Genotyping of hepatitis C virus isolates from Basque Country, Spain

Changes in the epidemiology and distribution of the hepatitis C virus genotypes in North-Eastern Spain over the last 35 years

BACKGROUND

Genotypic distribution and epidemiology of HCV infection in Western Europe countries has changed over the last decades.

AIM

To establish the local genotypic profile and characterize the associated demographic variables.

MATERIAL AND METHOD

All the genotyping from 1988 to 2015 were considered. Associated demographic variables were included in logistic regression models. Genotyping was carried out with updated commercial kits.

RESULTS

Genotype 1b was the most prevalent (42.4%) followed by 1a (22.5%), 3 (18.6%), 4 (10.6%) and 2 (4.6%). The prevalence of 1a was higher in males, in patients younger than 45 and in intravenous drug users (IDU). 1b was more frequent in older than 45, with transfusion-associated and parenteral/nosocomial infections and in immigrants from Eastern Europe. Genotype 2 was highly prevalent in the postransfusional route (54.9%). Genotype 3 prevalence was high in males, in patients younger than 45, in IDU (69.3%) and in Asian and Eastern European immigrants. Genotype 4 was high in males, in patients younger than 45, and in IDU (63.5%). 1a, 3, 4 were the most prevalent genotypes in HIV-coinfected patients. There was a significant decline in genotype 1b and an increase in genotypes 3 and 4 over time.

CONCLUSIONS

There has been a decline of genotype 1b, associated with transfusion or parenteral/nosocomial infections, and increases in the prevalence of genotypes 1a, 3 and 4 associated with male gender and IDU, now the most prevalent infection route. Immigration contributed with genotype 2 infections from Africa and genotype 1b and 3 infections from Eastern Europe and Asia.

Distribution of hepatitis C virus genotypes among injecting drug users in contact with treatment centers in Belgium, 2004-2005

The aim of this study was to determine the current prevalence of HCV genotypes in injecting drug users recruited at treatment centers all over Belgium, and to analyze if the distribution of genotypes was correlated with demographic characteristics, at-risk behaviors, and co-infection with other viruses. Therefore 147 anti-HCV-positive serum samples were selected for subsequent HCV RNA detection and genotyping. HCV RNA could be detected in 98 (67%) of the 147 serum samples. Genotype 1 (38%) and 3 (49%) were the most common genotypes followed by genotype 4 (9%) and genotype 2 (2%). One mixed infection (1%) was detected. The subtype could be determined in 80 cases: genotype 3a was the most prevalent (49%), followed by genotype 1a (16%) and genotype 1b (15%). No significant difference was found between the distribution of genotypes and the location of treatment centers, at-risk behaviors and co-infection with other viruses. Nevertheless, a slight variation over time could be identified (P = 0.06): one in two genotype 3 drug users started with their injecting drug use in the last 10 years (33% in the period 1995-1999 and 21% in the period > or =2000) compared to only one in four genotype 1 drug users (20% in the period 1995-1999 and 9% in the period > or =2000).

Changes in the distribution of hepatitis C virus (HCV) genotypes over time in Spain according to HIV serostatus: implications for HCV therapy in HCV/HIV-coinfected patients

BACKGROUND

Changes in the prevalence of distinct hepatitis C virus (HCV) genotypes and subtypes over time have not been explored in detail.

METHODS

A retrospective analysis was carried out in all specimens from subjects with chronic hepatitis C sent for testing to a reference laboratory in Spain since 1998-2004.

RESULTS

A total of 1226 distinct subjects were analyzed. The most frequent HCV genotype was 1 (64.1%), followed by 3 (20.9%) and 4 (11.7%). The most frequent HCV subtype was 1b (32.4%). A total of 797 patients (65%) were HIV-positive. Although genotype 1 was the most frequent, it represented 74.6% of HIV-negative and 58.5% of HIV-positive patients (p<0.01). While HCV subtype 1a was the most frequent among HIV-positive subjects (32.1%), 1b was the most common in HIV-negative patients (53.8%). There was a significant increase in the prevalence of genotype 4 and conversely a decline in genotype 3 among HIV-positive patients over time.

CONCLUSION

Genotype 1 is the most frequent HCV variant circulating in Spain. Genotypes 3 and 4 are significantly more prevalent in HIV/HCV-coinfected than in HCV-monoinfected patients. However, HCV-3 has declined and HCV-4 is increasing in the former group. These findings are relevant given their different susceptibility to interferon-based therapies.

Molecular epidemiology of hepatitis C among drug users in Flanders, Belgium: association of genotype with clinical parameters and with sex- and drug-related risk behaviours

The aim of this study was to determine the genotypic variation of hepatitis C among drug users in Flanders and to relate the distribution of genotypes to the characteristics of the population. Hepatitis C virus RNA (HCV-RNA) quantification and genotyping was performed on stored samples from 161 anti-HCV-positive injecting and non-injecting drug users. Information on sociodemographic status, drug-related risk behaviour and sexual risk behaviour was available for each drug user. HCV-RNA was present in 152 of 161 samples (94.4%). Genotype 1 was predominant (48.7%), followed by genotype 3 (41.2%), genotype 4 (8.8%) and genotype 2 (1.4%). In the multivariate analysis, lack of a history of injecting drug use was confirmed as a statistically significant predictor for infection with genotype 1. Predictors for infection with genotype 3 were the presence of anti-HBc antibodies and a history of injecting drug use. Being tattooed emerged as a statistically significant predictor for infection with genotype 4. The 94.4% prevalence of HCV-RNA among anti-HCV-positive drug users was considerably higher than the 54-86% chronicity rate found globally among HCV-infected patients. The results of this study suggest the existence of separate transmission networks for injecting drug users and non-injecting drug users. Finally, the results suggest that tattooing practices play a role in the spread of HCV among drug users.