High Prevalence and Genetic Diversity of HCV among HIV-1 Infected People from Various High-Risk Groups in China

Abstract

BackgroundCo-infection with HIV-1 and HCV is a significant global public health problem and a major consideration for anti-HIV-1 treatment. HCV infection among HIV-1 positive people who are eligible for the newly launched nationwide anti-HIV-1 treatment program in China has not been well characterized.MethodologyA nationwide survey of HIV-1 positive injection drug uses (IDU), former paid blood donors (FBD), and sexually transmitted cases from multiple provinces including the four most affected provinces in China was conducted. HCV prevalence and genetic diversity were determined. We found that IDU and FBD have extremely high rates of HCV infection (97% and 93%, respectively). Surprisingly, people who acquired HIV-1 through sexual contact also had a higher rate of HCV infection (20%) than the general population. HIV-1 subtype and HCV genotypes were amazingly similar among FBD from multiple provinces stretching from Central to Northeast China. However, although patterns of overland trafficking of heroin and distinct HIV-1 subtypes could be detected among IDU, HCV genotypes of IDU were more diverse and exhibited significant regional differences.ConclusionEmerging HIV-1 and HCV co-infection and possible sexual transmission of HCV in China require urgent prevention measures and should be taken into consideration in the nationwide antiretroviral treatment program.

High Prevalence of Hepatitis C virus Among Injection Drug Users in Zhenjiang, Jiangsu, China

“…High HCV prevalence and co-infection rate with HIV were observed previously among IDUs in some areas of China [4,12,16,18,20,28,30]. Here, we found that HCV prevalence were 81.6 and 69.9% among IDUs and all drug users in Zhenjiang, Jiangsu (Table 1), respectively, slightly lower than 88.5 and 75.5% in other neighbor cities of Jiangsu, respectively [5].…”

Complex patterns of HCV epidemic in Suzhou: Evidence for dual infection and HCV recombination in East China

“…Co-circulation of more than 6 HCV subtypes among IDUs were reported previously in Yunnan and Guangxi provinces, 3,5,12 and Zhenjiang city of Jiangsu province. 6 Because of special geographic location, Yunnan and Guangxi serve as important transfer stations for drug trafficking from heroine-producing areas (Golden Triangle region) to China and neighboring countries, and play crucial roles in HIV-1 and HCV transmissions via drug trafficking routes, 2,4,26,27 which result in the mixing multiple HIV-1 and HCV subtypes.…”

“…2 High prevalence of HCV and HIV-1 co-infection have been reported among IDUs in China. 5,12,13 Among IDUs, extensive HIV-1 intersubtype recombinants have been detected, 14,15 whereas very few HCV intersubtype recombinants were identified. 16 Up to now, only 2k/1b, 1b/1a, 1a/1c, 2/6, 2b/1b, and 2/5 recombinants have been identified in HCV, [17][18][19][20][21][22][23][24] and no recombinant was detected in China.…”

“…2 HCV subtype 1b is the most predominant strains among general population (GP), whereas multiple subtypes including 1a, 1b, 3a, 3b, 6a, 6n, and 6u are circulating among injection drug users (IDUs). [3][4][5][6][7][8] HCV is transmitted via injection drug use (IDU), blood transfusion, and sexual contact. 9 IDU is the predominant mode of HCV transmission in China.…”

Update on Current Epidemiologic Trends in Hepatitis C

“…However, the HCV incidence increased in repeat donors, primarily among 50 years old and older white donors (corresponding to the aging prevalent HCV observed in NHANES) [25•]. As a reminder of the importance of a volunteer, nonremunerated donor system, 93% of former paid blood donors in China had HCV infection [26].…”