Publications des scientifiques de l'IRD

Rouet F., Nouhin J., Zheng D. P., Roche Benjamin, Black A., Prak S., Leoz M., Gaudy-Graffin C., Ferradini L., Mom C., Mam S., Gautier C., Lesage G., Ken S., Phon K., Kerleguer A., Yang C. F., Killam W., Fujita M., Mean C., Fontenille Didier, Baring F., Plantier J. C., Bedford T., Ramos A., Saphonn V. (2018). Massive iatrogenic outbreak of Human Immunodeficiency Virus type 1 in rural Cambodia, 2014-2015. Clinical Infectious Diseases, 66 (11), p. 1733-1741. ISSN 1058-4838.

Titre du document
Massive iatrogenic outbreak of Human Immunodeficiency Virus type 1 in rural Cambodia, 2014-2015
Année de publication
2018
Type de document
Article référencé dans le Web of Science WOS:000432680800016
Auteurs
Rouet F., Nouhin J., Zheng D. P., Roche Benjamin, Black A., Prak S., Leoz M., Gaudy-Graffin C., Ferradini L., Mom C., Mam S., Gautier C., Lesage G., Ken S., Phon K., Kerleguer A., Yang C. F., Killam W., Fujita M., Mean C., Fontenille Didier, Baring F., Plantier J. C., Bedford T., Ramos A., Saphonn V.
Source
Clinical Infectious Diseases, 2018, 66 (11), p. 1733-1741 ISSN 1058-4838
Background. In 2014-2015, 242 individuals aged 2-89 years were newly diagnosed with human immunodeficiency virus type 1 (HIV-1) in Roka, a rural commune in Cambodia. A case-control study attributed the outbreak to unsafe injections. We aimed to reconstruct the likely transmission history of the outbreak. Methods. We assessed in 209 (86.4%) HIV-infected cases the presence of hepatitis C virus (HCV) and hepatitis B virus (HBV). We identified recent infections using antibody (Ab) avidity testing for HIV and HCV. We performed amplification, sequencing, and evolutionary phylogenetic analyses of viral strains. Geographical coordinates and parenteral exposure through medical services provided by an unlicensed healthcare practitioner were obtained from 193 cases and 1499 controls during interviews. Results. Cases were coinfected with HCV (78.5%) and HBV (12.9%). We identified 79 (37.8%) recent (< 130 days) HIV infections. Phylogeny of 202 HIV env C2V3 sequences showed a 198-sample CRF01_AE strains cluster, with time to most recent common ancestor (tMRCA) in September 2013 (95% highest posterior density, August 2012-July 2014), and a peak of 15 infections/day in September 2014. Three geospatial HIV hotspots were discernible in Roka and correlated with high exposure to the practitioner (P=.04). Fifty-nine of 153 (38.6%) tested cases showed recent (< 180 days) HCV infections. Ninety HCV NS5B sequences formed 3 main clades, 1 containing 34 subtypes 1b with tMRCA in 2012, and 2 with 51 subtypes 6e and tMRCAs in 2002-2003. Conclusions. Unsafe injections in Cambodia most likely led to an explosive iatrogenic spreading of HIV, associated with a long-standing and more genetically diverse HCV propagation.
Plan de classement
Santé : généralités [050] ; Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
CAMBODGE
Localisation
Fonds IRD [F B010073052]
Identifiant IRD
fdi:010073052
Contact