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Prevalence and Phylogenetic Characterization of Hepatitis C Virus Among Indian Men Who Have Sex With Men: Limited Evidence for Sexual Transmission.
The Journal of Infectious Diseases ( IF 6.4 ) Pub Date : 2020-05-11 , DOI: 10.1093/infdis/jiaa006
Steven J Clipman 1 , Priya Duggal 1, 2 , Aylur K Srikrishnan 3 , Shanmugam Saravanan 3 , Pachamuthu Balakrishnan 3 , Canjeevaran K Vasudevan 3 , David D Celentano 2 , David L Thomas 4 , Shruti H Mehta 2 , Sunil S Solomon 3, 4
Affiliation  

BACKGROUND Data from high-income countries suggest increasing hepatitis C virus (HCV) prevalence/incidence among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM), but limited data derive from low-and-middle-income countries. METHODS We recruited 4994 MSM from 5 states across India using respondent-driven sampling. Logistic regression incorporating respondent-driven sampling weights and machine learning feature selection were used to identify correlates of prevalent HCV, and Bayesian phylogenetic analysis was used to examine genetic clustering. RESULTS The median age was 25 years, the HIV prevalence was 7.2%, and 49.3% of participants reported recent unprotected anal intercourse. The HCV prevalence was 1.3% (95% confidence interval, 1.0%-1.6%; site range, 0.2%-3.4%) and was 3.1% in HIV-positive versus 1.1% among HIV-negative men. HCV infection was significantly associated with injection drug use (odds ratio, 177.1; 95% confidence interval, 72.7-431.5) and HIV infection (4.34; 1.88-10.05). Machine learning did not uncover any additional epidemiologic signal. Phylogenetic analysis revealed 3 clusters suggestive of linked transmission; each contained ≥1 individual reporting injection drug use. CONCLUSIONS We observed a low HCV prevalence in this large sample of MSM despite a high prevalence of known risk factors, reflecting either the need for a threshold of HCV for sexual transmission and/or variability in sexual practices across settings.

中文翻译:

与男性发生性关系的印度男性中丙型肝炎病毒的流行和系统发生特征:性传播的证据有限。

背景技术来自高收入国家的数据表明,在与男人发生性关系的男性免疫缺陷病毒(HIV)感染的男性中,丙型肝炎病毒(HCV)的患病率/发病率不断上升,但是来自中低收入国家的数据有限。方法我们采用受访者驱动的抽样方法,从印度5个州招募了4994名MSM。结合响应者驱动的抽样权重和机器学习特征选择的逻辑回归用于确定流行的HCV的相关性,贝叶斯系统发育分析用于检查遗传聚类。结果中位年龄为25岁,艾滋病毒感染率为7.2%,有49.3%的参与者报告了最近未保护的肛门性交。HCV患病率为1.3%(95%置信区间为1.0%-1.6%;位点范围为0.2%-3.4%),而HIV阳性率为3.1%。在HIV阴性男性中占1%。HCV感染与注射毒品的使用(比值比为177.1; 95%置信区间为72.7-431.5)和HIV感染(4.34; 1.88-10.05)显着相关。机器学习未发现任何其他流行病学信号。系统发育分析表明有3个簇暗示了连锁传播。每人包含≥1个人报告注射毒品使用情况。结论尽管已知危险因素的患病率很高,我们仍在大量MSM样本中观察到了较低的HCV患病率,反映出性传播需要HCV阈值和/或不同场所的性行为存在差异。机器学习未发现任何其他流行病学信号。系统发育分析表明有3个簇暗示了连锁传播。每人包含≥1个人报告注射毒品使用情况。结论尽管已知危险因素的患病率很高,我们仍在大量MSM样本中观察到了较低的HCV患病率,反映出性传播需要HCV阈值和/或不同场所的性行为存在差异。机器学习未发现任何其他流行病学信号。系统发育分析表明有3个簇暗示了连锁传播。每人包含≥1个人报告注射毒品使用情况。结论尽管已知危险因素的患病率很高,我们仍在大量MSM样本中观察到了较低的HCV患病率,反映出性传播需要HCV阈值和/或不同场所的性行为存在差异。
更新日期:2020-01-13
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