RT Journal Article
T1 Increasing importance of European lineages in seeding the hepatitis C virus subtype 1a epidemic in Spain.
A1 Perez, Ana Belen
A1 Vrancken, Bram
A1 Chueca, Natalia
A1 Aguilera, Antonio
A1 Reina, Gabriel
A1 García-Del Toro, Miguel
A1 Vera, Francisco
A1 Von Wichman, Miguel Angel
A1 Arenas, Juan Ignacio
A1 Tellez, Francisco
A1 Pineda, Juan A
A1 Omar, Mohamed
A1 Bernal, Enrique
A1 Rivero-Juarez, Antonio
A1 Fernandez-Fuertes, Elisa
A1 de la Iglesia, Alberto
A1 Pascasio, Juan Manuel
A1 Lemey, Philippe
A1 Garcia, Federico
A1 Cuypers, Lize
K1 Europe
K1 HCV1a
K1 North America
K1 Spain
K1 Hepatitis C virus
K1 Phylogeography
K1 Public health
K1 Public health policy
K1 Área de Gestión Sanitaria Sur de Sevilla
AB BackgroundReducing the burden of the hepatitis C virus (HCV) requires large-scale deployment of intervention programmes, which can be informed by the dynamic pattern of HCV spread. In Spain, ongoing transmission of HCV is mostly fuelled by people who inject drugs (PWID) infected with subtype 1a (HCV1a).AimOur aim was to map how infections spread within and between populations, which could help formulate more effective intervention programmes to halt the HCV1a epidemic in Spain.MethodsEpidemiological links between HCV1a viruses from a convenience sample of 283 patients in Spain, mostly PWID, collected between 2014 and 2016, and 1,317, 1,291 and 1,009 samples collected abroad between 1989 and 2016 were reconstructed using sequences covering the NS3, NS5A and NS5B genes. To efficiently do so, fast maximum likelihood-based tree estimation was coupled to a flexible Bayesian discrete phylogeographic inference method.ResultsThe transmission network structure of the Spanish HCV1a epidemic was shaped by continuous seeding of HCV1a into Spain, almost exclusively from North America and European countries. The latter became increasingly relevant and have dominated in recent times. Export from Spain to other countries in Europe was also strongly supported, although Spain was a net sink for European HCV1a lineages. Spatial reconstructions showed that the epidemic in Spain is diffuse, without large, dominant within-country networks.ConclusionTo boost the effectiveness of local intervention efforts, concerted supra-national strategies to control HCV1a transmission are needed, with a strong focus on the most important drivers of ongoing transmission, i.e. PWID and other high-risk populations.
PB European Centre for Disease Prevention and Control
YR 2018
FD 2018-12-18
LK http://hdl.handle.net/10668/13693
UL http://hdl.handle.net/10668/13693
LA en
NO Pérez AB, Vrancken B, Chueca N, Aguilera A, Reina G, García-Del Toro M, et al. Increasing importance of European lineages in seeding the hepatitis C virus subtype 1a epidemic in Spain. Euro Surveill. 2019 Feb;24(9):1800227
NO Funding from the European Research Council under the European Union’s Horizon 2020 research and innovation programme (grant agreement no.725422-ReservoirDOCS) has been used for this study. A part of the computational resources and services used in this work were provided by the Hercules Foundation and the Flemish Government - department EWI-FWO Krediet aan Navorsers (Theys, KAN2012 1.2.249.12). This work wassupported in part by grants from Fondo de Investigación Sanitaria (www.isciii.es) (PI15/00713), Plan Nacional de I+D+I and Fondo Europeo de Desarrollo Regional-FEDER (www.red. es/redes/inicio) (RD16/0025/0040), Fundación Progreso y salud, Junta de Andalucía (www.fps2.junta-andalucia.es/fundacionprogresoysalud/es/home) (PI-0411-2014), andGEHEP-SEIMC (GEHEP-004 and GEHEP-005). The authors declare that they have no other competing interests than the financial disclosures.
DS RISalud
RD Apr 8, 2025