Methamphetamine Injecting Is Associated with Phylogenetic Clustering of Hepatitis C Virus Infection among Street-Involved Youth in Vancouver, Canada

BACKGROUND:

Among prospective cohorts of people who inject drugs (PWID), phylogenetic clustering of HCV infection has been observed. However, the majority of studies have included older PWID, representing distant transmission events. The aim of this study was to investigate phylogenetic clustering of HCV infection among a cohort of street-involved youth.

METHODS:

Data were derived from a prospective cohort of street-involved youth aged 14-26 recruited between 2005 and 2012 in Vancouver, Canada (At Risk Youth Study, ARYS). HCV RNA testing and sequencing (Core-E2) were performed on HCV positive participants. Phylogenetic trees were inferred using maximum likelihood methods and clusters were identified using ClusterPicker (Core-E2 without HVR1, 90% bootstrap threshold, 0.05 genetic distance threshold).

RESULTS:

Among 945 individuals enrolled in ARYS, 16% (n=149, 100% recent injectors) were HCV antibody positive at baseline interview (n=86) or seroconverted during follow-up (n=63). Among HCV antibody positive participants with available samples (n=131), 75% (n=98) had detectable HCV RNA and 66% (n=65, mean age 23, 58% with recent methamphetamine injection, 31% female, 3% HIV+) had available Core-E2 sequences. Of those with Core-E2 sequence, 14% (n=9) were in a cluster (one cluster of three) or pair (two pairs), with all reporting recent methamphetamine injection. Recent methamphetamine injection was associated with membership in a cluster or pair (P=0.009).

CONCLUSION:

In this study of street-involved youth with HCV infection and recent injecting, 14% demonstrated phylogenetic clustering. Phylogenetic clustering was associated with recent methamphetamine injection, suggesting that methamphetamine drug injection may play an important role in networks of HCV transmission.

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By:  Cunningham EB1, Jacka B2, DeBeck K3, Applegate TL2, Harrigan PR4, Krajden M5, Marshall BD6, Montaner J7, Lima VD7, Olmstead AD5, Milloy MJ7, Wood E7, Grebely J2.

¹Viral Hepatitis Clinical Research Program, The Kirby Institute, UNSW Australia, Sydney, NSW, Australia. Electronic address: ecunningham@kirby.unsw.edu.au.

²Viral Hepatitis Clinical Research Program, The Kirby Institute, UNSW Australia, Sydney, NSW, Australia.

³British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada; School of Public Policy, Simon Fraser University, Vancouver, BC, Canada.

⁴British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada.

⁵BC Centre for Disease Control, Vancouver, BC, Canada.

⁶Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States.

⁷British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada; Division of AIDS, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

Drug Alcohol Depend. 2015 Jul 1;152:272-6. doi: 10.1016/j.drugalcdep.2015.04.005. Epub 2015 Apr 20.

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