title: Population dynamics of hepatitis C virus subtypes in injecting drug users on methadone maintenance treatment in China associated with economic and health reform.
abstract: The extensive genetic heterogeneity of hepatitis C virus (HCV) requires in-depth understanding of the population dynamics of different viral subtypes for more effective control of epidemic outbreaks. We analysed HCV sequences data from 125 participants in Wuhan, China. These participants were newly infected by subtype 1b (n=13), 3a (n=15), 3b (n=50) and 6a (n=39) while on methadone maintenance treatment (MMT). Bayesian phylogenies and demographic histories were inferred for these subtypes. Participants infected with HCV-1b and 3a were clustered in well-supported monophyletic clades, indicating local subepidemics. Subtypes 3b and 6a strains were intermixed with other Chinese isolates, as well as isolates from other Asian countries, reflecting ongoing across geographic boundary transmissions. Subtypes 1b and 3a declined continuously during the past ten years, consistent with the health and economic reform in China, while subtype 3b showed ongoing exponential growth and 6a was characterized by several epidemic waves, possibly related to the recently growing number of travellers between China and other Asian countries. In conclusion, results of this study suggest that HCV subtype 3b and 6a subepidemics in China are currently not under control, and new epidemic waves may emerge given the rapid increase in international travelling following substantial economic growth.
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.|Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors.forename: S
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanità, Rome, Italy.|Public Health and Infectious Diseases, Sapienza University, Rome, Italy.|Department of Pathology, Immunology, and Laboratory Sciences, College of Medicine, University of Florida, Gainesville, FL, USA.
authors.forename: E
authors.initials: E
authors.lastname: Cella
authors.affiliation: Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors.forename: W
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors.forename: W-H
authors.initials: WH
authors.lastname: Kong
authors.affiliation: Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors.forename: M-Q
authors.initials: MQ
authors.lastname: Liu
authors.affiliation: Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors.forename: P-L
authors.initials: PL
authors.lastname: Liu
authors.affiliation: Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution (FEMEM)/Epidemiology Unit, Istituto Superiore di Sanità, Rome, Italy.|University Hospital Campus Bio-Medico, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ciccozzi
authors.affiliation: Department of Pathology, Immunology, and Laboratory Sciences, College of Medicine, University of Florida, Gainesville, FL, USA.|Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
authors.forename: M
authors.initials: M
authors.lastname: Salemi
authors.affiliation: Wuhan Centers for Disease Prevention and Control, Wuhan, China.|Department of Epidemiology, College of Public Health and Health Profession & College of Medicine, University of Florida, Gainesville, FL, USA.
authors.forename: X
authors.initials: X
authors.lastname: Chen
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002681:China / Q000453:epidemiology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D017720:Molecular Epidemiology; D058850:Opiate Substitution Treatment / Q000379:methods*; D010802:Phylogeny; D011157:Population Dynamics; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: China; HCV demographic history; HCV subtypes; Wuhan City; phylogenetics