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Molecular epidemiological analysis of viral pathogens can identify factors associated with increased transmission risk. We investigated the frequency of genetic clustering in a large dataset of NS34A, NS5A, and NS5B viral sequences from patients with chronic hepatitis C virus (HCV) genotypes 1-6 infection. Within a subset of patients with longitudinal samples, Receiver Operator Characteristic (ROC) analysis was applied which identified a threshold of 0.02 substitutions/site as most appropriate for clustering. From the 7,457 patients with chronic HCV infection included in this analysis, we inferred 256 clusters comprising 541 patients (7.3%). We found that HCV/HIV co-infection, young age, and high HCV viral load were all associated with increased clustering frequency, an indicator of increased transmission risk. In light of previous work on HCV/HIV co-infection in acute HCV cohorts, our results suggest that patients with HCV/HIV co-infection may disproportionately be the source of new HCV infections and treatment efforts should be geared towards elimination in this vulnerable population. This article is protected by copyright. All rights reserved.
This article was published in the following journal.
Name: Journal of viral hepatitis
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Physicians or other qualified individuals responsible for implementing and overseeing the policies and procedures followed by a health care facility to reduce the risk of infection to patients and staff.
The transmission of infectious disease or pathogens from patients to health professionals or health care workers. It includes transmission via direct or indirect exposure to bacterial, fungal, parasitic, or viral agents.
The transmission of infectious disease or pathogens from health professional or health care worker to patients. It includes transmission via direct or indirect exposure to bacterial, fungal, parasitic, or viral agents.
A parasitic infection caused by the nematode Loa loa. The vector in the transmission of this infection is the horsefly (Tabanus) or the deerfly or mango fly (Chrysops). The larvae may be seen just beneath the skin or passing through the conjunctiva. Eye lesions are not uncommon. The disease is generally mild and painless.
Infection by a variety of fungi, usually through four possible mechanisms: superficial infection producing conjunctivitis, keratitis, or lacrimal obstruction; extension of infection from neighboring structures - skin, paranasal sinuses, nasopharynx; direct introduction during surgery or accidental penetrating trauma; or via the blood or lymphatic routes in patients with underlying mycoses.
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