Phylogenetic investigation of HCV-4d epidemic in Paris MSM HIV population reveals a still active outbreak and a strong link to the Netherlands

B Visseaux; S Hué; Q Le Hingrat; M Salmona; S Lebourgeois; C Delaugerre; D Descamps; M-L Chaix; J Ghosn

doi:10.1016/j.cmi.2020.01.034

Phylogenetic investigation of HCV-4d epidemic in Paris MSM HIV population reveals a still active outbreak and a strong link to the Netherlands

Clin Microbiol Infect. 2020 Jun;26(6):785.e1-785.e4. doi: 10.1016/j.cmi.2020.01.034. Epub 2020 Feb 6.

Authors

B Visseaux¹, S Hué², Q Le Hingrat³, M Salmona⁴, S Lebourgeois³, C Delaugerre⁴, D Descamps³, M-L Chaix⁴, J Ghosn⁵

Affiliations

¹ Université de Paris, INSERM UMR 1137 IAME, Paris, France; Laboratoire de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France. Electronic address: benoit.visseaux@aphp.fr.
² London School of Hygiene and Tropical Medicine, Department of Infectious Diseases Epidemiology, London, UK.
³ Université de Paris, INSERM UMR 1137 IAME, Paris, France; Laboratoire de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
⁴ Université de Paris, U944, INSERM, France; Laboratoire de Virologie, AP-HP, Hôpital Saint-Louis, Paris, France.
⁵ Université de Paris, INSERM UMR 1137 IAME, Paris, France; Service de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.

PMID: 32035235
DOI: 10.1016/j.cmi.2020.01.034

Abstract

Objectives: The hepatitis C virus (HCV) epidemic is evolving quickly despite new treatments, and due to behaviour changes increasing at-risk situations. We investigated potential origins and evolution of the HCV-4d French emergence among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM), in Paris in 2003.

Methods: We analysed all HCV sequences from the initial Paris outbreak with all newly available sequences publicly available, including sampling date and geographical location, resulting in 184, 68, 156, 107, 13 and 2 sequences from France, The Netherlands, other European countries, Africa, the Middle East or Turkey, Americas and Asia, respectively. Phylogenetic reconstruction was performed using maximum likelihood and Bayesian approaches.

Results: HCV-4d sequences from Europe were strongly separated from non-European sequences. Sequences from the initial Paris outbreak were all included into two well-separated and supported clusters with branch support at 100%, mean genetic distance <2.8 substitutions/100 nucleotides and >3.4 substitutions/100 nucleotides between their common ancestor and the previous node. The largest cluster interleaved French (n = 98) and Dutch (n = 28) sequences, suggesting several translocations between these countries. This cluster included 41 French sequences from Lyon sampled after 2014, highlighting its continuous spread within France since the initial outbreak. The smallest cluster included one Paris sequence with UK sequences (n = 9).

Discussion: A few previous works have shown HCV-4d transmissions occurring between a few countries. In our work, we suggest a new and large connection between France and The Netherlands MSM communities and highlight a well-separated pan-European transmission network. Large collaborative networks are needed to investigate ongoing transmissions across countries and help specific prevention measures.

Keywords: Emergence; France; HCV; HCV-4d; Netherlands; Outbreak; Phylogenetic; Transmission network.

MeSH terms

Bayes Theorem
Epidemics / statistics & numerical data*
Genotype
Hepacivirus / classification*
Hepacivirus / genetics*
Hepatitis C / epidemiology*
Hepatitis C / transmission*
Homosexuality, Male
Humans
Male
Netherlands / epidemiology
Paris / epidemiology
Phylogeny*
Sequence Analysis, DNA
Sexual Behavior
Sexual and Gender Minorities