Drug use and phylogenetic clustering of hepatitis C virus infection among people who use drugs in Vancouver, Canada

A latent class analysis approach

B. Jacka, Bethany Cara Bray, T. L. Applegate, B. D.L. Marshall, V. D. Lima, K. Hayashi, K. DeBeck, J. Raghwani, P. R. Harrigan, M. Krajden, J. S.G. Montaner, J. Grebely

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

This study estimated latent classes (ie, unobserved subgroups in a population) of people who use drugs in Vancouver, Canada, and examined how these classes relate to phylogenetic clustering of hepatitis C virus (HCV) infection. HCV antibody-positive people who use drugs from two cohorts in Vancouver, Canada (1996-2012), with a Core-E2 sequence were included. Time-stamped phylogenetic trees were inferred, and phylogenetic clustering was determined by time to most common recent ancestor. Latent classes were estimated, and the association with the phylogenetic clustering outcome was assessed using an inclusive classify/analyse approach. Among 699 HCV RNA-positive participants (26% female, 24% HIV+), recent drug use included injecting cocaine (80%), injecting heroin (70%), injecting cocaine/heroin (ie, speedball, 38%) and crack cocaine smoking (28%). Latent class analysis identified four distinct subgroups of drug use typologies: (i) cocaine injecting, (ii) opioid and cocaine injecting, (iii) crack cocaine smoking and (iv) heroin injecting and currently receiving opioid substitution therapy. After adjusting for age and HIV infection, compared to the group defined by heroin injecting and currently receiving opioid substitution therapy, the odds of phylogenetic cluster membership was greater in the cocaine injecting group (adjusted OR [aOR]: 3.06; 95% CI: 1.73, 5.42) and lower in the crack cocaine smoking group (aOR: 0.06; 95% CI: 0.01, 0.48). Combining latent class and phylogenetic clustering analyses provides novel insights into the complex dynamics of HCV transmission. Incorporating differing risk profiles associated with drug use may provide opportunities to further optimize and target HCV treatment and prevention strategies.

Original languageEnglish (US)
Pages (from-to)28-36
Number of pages9
JournalJournal of Viral Hepatitis
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Virus Diseases
Cocaine
Hepacivirus
Canada
Heroin
Cluster Analysis
Crack Cocaine
Opiate Substitution Treatment
Pharmaceutical Preparations
Smoking
Hepatitis C Antibodies
Opioid Analgesics
HIV Infections
HIV
RNA
Population

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases
  • Virology

Cite this

Jacka, B. ; Bray, Bethany Cara ; Applegate, T. L. ; Marshall, B. D.L. ; Lima, V. D. ; Hayashi, K. ; DeBeck, K. ; Raghwani, J. ; Harrigan, P. R. ; Krajden, M. ; Montaner, J. S.G. ; Grebely, J. / Drug use and phylogenetic clustering of hepatitis C virus infection among people who use drugs in Vancouver, Canada : A latent class analysis approach. In: Journal of Viral Hepatitis. 2018 ; Vol. 25, No. 1. pp. 28-36.
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abstract = "This study estimated latent classes (ie, unobserved subgroups in a population) of people who use drugs in Vancouver, Canada, and examined how these classes relate to phylogenetic clustering of hepatitis C virus (HCV) infection. HCV antibody-positive people who use drugs from two cohorts in Vancouver, Canada (1996-2012), with a Core-E2 sequence were included. Time-stamped phylogenetic trees were inferred, and phylogenetic clustering was determined by time to most common recent ancestor. Latent classes were estimated, and the association with the phylogenetic clustering outcome was assessed using an inclusive classify/analyse approach. Among 699 HCV RNA-positive participants (26{\%} female, 24{\%} HIV+), recent drug use included injecting cocaine (80{\%}), injecting heroin (70{\%}), injecting cocaine/heroin (ie, speedball, 38{\%}) and crack cocaine smoking (28{\%}). Latent class analysis identified four distinct subgroups of drug use typologies: (i) cocaine injecting, (ii) opioid and cocaine injecting, (iii) crack cocaine smoking and (iv) heroin injecting and currently receiving opioid substitution therapy. After adjusting for age and HIV infection, compared to the group defined by heroin injecting and currently receiving opioid substitution therapy, the odds of phylogenetic cluster membership was greater in the cocaine injecting group (adjusted OR [aOR]: 3.06; 95{\%} CI: 1.73, 5.42) and lower in the crack cocaine smoking group (aOR: 0.06; 95{\%} CI: 0.01, 0.48). Combining latent class and phylogenetic clustering analyses provides novel insights into the complex dynamics of HCV transmission. Incorporating differing risk profiles associated with drug use may provide opportunities to further optimize and target HCV treatment and prevention strategies.",
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Jacka, B, Bray, BC, Applegate, TL, Marshall, BDL, Lima, VD, Hayashi, K, DeBeck, K, Raghwani, J, Harrigan, PR, Krajden, M, Montaner, JSG & Grebely, J 2018, 'Drug use and phylogenetic clustering of hepatitis C virus infection among people who use drugs in Vancouver, Canada: A latent class analysis approach', Journal of Viral Hepatitis, vol. 25, no. 1, pp. 28-36. https://doi.org/10.1111/jvh.12758

Drug use and phylogenetic clustering of hepatitis C virus infection among people who use drugs in Vancouver, Canada : A latent class analysis approach. / Jacka, B.; Bray, Bethany Cara; Applegate, T. L.; Marshall, B. D.L.; Lima, V. D.; Hayashi, K.; DeBeck, K.; Raghwani, J.; Harrigan, P. R.; Krajden, M.; Montaner, J. S.G.; Grebely, J.

In: Journal of Viral Hepatitis, Vol. 25, No. 1, 01.01.2018, p. 28-36.

Research output: Contribution to journalArticle

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T1 - Drug use and phylogenetic clustering of hepatitis C virus infection among people who use drugs in Vancouver, Canada

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AU - Jacka, B.

AU - Bray, Bethany Cara

AU - Applegate, T. L.

AU - Marshall, B. D.L.

AU - Lima, V. D.

AU - Hayashi, K.

AU - DeBeck, K.

AU - Raghwani, J.

AU - Harrigan, P. R.

AU - Krajden, M.

AU - Montaner, J. S.G.

AU - Grebely, J.

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N2 - This study estimated latent classes (ie, unobserved subgroups in a population) of people who use drugs in Vancouver, Canada, and examined how these classes relate to phylogenetic clustering of hepatitis C virus (HCV) infection. HCV antibody-positive people who use drugs from two cohorts in Vancouver, Canada (1996-2012), with a Core-E2 sequence were included. Time-stamped phylogenetic trees were inferred, and phylogenetic clustering was determined by time to most common recent ancestor. Latent classes were estimated, and the association with the phylogenetic clustering outcome was assessed using an inclusive classify/analyse approach. Among 699 HCV RNA-positive participants (26% female, 24% HIV+), recent drug use included injecting cocaine (80%), injecting heroin (70%), injecting cocaine/heroin (ie, speedball, 38%) and crack cocaine smoking (28%). Latent class analysis identified four distinct subgroups of drug use typologies: (i) cocaine injecting, (ii) opioid and cocaine injecting, (iii) crack cocaine smoking and (iv) heroin injecting and currently receiving opioid substitution therapy. After adjusting for age and HIV infection, compared to the group defined by heroin injecting and currently receiving opioid substitution therapy, the odds of phylogenetic cluster membership was greater in the cocaine injecting group (adjusted OR [aOR]: 3.06; 95% CI: 1.73, 5.42) and lower in the crack cocaine smoking group (aOR: 0.06; 95% CI: 0.01, 0.48). Combining latent class and phylogenetic clustering analyses provides novel insights into the complex dynamics of HCV transmission. Incorporating differing risk profiles associated with drug use may provide opportunities to further optimize and target HCV treatment and prevention strategies.

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