA transcriptome response to fentanyl use in persons with HIV infection.Scientific reports · 2026Article
- Analysis of genetic evolution and molecular transmission of hepatitis C virus in key areas of the southeast coast of China.Frontiers in public health · 2026Article
- Leveraging injection networks to prevent HIV and other blood borne infections among people who inject drugs in Kenya: design and rationale.BMC infectious diseases · 2025Article
- Genomic surveillance uncovers regional variation in HCV transmission networks in rural United States.Nature communications · 2025Article
- HCV genotyping and rational computational designing of an immunogenic multiepitope vaccine against genotype 3a.Journal of computer-aided molecular design · 2025Article
- Modeling the impact of changing drug markets and structural determinants on HCV and/or HIV transmission among people who inject drugs in the United States: A rural and urban comparison.The International journal on drug policy · 2025Article
- A graph homomorphism approach for unraveling histories of metastatic cancers and viral outbreaks under evolutionary constraints.Nature communications · 2025Article
- Strategies and Opportunities to Improve Community Health through Advanced Molecular Detection and Genomic Surveillance of Infectious Diseases.Emerging infectious diseases · 2025Article
- Phylodynamics analysis of HIV epidemic history in Belarus in 1987-2022.Frontiers in epidemiology · 2025Article
- Widespread hepatitis C virus transmission network among people who inject drugs in Kenya.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024Article
- Transmission network of Hepatitis C virus subtype 2a in Huazhou County, Shaanxi Province, China.BMC infectious diseases · 2024Article
- Trends in hepatitis C virus seroprevalence and associated risk factors among msm in Pakistan: insights from a community-based study.Scientific reports · 2024Article
- Hepatitis C virus subtype diversity and transmission clusters characteristics among drug users in Zhuhai, South China.BMC infectious diseases · 2024Article
- Hepatitis C Virus-HIV Coinfection in the United States Among People Who Inject Drugs: Data Needed for Ending Dual Epidemics.Public health reports (Washington, D.C. : 1974) · 2023Review
- Hepatitis C Virus Infection Preceding an Outbreak of Human Immunodeficiency Virus Among Persons Who Inject Drugs-Kanawha County, West Virginia, 2019-2021.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Application of machine learning algorithms for localized syringe services program policy implementation - Florida, 2017.Annals of medicine · 2022Article
- SOPHIE: Viral outbreak investigation and transmission history reconstruction in a joint phylogenetic and network theory framework.Cell systems · 2022Article
- PrEP Indications and PrEP Knowledge, Access, and Interest Among Individuals With HCV.Open forum infectious diseases · 2022Article
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Authors and funding
18 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA high prevalence (92.3%) of hepatitis C virus (HCV) co-infection among HIV patients identified during a large HIV outbreak associated with injection of oxymorphone in Indiana prompted genetic analysis of HCV strains.
methodsMolecular epidemiological analysis of HCV-positive samples included genotyping, sampling intra-host HVR1 variants by next-generation sequencing (NGS) and constructing transmission networks using Global Hepatitis Outbreak and Surveillance Technology (GHOST).
findingsResults from the 492 samples indicate predominance of HCV genotypes 1a (72.2%) and 3a (20.4%), and existence of 2 major endemic NS5B clusters involving 49.8% of the sequenced strains. Among 76 HIV co-infected patients, 60.5% segregated into 2 endemic clusters. NGS analyses of 281 cases identified 826,917 unique HVR1 sequences and 51 cases of mixed subtype/genotype infections. GHOST mapped 23 transmission clusters. One large cluster (n = 130) included 50 cases infected with ≥2 subtypes/genotypes and 43 cases co-infected with HIV. Rapid strain replacement and superinfection with different strains were found among 7 of 12 cases who were followed up.
interpretationGHOST enabled mapping of HCV transmission networks among persons who inject drugs (PWID). Findings of numerous transmission clusters, mixed-genotype infections and rapid succession of infections with different HCV strains indicate a high rate of HCV spread. Co-localization of HIV co-infected patients in the major HCV clusters suggests that HIV dissemination was enabled by existing HCV transmission networks that likely perpetuated HCV in the community for years. Identification of transmission networks is an important step to guiding efficient public health interventions for preventing and interrupting HCV and HIV transmission among PWID. FUND: US Centers for Disease Control and Prevention, and US state and local public health departments.
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