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HIV-1 and hepatitis C virus selection bottleneck in Chinese people who inject drugs
1State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing.
Insights
Multivariant transmission (MVT) of human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) is frequent in people who inject drugs (PWID), indicating a less stringent parenteral transmission process compared to sexual transmission.
Area of Science:
- Virology
- Infectious Diseases
- Public Health
Background:
- Assessing transmission stringency for HIV-1 and HCV is a scientific priority.
- Sexual transmission of HIV-1 shows a strict bottleneck, while HCV shows a wide range in infection multiplicity.
- Parenteral transmission in people who inject drugs (PWID) requires further stringency assessment.
Purpose of the Study:
- To determine the stringency of parenteral transmission for HIV-1 and HCV in PWID.
- To enumerate transmitted/founder (TF) HIV-1 and HCV variants in a PWID cohort.
- To identify correlates of multivariant transmission (MVT) in this population.
Main Methods:
- Single genome sequencing of HIV-1 env and HCV 5' half genomes.
- Phylogenetic analysis and early virus diversification models to enumerate TF viruses.
- Multivariate analysis to determine correlates of MVT in 60 PWID.
Main Results:
- Identified MVT rates of 39% for HIV-1 and 54% for HCV in Xinjiang PWID.
- Observed a limited range in the number of TF viruses for both infections.
- Found no association between specific behaviors and MVT, despite indications of high-risk injection practices.
Conclusions:
- MVT is frequent in parenteral HIV-1 and HCV transmission among PWID in Xinjiang.
- Parenteral transmission of these viruses is less stringent than sexual transmission.
- Findings highlight the need for targeted interventions in PWID populations.
Objectives:
For both HIV-1 and hepatitis C virus (HCV), assessing the stringency of the transmission process is a scientific priority. Enumerations of transmitted/founder (TF) viruses have shown a strict transmission bottleneck in sexual transmission of HIV-1 and a wide range in the multiplicity of infection in HCV. Here, we aim to determine the stringency of parenteral transmission for HIV-1 and HCV in people who inject drugs (PWID).
Design:
We used molecular sequencing and several complementary analyses to enumerate the TF HIV-1 and HCV variants in a well described cohort of PWID in Xinjiang, China.
Methods:
We performed single genome sequencing of HIV-1 env and 5' half HCV genomes, then applied phylogenetic analysis and validated models of early virus diversification to enumerate TF viruses in 60 PWID. We used multivariate analysis to determine correlates of multivariant transmission (MVT).
Results:
We generated 1070 env region sequences from 33 HIV-1 early infected individuals and 773 5' half region sequences from 27 HCV early infected individuals. We found rates of MVT of 39 and 54%, respectively, for HIV-1 and HCV, with a limited range in the number of TF viruses in both infections. Behavioural characteristics suggested high-risk injection practices and lower risk sexual practices; we did not find an association between any specific behaviours and MVT.
Conclusion:
MVT is frequent in parenteral transmission of both HIV-1 and HCV in Xinjiang PWID, indicating a less stringent transmission process than sexual transmission.
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