Marie Curie "Promising Research Talent" Prize Winner 2012, Gkikas Magiorkinis, recently published an article in the high profile publication PLoS Computational Biology, describing how the Hepatitis C Virus spreads in a population. This ground breaking research was also reported on by the BBC. Knowing the main source of the virus transmission can help diagnosing the disease at an early stage, and increase the efficiency of the therapies.
Hepatitis Virus C is a major Public Health problem. The virus, which mainly transmits through contaminated blood, was discovered in 1989 and currently infects up to 180 million people. 20% of them will develop liver scarring (cirrhosis) or cancer after 20 years of infection, at which point the only viable treatment is liver transplantation costing over €100 000.
Most of these people are unaware of their infection; they got infected silently and live with HCV undiagnosed for more than 10 years. Therefore, essential details of the epidemic such as how many people are to be infected by a single carrier (and how soon) have never been described.
Now a multidisciplinary team from the Universities of Oxford, Athens and the Imperial College has developed a method that combines epidemiological surveillance and genomic information (i.e. RNA sequence of the virus) to describe in detail how viruses spread in a population. They applied the method on HCV and for the first time they describe amongst other the superspreaders of HCV transmission. The study is published in PLoS Computational Biology.
Why is this study important?
There is no vaccine available at the moment, but there are potent therapies clearing HCV. Intravenous drug use is currently the major transmission route, but administration of these potent regimens to active drug users is low. This paradox exists because of adverse effects being higher to active drug users, and also because active drug users are likely to get re-infected, thus the antiviral treatment is unlikely to be beneficial.
The study shows that each infected drug user is likely to infect around 20 people, 10 of which within the first 2 years of their infection. By diagnosing HCV early and providing treatment to active drug users it suggests that most of the transmissions can be prevented. The overall impact of early diagnosis and treatment on Public Health (i.e. reducing the overall number of infections) based on these findings remains to be explored.
Gkikas Magiorkinis, lead author of the study said: “For the first time we show that superspreading in HCV is lead by active drug users early in their infection. Using this information we can hopefully soon make a solid argument to support scale-up of early diagnosis and antiviral treatment in IDUs. Helping these people, stopping the spread of HCV is our ultimate target.”
Gkikas Magiorkinis has been recently awarded with the Marie Curie Prize of the European Commission as Promising Research Talent for his work on how pandemic HCV spread around the world. The work has been supported by the Wellcome Trust, the European Commission, the Royal Society, the European Social Fund and Greek National Resources (EPEAK-II) and the Hellenic Scientific Society for the Study of AIDS and Sexually Transmitted Diseases.
Further information is available here