Phylogenetic analysis of acute hepatitis C virus genotype 4 infections among human immunodeficiency virus-positive men who have sex with men in Germany
Article first published online: 12 JUL 2010
© 2010 John Wiley & Sons A/S
Volume 30, Issue 8, pages 1169–1172, September 2010
How to Cite
Vogel, M., Van De Laar, T., Kupfer, B., Stellbrink, H.-J., Kümmerle, T., Mauss, S., Knecht, G., Berger, A., Bruisten, S. and Rockstroh, J. K. (2010), Phylogenetic analysis of acute hepatitis C virus genotype 4 infections among human immunodeficiency virus-positive men who have sex with men in Germany. Liver International, 30: 1169–1172. doi: 10.1111/j.1478-3231.2010.02305.x
- Issue published online: 3 AUG 2010
- Article first published online: 12 JUL 2010
- Received 24 March 2010Accepted 2 June 2010
- acute HCV;
- men who have sex with men (MSM);
- sexual transmission;
- sexual transmitted disease
Background: An ongoing HCV epidemic currently affects a growing proportion of HIV-positive men who have sex with men (MSM) in Europe. Recently in the North-Rhine region of Germany, we have observed an increase in acute HCV infections of genotype 4 (HCV-4).
Aims: To characterize the current spread of HCV-4 among German MSM using a molecular epidemiological approach.
Methods: Patient characteristics and sera were collected for HIV-positive MSM diagnosed with acute HCV-4 infections in the North-Rhine region (n=14), Hamburg (n=14), Frankfurt (n=4) and Berlin (n=4). Part of the HCV NS5B region (436 bp) was amplified, sequenced and compared with HCV-4 sequences from HIV-positive Dutch, English and French MSM (n=50) as well as unrelated HCV risk groups (n=61).
Results: NS5B sequences were obtained from 35/36 (97%) of German cases, all of which were HCV subtype 4d (HCV-4d). The phylogenetic analysis of HCV sequences revealed two MSM-specific HCV-4d clusters of 71 and 12 sequences. All except one of the German MSM belonged to a large MSM-specific HCV cluster containing MSM from all four different European countries. None of the HCV-4 strains circulating among injecting drug users or in HCV-4 endemic areas were part of the MSM-specific clusters.
Conclusions: HCV rapidly spreads among European HIV-positive MSM through a joint international transmission network, separate from that of injecting drug users. In order to contain this epidemic, non-parenteral routes of transmission, such as unsafe sex, must be taken into consideration and prevention measures should be refocused accordingly.