Epidemic History and Iatrogenic Transmission of Blood-borne Viruses in Mid-20th Century Kinshasa

NCT02439918 | Completed

• 1 other identifier: 12-054
• Study Type: observational
• Target: 839
• Locations: 0 countries
• Sites: N/A

Brief Summary

Kinshasa, Democratic Republic of Congo (DRC), is where human immunodeficiency virus type 1 (HIV-1) appears to have most diversified. The factors that lead to jumpstarting the HIV-1 epidemic remain unclear; mounting evidence suggests medical interventions may have contributed. Hepatitis C virus (HCV) and human T-cell lymphotropic virus type 1 (HTLV-1) are viruses compatible with long-term survival but with broadly similar modes of transmission as HIV. The main objective was to assess the association of past intravenous treatment with HCV and HTLV-1 seropositivity. The investigators hypothesized that medical interventions in the mid-20th century may have facilitated the emergence of HIV-1 in central Africa. To assess the association of injectable treatments with HCV and HTLV-1 infection and to reconstruct past virus dynamics, the investigators conducted a cross-sectional study of 839 elderly long-term inhabitants of Kinshasa, with serological assays followed by amplification and sequencing. Risk factors were assessed through logistic regression. Phylogenetic methods were used to reconstruct the epidemic history of HCV.

Conditions

HIV; HTLV-1; Hepatitis C, Chronic

Outcome Measures

Primary Outcomes (1)

• HCV serology

  2 months

Secondary Outcomes (1)

• HTLV-1 serology

  2 months

Eligibility Criteria

• Age: 70 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

We will attempt to recruit into this cross-sectional study participants aged 70 years or more living in various districts of Kinshasa. According to countrywide demographic data, 1.4% of the Congolese population is aged 70 years or more.40 Assuming that the population of Kinshasa is around 8 million, and that the proportion of elderly is similar to that of the whole country, there could be within the capital approximately 112.000 residents aged 70 years or more. As we are interested in documenting the mechanisms of virus transmission within the city itself, we will enrol only individuals who have lived in Kinshasa for at least 35 years.

You may qualify if:

• age ≥70 years
• having resided in Kinshasa for ≥ 30 years
• willingness to consent

You may not qualify if:

• dementia or aphasia
• inability to understand Lingala.

Sponsors & Collaborators

• Université de Sherbrooke: lead

Related Publications (5)

• Gao F, Bailes E, Robertson DL, Chen Y, Rodenburg CM, Michael SF, Cummins LB, Arthur LO, Peeters M, Shaw GM, Sharp PM, Hahn BH. Origin of HIV-1 in the chimpanzee Pan troglodytes troglodytes. Nature. 1999 Feb 4;397(6718):436-41. doi: 10.1038/17130.

  PMID: 9989410 BACKGROUND

• Keele BF, Van Heuverswyn F, Li Y, Bailes E, Takehisa J, Santiago ML, Bibollet-Ruche F, Chen Y, Wain LV, Liegeois F, Loul S, Ngole EM, Bienvenue Y, Delaporte E, Brookfield JF, Sharp PM, Shaw GM, Peeters M, Hahn BH. Chimpanzee reservoirs of pandemic and nonpandemic HIV-1. Science. 2006 Jul 28;313(5786):523-6. doi: 10.1126/science.1126531. Epub 2006 May 25.

  PMID: 16728595 BACKGROUND

• Worobey M, Gemmel M, Teuwen DE, Haselkorn T, Kunstman K, Bunce M, Muyembe JJ, Kabongo JM, Kalengayi RM, Van Marck E, Gilbert MT, Wolinsky SM. Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960. Nature. 2008 Oct 2;455(7213):661-4. doi: 10.1038/nature07390.

  PMID: 18833279 BACKGROUND

• Peeters M, Toure-Kane C, Nkengasong JN. Genetic diversity of HIV in Africa: impact on diagnosis, treatment, vaccine development and trials. AIDS. 2003 Dec 5;17(18):2547-60. doi: 10.1097/01.aids.0000096895.73209.89. No abstract available.

  PMID: 14685049 BACKGROUND

• Zhu T, Korber BT, Nahmias AJ, Hooper E, Sharp PM, Ho DD. An African HIV-1 sequence from 1959 and implications for the origin of the epidemic. Nature. 1998 Feb 5;391(6667):594-7. doi: 10.1038/35400.

  PMID: 9468138 BACKGROUND

Biospecimen

Retention: SAMPLES WITH DNA

Laboratory assays Dry blood spots were made from capillary blood deposited on Whatman 3 filter paper (serology) and Whatman Protein Saver Card (molecular biology). To document our two main outcomes (HCV and HTLV-1 infections), serological assays were performed as detailed in Web extra material, Appendix. For HCV, PCR amplification of the NS5b (485-nt) and core/E1 (1026-nt) genome regions was attempted on reactive samples. For HTLV-1, the gp21 env gene was amplified (885-nt).

MeSH Terms

Conditions

Hepatitis C, Chronic

Condition Hierarchy (Ancestors)

Hepatitis C; Blood-Borne Infections; Communicable Diseases; Infections; Hepatitis, Viral, Human; Virus Diseases; Flaviviridae Infections; RNA Virus Infections; Hepatitis, Chronic; Hepatitis; Liver Diseases; Digestive System Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Jacques Pépin, MD

  Université de Sherbrooke

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 29, 2015
• First Posted: May 12, 2015
• Study Start: June 1, 2012
• Primary Completion: August 1, 2012
• Study Completion: August 1, 2012
• Last Updated: May 12, 2015

Record last verified: 2015-04