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Little is known about transmission of acute or recent HCV<\/jats:styled-content>, in particular among MSM<\/jats:styled-content> living with HIV<\/jats:styled-content> co\u2010infection, which creates uncertainty about potential for reinfection after HCV<\/jats:styled-content> treatment. Using phylogenetic methods, clinical, epidemiological and molecular data can be combined to better understand transmission patterns. These insights may help identify strategies to reduce reinfection risk, enhancing effectiveness of HCV<\/jats:styled-content> treatment as prevention strategies. The aim of this study was to identify multi\u2010risk profiles and factors associated with phylogenetic pairs and clusters among people with recent HCV<\/jats:styled-content> infection.<\/jats:p><\/jats:sec>Methods<\/jats:title>Data and specimens from five studies of recent HCV<\/jats:styled-content> in Australia and New Zealand (2004 to 2015) were used. HCV<\/jats:styled-content> Core\u2010E2 sequences were used to infer maximum likelihood trees. Clusters were identified using 90% bootstrap and 5% genetic distance threshold. Multivariate logistic regression and latent class analyses were performed.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 237 participants with Core\u2010E2 sequences, 47% were in a pair\/cluster. Among HIV<\/jats:styled-content>\/HCV<\/jats:styled-content> co\u2010infected participants, 60% (74\/123) were in a pair\/cluster, compared to 30% (34\/114) with HCV<\/jats:styled-content> mono\u2010infection (p\u00a0<\/jats:italic><\u00a00.001). HIV<\/jats:styled-content>\/HCV<\/jats:styled-content> co\u2010infection (vs. HCV<\/jats:styled-content> mono\u2010infection; adjusted odds ratio (AOR<\/jats:styled-content>), 2.37, 95% confidence interval (CI<\/jats:styled-content>), 1.45, 5.15) was independently associated with phylogenetic clustering. Latent class analysis identified three distinct risk profiles: (1) people who inject drugs, (2) HIV<\/jats:styled-content>\u2010positive gay and bisexual men (GBM<\/jats:styled-content>) with low probability of injecting drug use (IDU<\/jats:styled-content>) and (3) GBM<\/jats:styled-content> with IDU<\/jats:styled-content> & sexual risk behaviour. Class 2 (vs. Class 1, AOR<\/jats:styled-content> 3.40; 95% CI<\/jats:styled-content>, 1.52, 7.60), was independently associated with phylogenetic clustering. Many clusters displayed homogeneous characteristics, such as containing individuals exclusively from one city, individuals all with HIV<\/jats:styled-content>\/HCV<\/jats:styled-content> co\u2010infection or individuals sharing the same route of acquisition of HCV<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Clusters containing individuals with specific characteristics suggest that HCV<\/jats:styled-content> transmission occurs through discrete networks, particularly among HIV<\/jats:styled-content>\/HCV<\/jats:styled-content> co\u2010infected individuals. The greater proportion of clustering found among HIV<\/jats:styled-content>\/HCV<\/jats:styled-content> co\u2010infected participants highlights the need to provide broad direct\u2010acting antiviral access encouraging rapid uptake in this population and ongoing monitoring of the phylogeny.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25222","type":"journal-article","created":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T10:26:05Z","timestamp":1549967165000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A latent class approach to identify multi\u2010risk profiles associated with phylogenetic clustering of recent hepatitis C virus infection in Australia and New Zealand from 2004 to 2015"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-2250","authenticated-orcid":false,"given":"Sofia R","family":"Bartlett","sequence":"first","affiliation":[{"name":"Kirby Institute UNSW Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya L","family":"Applegate","sequence":"additional","affiliation":[{"name":"Kirby Institute UNSW Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan P","family":"Jacka","sequence":"additional","affiliation":[{"name":"Kirby Institute UNSW Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Martinello","sequence":"additional","affiliation":[{"name":"Kirby Institute UNSW Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francois MJ","family":"Lamoury","sequence":"additional","affiliation":[{"name":"Kirby Institute UNSW Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Danta","sequence":"additional","affiliation":[{"name":"St Vincent's Clinical School UNSW Sydney NSW Australia"},{"name":"Department of Gastroenterology St Vincent's Hospital Sydney Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Shaw","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew R","family":"Lloyd","sequence":"additional","affiliation":[{"name":"Kirby Institute UNSW Sydney NSW Australia"},{"name":"School of Medical Sciences UNSW Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Hellard","sequence":"additional","affiliation":[{"name":"The Burnet Institute Melbourne Vic. 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