[Source: The Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]
Epidemic history and iatrogenic transmission of blood-borne viruses in mid-20th century Kinshasa [ ]
Catherine Hogan 1,*, James Iles 2,*, Eric H. Frost 1,*, Geneviève Giroux 1, Olivier Cassar 3,4, Antoine Gessain 3,4, Marie-Josée Dion 1, Vicky Ilunga 5, Andrew Rambaut 6, André-Édouard Yengo-ki-Ngimbi 7, Frieda Behets 5,8, Oliver G. Pybus 2 and Jacques Pépin 1
Author Affiliations: 1Université de Sherbrooke, Sherbrooke, Canada 2University of Oxford, Oxford, United Kingdom 3Institut Pasteur, Paris, France 4Centre National de la Recherche Scientifique, UMR 3569, Paris, France 5Programme ESP/UNC-DRC, Kinshasa, Democratic Republic of Congo 6University of Edinburgh, Edinburgh, United Kingdom 7Université de Kinshasa, Kinshasa, Democratic Republic of Congo 8University of North Carolina, Chapel Hill, USA
Corresponding authors: For evolutionary epidemiology: Professor Oliver Pybus, Department of Zoology, University of Oxford, South Parks Road, Oxford, OX1 3PS, United Kingdom. email@example.com, Phone/Fax: 44 (0)1865 271274, For epidemiology: Professor Jacques Pépin, Department of Microbiology and Infectious Diseases, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, Qc, J1J 4L4, Canada. firstname.lastname@example.org, Phone 1-819-346-1110 ext 74234, Fax 1-819-821-7101
* Contributed equally to this work
The HIV-1 pandemic was ignited in Léopoldville (Kinshasa), Belgian Congo. Factors that jumpstarted its early expansion remain unclear. Non-lethal Hepatitis C and human T-cell lymphotropic viruses can be used to investigate past iatrogenic transmission.
We undertook a cross-sectional study of elderly inhabitants of Kinshasa, with serological assays, amplification and sequencing. Risk factors were assessed through logistic regression. Phylogenetic methods reconstructed the genetic history of HCV.
217/839 (25.9%) participants were HCV-seropositive; 26 (3.1%) were HTLV-1-seropositive. Amplification products were obtained from 118 HCV-seropositives; subtypes 4k (n=47) and 4r (n=38) were most common. Independent risk factors for HCV subtype 4r were intramuscular tuberculosis therapy, intravenous injections at Hospital A, intravenous injections before 1960 and injections at a colonial-era venereology clinic. Intravenous injections at Hospital B and antimalarials were associated with HCV subtype 4k. Risk factors for HTLV-1 included intravenous injections at Hospitals C or D, and transfusions. Evolutionary analysis of viral sequences revealed independent exponential amplification of HCV subtypes 4r and 4k from the 1950s onwards.
Iatrogenic transmission of HCV and HTLV-1 occurred in mid-20th century Kinshasa, at the same time and place HIV-1 emerged. Iatrogenic routes may have contributed to the early establishment of the pandemic.
© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail email@example.com.
Keywords: Research; Abstracts; Congo DR; HIV; HTLV-1; Hepatitis C.