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Molecular surveillance of hepatitis C virus genotypes identifies the emergence of a genotype 4d lineage among men in Quebec, 2001-2017.

Authors
  • Murphy, D G1
  • Dion, R1, 2
  • Simard, M3
  • Vachon, M L4
  • Martel-Laferrière, V5
  • Serhir, B1
  • Longtin, J1
  • 1 Institut national de santé publique du Québec, Laboratoire de santé publique du Québec, Sainte-Anne-de-Bellevue, QC.
  • 2 École de santé publique de l'Université de Montréal, Département de médecine sociale et préventive, Montréal, QC.
  • 3 Institut national de santé publique du Québec, Bureau d'information et d'études en santé des populations, Québec, QC.
  • 4 Centre hospitalier de l'Université Laval, Québec, QC.
  • 5 Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC.
Type
Published Article
Journal
Canada communicable disease report = Releve des maladies transmissibles au Canada
Publication Date
Sep 05, 2019
Volume
45
Issue
9
Pages
230–237
Identifiers
DOI: 10.14745/ccdr.v45i09a02
PMID: 31650986
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Molecular phylogenetics are generally used to confirm hepatitis C virus (HCV) transmission events. In addition, the Laboratoire de santé publique du Québec (LSPQ) has been using molecular phylogenetics for surveillance of HCV genotyping since November 2001. To describe the emergence of a specific lineage of HCV genotype 4d (G4d) and its characteristics using molecular phylogenetics as a surveillance tool for identifying HCV strain clustering. The LSPQ prospectively applied Sanger sequencing and phylogenetic analysis to determine the HCV genotype on samples collected from November 2001 to December 2017. When a major G4d cluster was identified, demographic information, HIV-infection status and syphilis test results were analyzed. Phylogenetic analyses performed on approximately 22,000 cases identified 122 G4d cases. One major G4d cluster composed of 37 cases was singled out. Two cases were identified in 2010, 10 from 2011-2014 and 25 from 2015-2017. Cases in the cluster were concentrated in two urban health regions. Compared to the other G4d cases, cluster cases were all male (p<0.001) and more likely to be HIV-positive (adjusted risk ratio: 4.4; 95% confidence interval: 2.5-7.9). A positive syphilis test result was observed for 27 (73%) of the cluster cases. The sequences in this cluster and of four outlier cases were located on the same monophyletic lineage as G4d sequences reported in HIV-positive men who have sex with men (MSM) in Europe. Molecular phylogenetics enabled the identification and surveillance of ongoing transmission of a specific HCV G4d lineage in HIV-positive and HIV-negative men in Quebec and its cross-continental spread. This information can orient intervention strategies to avoid transmission of HCV in MSM.

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