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Shared HCV transmission networks among HIV-1 positive and
HIV-1 negative men having sex with men in Paris

  Reported by Jules Levin
IAC Amsterdam July 23-27 2018
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Thuy Nguyen
T. Nguyen1, C. Delaugerre2,3, M.-A. Valatin4, E. Netzer5, P.-M. Girard6, N. Day7, G. Kreplak7, G. Pialoux8, J.-M. Molina3,9, V. Calvez1, A.-G. Marcelin1, E. Todesco1
1Sorbonne Universite, INSERM, Institut Pierre Louis d'Epidemiologie et de Sante Publique (iPLESP), AP-HP, Hopital Pitie-Salpetriere, Laboratoire de Virologie, Paris, France, 2Saint-Louis, Assistance Publique Hopitaux de Paris, Paris, France, 3INSERM UMR 941, Universite de Paris Diderot, Sorbonne Paris Cite, Paris, France, 4Sorbonne Universite, INSERM, Institut Pierre Louis d'Epidemiologie et de Sante Publique (iPLESP), AP-HP, Hopital Pitie-Salpetriere, Services de Maladies Infectieuses et Tropicales, Paris, France, 5INSERM SC10, Villejuif, France, 6Saint-Antoine Hospital, Assistance Publique-Hopitaux de Paris, Paris, France, 7Cerballiance Laboratory, Paris, France, 8Hopital Tenon, APHP, Universite Pierre et Marie Curie, Department of Infectious Diseases, Paris, France, 9Maladies Infectieuse, Hopital Saint-Louis, Assistance Publique Hopitaux de Paris, Paris, France
Infection of acute hepatitis C (AHC) among men having sex with men (MSM) has become an outbreak in several high-income countries from 2000. Several studies reported existence of specific HCV transmission network among MSM communities in Europe and especially a spread of HCV strains from HIV-HCV co-infected MSM toward HCV mono-infected MSM. We aimed to characterize HCV transmission clusters in HIV positive and HIV negative MSM communities in Parisian region by ultra-deep sequencing (UDS).
Methods: Illumina (Miseq) deep-sequencing of NS5B fragment was performed on plasma samples of 50 AHC HIV-positive and 18 AHC HIV-negative individuals including 13 from the Prep IPERGAY ANRS study. UDS data were analysed by Geneious (version 10.1.3). Phylogenetic trees were realized using Fasttree 2.1 and local support value of > 80% was chosen to define a robust tree. Trees were submitted to ClusterPicker (version 1.2.3) to determine transmission cluster at different thresholds of maximum genetic distance (MGD). We compared results of Sanger at 3%, UDS at 3%, and at 4.5% of MGD.
Results: Of 68 acute hepatitis C patients, 15 were cases of recontamination. HCV genotyping showed genotype 1a (47%), 4d (41%), 3a (9%), and 2k (3%). Sanger at 3%, UDS at 3% and at 4.5% of MGD allowed detection of 10, 17, and 18 clusters, respectively. By UDS, more clusters were detected but fewer subjects (median: 2 subjects) were identified within each cluster than Sanger did (median: 3 subjects). Furthermore, mixed clusters including HIV-positive and HIV-negative MSM were observed in 8/10 clusters by Sanger, in 10/17 by UDS at 3%, and in 10/18 by UDS at 4.5% of MGD. Overall, the number of HIV-negative individuals clustering with HIV-positive ones was 8/18 by Sanger, 8/18 by UDS at 3%, and 9/18 by UDS at 4.5% of MGD.
Conclusions: By Sanger or UDS, our study allowed the detection of HCV transmission clusters in MSM communities in Parisian region. Particularly in this population, the HIV-positive MSM shared the HCV transmission network with HIV-negative MSM, which in turn alerts the public health for surveillance and prevention measures in these communities, regardless of their HIV status.