Confirmation of Nosocomial Transmission of Hepatitis C Virus by Phylogenetic Analysis of the NS5-B Region

Nordér, Helené; Bergström, Åsa; Uhnoo, Ingrid; Alden, J. C.; Weiss, Lars; Czajkowski, Jan; Magnius, Lars O.

doi:10.1128/jcm.36.10.3066-3069.1998

Cited by 72 publications

(17 citation statements)

References 21 publications

(31 reference statements)

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“…Japan have revealed nosocomial HCV infection in haemodialysis units using phylogenetic analysis of different sequences of the HVR-1 region [Mizuno et al, 1998;Iwasaki et al, 2000]. Nosocomial transmission was also shown by sequencing the NS5B region [Le Pogam et al, 1998;Norder et al, 1998]. Nevertheless, sequencing the HVR-1 region confirmed these results, as this very variable region was identical in two HCV isolates we conclude that it was the same viral isolate.…”

Section: Discussionmentioning

confidence: 59%

Hepatitis C virus infection among dialysis patients in Tunisia: Incidence and molecular evidence for nosocomial transmission

et al. 2005

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In order to study the incidence of hepatitis C virus (HCV) infection in Tunisian haemodialysis patients and detect its nosocomial transmission, 395 patients were enrolled in a prospective study (November 2001-2003). HCV serological and virological status was determined initially using, respectively a third generation ELISA and an RT-PCR qualitative assay. The genotype of the HCV isolates was determined by sequencing NS5B region. The issue of nosocomial transmission was addressed by sequencing the HVR-1 region of the E2 gene. About 20% of the patients had anti-HCV antibodies and HCV-RNA was detected in 73% of the anti-HCV positive patients. Two cases of de novo HCV infection were identified in two dialysis centers, during virological follow-up of patients susceptible to HCV infection. The incidence of de novo HCV infection was 0.5%. Determining the genotypes in the first center disclosed that all HCV-positive patients were infected with genotype 1b; sequencing of the HVR-1 region of the E2 gene provided strong evidence that the isolate from the newly infected patient and another infected dialysis patient were closely related, confirming nosocomial contamination. The investigation of the second center is pending. Besides, one patient with negative HCV serology had detectable HCV-RNA at the beginning of the study. This case had HCV genotype 1b, two other infected dialysis patients in the same unit had HCV genotypes 4k and 3a; thus precluding nosocomial transmission. Thanks to molecular and phylogenetic methods, one case of nosocomial HCV transmission in haemodialysis was confirmed. Epidemiological investigation suggested nosocomial transmission via the medical and/or nursing staff.

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Section: Discussionmentioning

confidence: 59%

Hepatitis C virus infection among dialysis patients in Tunisia: Incidence and molecular evidence for nosocomial transmission

et al. 2005

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“…cDNA of all samples found positive by 5 H UTR PCR were subjected to another PCR within the NS5B region with primers hep-101 at position 8258 and hep-120 (5 H -TGCGCGACBGABACRTTKGAGGA-3 H ) at position 8687. The product was nested with primers hep-101 and hep-105 as described [Norder et al, 1998]. The NS5B region of ®ve strains, which could not be ampli®ed with the outer primers mentioned, were ampli®ed with outer primers hep-106 (5 H -GCTCNT-AYGGRTTYCARTACTC-3 H ) at position 8155 and hep-105.…”

Section: Rna Extraction and Cdna Synthesismentioning

confidence: 99%

Shift in predominating subtype of HCV from 1b to 3a in St. Petersburg mediated by increase in injecting drug use

Kalinina¹,

Nordér²,

Vetrov³

et al. 2001

J. Med. Virol.

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The genotypes of 149 HCV strains from St. Petersburg were determined by limited sequencing and phylogenetic analysis within the NS5B region. One hundred two strains derived from patients that attended infectious disease clinics, of whom 48 admitted injecting drug use, and 47 derived from dialysis patients. Subtype 3a was predominant in the patients from infectious disease clinics, both in patients that admitted injecting drug use (56%) and in those with unknown source of infection (46%). However, 89% of the strains from dialysis patients belonged to subtype 1b. Eleven of twelve characterised strains from recent cases of hepatitis C at these units were at phylogenetic analysis shown to be related to strains already circulating there, demonstrating that within the dialysis units nosocomial transmission is the most important route of HCV infection. The predominance of subtype 1b strains in dialysis patients indicates that these strains have been circulating for a long time in dialysis units. The predominance of subtype 3a also among patients who did not admit drug use and that their strains were intermixed with the strains from injecting drug users in the phylogenetic analysis shows that the increase in injecting drug use is the major factor that explains the recent spread of HCV in the St. Petersburg population. This supports the concept that injecting drug use remains the major route for HCV infection in developed countries and that the control of drug abuse is the most important measure to prevent its spread.

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“…While the HVR1 sequence comparison clearly and sensitively showed the phylogenetic relationships in HCV transmission [13,22±24], the obscure clustering in this study, on the contrary, revealed the limitations of phylogenetic analysis using HVR1 sequences. Other relatively variable regions, such as E1 and NS5 [16,17,25], should be examined in a similar manner to con®rm these clusters.…”

Section: ) 6a --Ht---a--ft-hrf--mf T---------(1) 6b --Ht---v-g F--rrfmentioning

confidence: 99%

“…Several investigators have reported nosocomial transmission of HCV, among haemodialysis patients, using similar molecular evolutionary analyses [12±17, 23,26]. They also demonstrated that patient-to-patient transmission occurred more frequently within the same treatment shift than within the same consoles [12,13,25]. A clear mode of HCV transmission among haemodialysis patients has not been established, but HCV was probably carried by the medical staff rather than on haemodialysis consoles or in the environment [27,28].…”

Section: ) 6a --Ht---a--ft-hrf--mf T---------(1) 6b --Ht---v-g F--rrfmentioning

confidence: 99%

Phylogenetic evidence, by multiple clone analysis of hypervariable region 1, for the transmission of hepatitis C virus to chronic haemodialysis patients

Hosokawa

Esumi

Iwasaki

et al. 2000

Journal of Viral Hepatitis

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We analysed hepatitis C virus (HCV) sequences to determine whether nosocomial transmission of HCV occurred in a haemodialysis unit. Twenty patients positive for serum HCV RNA were investigated. All were undergoing haemodialysis therapy in the same room. The hypervariable region 1 (HVR1) sequence of HCV was amplified and multiple clones sequenced. Phylogenetic analysis of these sequences revealed five genetic clusters consisting of HCV isolates from 11 of the 20 patients. In addition to two genetic clusters of HCV isolates from the four currently seroconverting patients and another patient who had been persistently infected, we identified three other phylogenetic relationships in HCV isolates from six patients. The patients grouped into the same cluster received haemodialysis individually on the same shift and/or side-by-side. Phylogenetic analysis of HCV HVR1 sequences corroborated the patient-to-patient HCV transmission suggested by an epidemiological study and that unrecognized transmission of HCV occurs in the dialysis room. Our multiple clone analysis of HCV isolates provides detailed information on nosocomial transmission of HCV. Transmission occurs more frequently when treatment is performed at the same time than in consoles located close to each other.

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Confirmation of Nosocomial Transmission of Hepatitis C Virus by Phylogenetic Analysis of the NS5-B Region

Cited by 72 publications

References 21 publications

Hepatitis C virus infection among dialysis patients in Tunisia: Incidence and molecular evidence for nosocomial transmission

Hepatitis C virus infection among dialysis patients in Tunisia: Incidence and molecular evidence for nosocomial transmission

Shift in predominating subtype of HCV from 1b to 3a in St. Petersburg mediated by increase in injecting drug use

Phylogenetic evidence, by multiple clone analysis of hypervariable region 1, for the transmission of hepatitis C virus to chronic haemodialysis patients

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