Hepatitis C virus infections in the Democratic Republic of Congo exhibit a cohort effect

Iles, James; Harrison, G. L. Abby; Lyons, Sinéad; Djoko, Cyrille F.; Tamoufé, Ubald; LeBreton, Matthew; Schneider, Bradley S.; Fair, Joseph N.; Tshala, Felix M.; Kayembé, Patrick; Muyembe, Jean Jacques; Edidi-Basepeo, Samuel; Wolfe, Nathan; Klenerman, Paul; Simmonds, Peter; Pybus, Oliver G.

doi:10.1016/j.meegid.2013.01.021

Cited by 34 publications

(32 citation statements)

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“…Of these 60 samples, 33 produced core sequence and 48 produced NS5B sequence. These results are broadly consistent with our pilot study which detected HCV RNA in 3.7% ( n =11) of samples and yielded 9 core sequences and 11 NS5B sequences (Iles et al, 2013). …”

Section: Resultssupporting

confidence: 92%

“…We confirmed that HCV positivity is significantly associated with older age in our study population (Fig. 2; Iles et al, 2013). Although the long-term persistence of most HCV infections means that older subjects are in general more likely to be infected, the notable increase in HCV prevalence in those born before 1945 suggests a distinct historical event.…”

Section: Discussionsupporting

confidence: 85%

“…The HCV-positive samples sequenced in this study were genetically diverse and were classified as belonging to subtypes 4c ( n =17), 4h ( n =2), 4k ( n =18), and 4r ( n =8). One sample (DRC0387) could not be classified into any known subtype but grouped with two unclassified isolates (DRC2431 and DRC2450) from our pilot study (Iles et al, 2013). This cluster of three strains is denoted 4drc here and represents a potentially new subtype (see Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…This collection has been studied previously for HIV-1 (Djoko et al, 2011), human parvovirus 4 (Sharp et al, 2010) and human pegiviruses (Iles et al, 2013). A preliminary small scale survey ( n =299) of this collection for HCV discovered HCV RNA in ~4% of samples (Iles et al, 2013). Collection took place during 2007 in Kinshasa, capital of the DRC.…”

Section: Methodsmentioning

confidence: 99%

“…In a previous small-scale survey of blood samples from the country (Iles et al, 2013) we detected HCV RNA in 11 individuals. Phylogenetic analysis of HCV core and NS5B region sequences from these samples indicated that they belonged to several classified and unclassified subtypes of genotype 4.…”

Section: Introductionmentioning

confidence: 94%

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Phylogeography and epidemic history of hepatitis C virus genotype 4 in Africa

et al. 2014

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HCV genotype 4 is prevalent in many African countries, yet little is known about the genotype׳s epidemic history on the continent. We present a comprehensive study of the molecular epidemiology of genotype 4. To address the deficit of data from the Democratic Republic of the Congo (DRC) we PCR amplified 60 new HCV isolates from the DRC, resulting in 33 core- and 48 NS5B-region sequences. Our data, together with genotype 4 database sequences, were analysed using Bayesian phylogenetic approaches. We find three well-supported intra-genotypic lineages and estimate that the genotype 4 common ancestor existed around 1733 (1650–1805). We show that genotype 4 originated in central Africa and that multiple lineages have been exported to north Africa since ~1850, including subtype 4a which dominates the epidemic in Egypt. We speculate on the causes of the historical intra-continental spread of genotype 4, including population movements during World War 2.

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Section: Resultssupporting

confidence: 92%

Section: Discussionsupporting

confidence: 85%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

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Phylogeography and epidemic history of hepatitis C virus genotype 4 in Africa

et al. 2014

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Highly Diverse Hepatitis C Strains Detected in Sub‐Saharan Africa Have Unknown Susceptibility to Direct‐Acting Antiviral Treatments

et al. 2019

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The global plan to eradicate hepatitis C virus (HCV) led by the World Health Organization outlines the use of highly effective direct‐acting antiviral drugs (DAAs) to achieve elimination by 2030. Identifying individuals with active disease and investigation of the breadth of diversity of the virus in sub‐Saharan Africa (SSA) is essential as genotypes in this region (where very few clinical trials have been carried out) are distinct from those found in other parts of the world. We undertook a population‐based, nested case‐control study in Uganda and obtained additional samples from the Democratic Republic of Congo (DRC) to estimate the prevalence of HCV, assess strategies for disease detection using serological and molecular techniques, and characterize genetic diversity of the virus. Using next‐generation and Sanger sequencing, we aimed to identify strains circulating in East and Central Africa. A total of 7,751 Ugandan patients were initially screened for HCV, and 20 PCR‐positive samples were obtained for sequencing. Serological assays were found to vary significantly in specificity for HCV. HCV strains detected in Uganda included genotype (g) 4k, g4p, g4q, and g4s and a newly identified unassigned g7 HCV strain. Two additional unassigned g7 strains were identified in patients originating from DRC (one partial and one full open reading frame sequence). These g4 and g7 strains contain nonstructural (ns) protein 3 and 5A polymorphisms associated with resistance to DAAs in other genotypes. Clinical studies are therefore indicated to investigate treatment response in infected patients. Conclusion : Although HCV prevalence and genotypes have been well characterized in patients in well‐resourced countries, clinical trials are urgently required in SSA, where highly diverse g4 and g7 strains circulate.

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Human pegivirus (HPgV) infection in sub‐Saharan Africa—A call for a renewed research agenda

Singh

Blackard

2017

Reviews in Medical Virology

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The human pegivirus (HPgV)-formerly GB virus C-has a beneficial impact on HIV disease progression that has been described in multiple studies. Given the high prevalence of HIV in sub-Saharan Africa and the continuing need to suppress HIV replication, this review provides a comprehensive overview of the existing data on HPgV infection in sub-Saharan Africa, with a particular focus on studies of prevalence and the circulating HPgV genotypes. This review also highlights the need for additional studies of HPgV conducted on the African continent and proposes a research agenda for evaluation of HPgV.

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Hepatitis C virus infections in the Democratic Republic of Congo exhibit a cohort effect

Cited by 34 publications

References 50 publications

Phylogeography and epidemic history of hepatitis C virus genotype 4 in Africa

Phylogeography and epidemic history of hepatitis C virus genotype 4 in Africa

Highly Diverse Hepatitis C Strains Detected in Sub‐Saharan Africa Have Unknown Susceptibility to Direct‐Acting Antiviral Treatments

Human pegivirus (HPgV) infection in sub‐Saharan Africa—A call for a renewed research agenda

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