Globalization may be fueling new epidemics of hepatitis C infection in China

Increased economic growth and international travel may be responsible for waves of hepatitis C outbreaks in China, according to a new study published in the Journal of Viral Hepatitis.

“The epidemic of hepatitis C is closely related to the epidemic of HIV, both of which are also related to globalization and subsequent social and cultural change,” said senior author Xinguang “Jim” Chen, M.D., Ph.D., a professor in the department of epidemiology in the UF College of Public Health and Health Professions and the UF College of Medicine. “Global strategies and collaborative efforts are needed to control these epidemics.”

The researchers, which included scientists from the University of Florida, the Johns Hopkins University and Italian and Chinese institutions, used an innovative study design that combined biological methods with social epidemiology to investigate the spread of hepatitis C virus subtypes in China.

The team analyzed demographic and biological data collected from 125 participants who had recently been diagnosed with hepatitis C while receiving methadone maintenance treatment at a public health agency in Wuhan, China. Study protocol was approved by the Wuhan Centers for Disease Control and Prevention’s institutional review board. Using phylogenetic analysis techniques to study the geographic origins of the identified hepatitis C strains, the researchers were able to investigate social and policy impacts on the disease’s spread, an approach they call social and phylogenetic analysis.

The researchers found that the population dynamics of the detected hepatitis C subtypes were consistent with economic growth, increased globalization and health care reform in China over the past 30 years. The detected clusters also provided evidence of continued injection drug use and sexual risk behavior in fueling the epidemic.

“Clinicians dealing with infectious diseases must pay attention to personal behavior to better understand the causes of a disease, particularly behaviors related to international travel, employment in other countries, and personal sexual and drug contacts,” Chen said.

Research team members are now using the social and phylogenetic analysis method to study other global disease outbreaks.

“The social and phylogenetic approach can be used to advance the research of any infectious diseases across the globe, such as Zika, dengue and influenza, as well as the diseases’ risk factors, transmission pathways and potential strategies for effective control,” Chen said.

In addition to Chen, the research team included lead author Sheng Zhou of the Johns Hopkins College of Medicine; Eleonora Cella and Massimo Ciccozzi of the Istituto Superiore di Sanita in Rome, Italy; Wang Zhou, Wen-Hua Kong, Manqing Liu and Pu-Lin Liu of the Wuhan Centers for Disease Control and Prevention in China; and Marco Salemi of the UF College of Medicine and Emerging Pathogens Institute.