Molecular epidemiology of newly acquired hepatitis C infections in England 2008-2011: genotype, phylogeny and mutation analysis.
BACKGROUND
Analysis of laboratory testing data collected through the Sentinel Surveillance programme has provided a method for identifying individuals who have recently acquired their hepatitis C virus (HCV) infection. Access to samples from these individuals provided a rare opportunity to undertake molecular characterization studies.


OBJECTIVE
To describe the epidemiology and genetic diversity of hepatitis C in recent seroconverter infections and to predict how this will impact on HCV treatment and control.


METHODS
One hundred and forty seven samples were available from individuals, identified to have recently acquired their HCV infection. Genotype determination with additional phylogenetic analysis was carried out on NS5B sequences. Analysis across the NS3 region investigated the presence of antiviral resistance mutations. Where possible, molecular data was linked to demographic and risk/behavioural factor information.


RESULTS
The majority of new infections occurred in males with a mean age of 37 years. The most commonly observed genotypes were 1a (49%) and 3a (42%) and injecting drug use (58%) was the most common risk factor. Genotype distribution differed between persons who inject drugs and those with other risk factors suggesting two possible epidemics. Phylogenetic analysis indicated possible transmission networks within specific risk groups. Amino acid changes associated with antiviral resistance were noted in the NS3 region in some samples.


CONCLUSIONS
Continued surveillance of linked molecular, virological, demographic and epidemiological information on recently acquired infections will contribute to understanding the on-going HCV epidemic in England.
Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
Shoshanna
S
May
Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
Siew Lin
SL
Ngui
Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
Sarah
S
Collins
Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
Sam
S
Lattimore
Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
Mary
M
Ramsay
Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK; Division of Infection and Immunity, University College London, Gower Street, London WC1E 6BT, UK; Transfusion Microbiology, NHS Blood and Transplant, Colindale Avenue, London, NW9 5BG, UK.
Richard S
RS
Tedder
Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK. Electronic address: samreen.ijaz@phe.gov.uk.
Samreen
S
Ijaz
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D004252:DNA Mutational Analysis; D004279:DNA, Viral / Q000235:genetics; D024882:Drug Resistance, Viral / Q000235:genetics; D004739:England / Q000453:epidemiology; D062665:Epidemiological Monitoring; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology* / Q000235:genetics / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D009154:Mutation; D010802:Phylogeny; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications; D013997:Time Factors; D055815:Young Adult
D004279:DNA, Viral
Genotype; Hepatitis C virus; Molecular epidemiology; Risk/behavioural factors