1
|
Du R, Xu R, Huang J, Wang H, Wang M, Liao Q, Shan Z, Zhong H, Zheng Y, Rong X, Fu Y. HCV 6a was expanding and became the predominant subtype among blood donors between 2004 and 2019 in Guangdong, China. Virol Sin 2022; 37:765-768. [PMID: 35842093 PMCID: PMC9583116 DOI: 10.1016/j.virs.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 06/15/2022] [Indexed: 11/19/2022] Open
Abstract
Currently, HCV 6a has replaced 1b as the most prevalent subtype in blood donors in Guangdong. HCV 6a was the predominant subtype in males and older donors, while 1b predominated in females and younger donors. HCV 6a may expand from Guangdong to other districts of China, and is worthy of attention.
Collapse
Affiliation(s)
- Rongsong Du
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023)
| | - Ru Xu
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023)
| | - Jieting Huang
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023)
| | - Hao Wang
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023)
| | - Min Wang
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023)
| | - Qiao Liao
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023)
| | - Zhengang Shan
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023)
| | - Huishan Zhong
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023)
| | - Yourong Zheng
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023)
| | - Xia Rong
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023).
| | - Yongshui Fu
- Guangzhou Blood Center, Guangzhou, 510095, China; The Key Medical Laboratory of Guangzhou, Guangzhou, 510095, China (2021-2023); Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, 510515, China.
| |
Collapse
|
2
|
Liu X, Chen Z, Tang Q, Hu P. Phylogenetic signature and prevalence of natural resistance-associated substitutions for hepatitis C virus genotypes 3a and 3b in southwestern China. J Virus Erad 2022; 8:100071. [PMID: 35757658 PMCID: PMC9218835 DOI: 10.1016/j.jve.2022.100071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/01/2022] [Accepted: 06/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background Patients infected with hepatitis C (HCV) genotype (GT) 3, especially GT3b, are still difficult to cure. GT3b is more common than GT3a in southwestern China. Here we aimed to investigate the prevalence of naturally occurring RASs in HCV GT3 in southwestern China and performed phylogenetic analysis. Methods Serum samples were collected from patients with HCV GT3 infection. Sanger sequencing was used to validate resistance-associated substitutions (RASs). Phylogenetic analysis was performed using MEGA X and the observed-minus-expected-squared algorithm was used to analyze amino acid covariance. Results A total of 136 patients were enrolled, including 41 HCV GT3a and 95 GT3b infected patients. In the NS5A region, the proportion of RASs found in GT3b (99%) was notably higher than in GT3a (9%). In the NS3 region, RASs prevalence in GT3b (5%) was lower than in GT3a (24%). NS5B-specific RASs were rare. Both the NS5A30k and L31 M substitutions occurred in 96% of GT3b sequences. The A30K + L31M combination was found in 94% of GT3b isolates, however, there were no A30K or L31M mutations observed in the GT3a sequence. Conclusions Significant differences were observed between HCV GT3a and GT3b in terms of RAS prevalence. The origin of GT3a appears to be more diverse compared with GT3b in southern China. Studies specifically aimed at HCV GT3b infection should be initiated to gain more insight into this subtype.
Collapse
Affiliation(s)
| | | | | | - Peng Hu
- Corresponding author. Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.,
| |
Collapse
|
3
|
Worldwide prevalence, genotype distribution and management of hepatitis C. Acta Gastroenterol Belg 2021; 84:637-656. [PMID: 34965046 DOI: 10.51821/84.4.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma, resulting in major global public health concerns. The HCV infection is unevenly distributed worldwide, with variations in prevalence across and within countries. The studies on molecular epidemiology conducted in several countries provide an essential supplement for a comprehensive knowledge of HCV epidemiology, genotypes, and subtypes, along with providing information on the impact of current and earlier migratory flows. HCV is phylogenetically classified into 8 major genotypes and 57 subtypes. HCV genotype and subtype distribution differ according to geographic origin and transmission risk category. Unless people with HCV infection are detected and treated appropriately, the number of deaths due to the disease will continue to increase. In 2015, 1.75 million new viral infections were mostly due to unsafe healthcare procedures and drug use injections. In the same year, access to direct-acting antivirals was challenging and varied in developing and developed countries, affecting HCV cure rates based on their availability. The World Health Assembly, in 2016, approved a global strategy to achieve the elimination of the HCV public health threat by 2030 (by reducing new infections by 90% and deaths by 65%). Globally, countries are implementing policies and measures to eliminate HCV risk based on their distribution of genotypes and prevalence.
Collapse
|
4
|
Prevalence of positivity to antibodies to hepatitis C virus among volunteer blood donors in China: a meta-analysis. Public Health 2021; 199:87-95. [PMID: 34571442 DOI: 10.1016/j.puhe.2021.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 06/17/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Safe blood transfusion plays an important role in the prevention of transfusion-transmissible infections, and hepatitis C virus (HCV) infection is one of the major problems associated with this procedure. This meta-analysis aimed to determine the prevalence of HCV infection in Chinese blood donors. STUDY DESIGN The study design of this study is a meta-analysis. METHODS Eligible studies were retrieved from PubMed, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database and Wanfang literature databases from 2010 to 2020. The effect measure was presented as HCV prevalence with a 95% confidence interval (CI). Q test was used to assess the heterogeneity, and the I2 statistics was determined to decide whether a random effects model or a fixed effects model should be used as the pooling method. Subgroup analyses were also conducted. RESULTS A total of 62 eligible studies, including 9,007,220 HCV blood donors, were analysed. Of the total blood donors, 35,017 were infected with HCV. The pooled HCV prevalence was 0.415% (95% CI: 0.371-0.458). The subgroup analysis revealed that the prevalence of positivity to anti-HCV antibodies was significantly different in each year (P < 0.05). However, no significant difference was observed in HCV prevalence in terms of sex. Moreover, the prevalence of positivity to anti-HCV was remarkably higher in first-time blood donors than in repeat blood donors (P < 0.05), and the rate of HCV infection among university students was significantly lower than that among soldiers (P < 0.05). CONCLUSIONS The rate of HCV infection showed a downward trend from 2010 to 2014, increased in 2015-2016, and finally decreased in 2017-2018. Thus, the prevalence of HCV infection has decreased in Chinese blood donors after comprehensive prevention and treatment.
Collapse
|
5
|
Prevalence of Hepatitis C Virus Infection in a Surgical Population of Southeast China: A Large-Scale Multicenter Study. Can J Gastroenterol Hepatol 2020; 2020:8219536. [PMID: 32377514 PMCID: PMC7180502 DOI: 10.1155/2020/8219536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic HCV infection affects 80 million people globally and may progress to advanced liver disease. The present study aims to investigate the present epidemiology of HCV infection in a southeastern Chinese surgical patient cohort. METHODS Blood samples obtained from 78,484 surgical patients from 18 different city and county hospitals were enrolled. The incidence of serum HCV antibody positivity, HCV RNA load, and HCV genotyping, as well as demographics and relevant clinical history, were investigated. Data were stratified using the multistage cluster random sampling method and further analyzed using the SPSS-20 package. RESULTS HCV antibody positivity was detected in 0.15% of the population (95% confidence interval (CI): 0.12%-0.18%). Genotype 1b (55.74%) was the dominant type. The HCV infection peaked in the age groups of 16-20, 41-50, and 61-65 years, and it was higher in males than in females (0.19% vs. 0.13%, P < 0.05). The geographical distribution of infection rates differed: 0.19% (95% CI: 0.14%-0.24%), 0.18% (95% CI: 0.13%-0.23%), and 0.06% (95% CI: 0.03-0.09%) in plain areas, islands, and valley regions, respectively. Patients with transfusion history and urban residence were associated with high HCV RNA levels (adjusted odds ratio = 11.24 and 6.20, P < 0.05). CONCLUSION The prevalence of HCV infection in this cohort from southeast China was 0.17%, which is lower than the reported 0.43% infection rate in China in 2006. This result can be (partially) explained by the improvement of blood donor screening and the successful campaign for the use of disposable syringes and needles.
Collapse
|
6
|
Du G, Li X, Musa TH, Ji Y, Wu B, He Y, Ni Q, Su L, Li W, Ge Y. The nationwide distribution and trends of hepatitis C virus genotypes in mainland China. J Med Virol 2018; 91:401-410. [PMID: 30192393 DOI: 10.1002/jmv.25311] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 09/03/2018] [Indexed: 12/15/2022]
Abstract
Comprehensive data on hepatitis C virus (HCV) genotypes distribution is critical for treatment regimen selection, vaccine design, and drug development. This study aimed to understand the dynamic distribution of HCV genotypes in Mainland China. Three hundred sixty-two studies published from January 1993 to December 2017 involving 64 891 samples (5133 injecting drug users, 2748 volunteer blood donors, 1509 former paid plasma donors, 160 sexually encounters, and 1992 human immunodeficiency virus (HIV)/HCV coinfection patients) were eligible for the quantitative synthesis estimation. Pooled proportion of HCV genotypes (and 95% confidence intervals [CIs]) was estimated through the Freeman-Tukey double arcsine transformation by period, region, and risk group. A sharp decline of the subtype 1b was observed in all regions except in northwestern and central regions. The genotypes 3 and 6 showed an obvious increase in southern and southwestern regions and have already spread nationwide. After 2010, subtype 1b was the most dominant variant in all regions and risk groups, accounting for 54.0% (95% CI, 51.9-56.1) of all national infections. Subtype 2a was the second most prevalent strain in all regions except in the south and southwest, with 15.4% (95% CI, 13.1-17.8) national infections. The subtype 6a in southern region and 3b and 3a in southwestern region had a higher proportion of infections than that in other regions. In addition, the genotypes 3 and 6 are already prevalent in almost all risk groups. The distribution of HCV genotypes were sharply shifting in China in the past three decades. The HCV subtype 1b posed a sharp decline, whereas genotypes 3 and 6 played an increasing role in the regional and populational HCV pandemic.
Collapse
Affiliation(s)
- Guoping Du
- Hospital Office, Southeast University Hospital, Nanjing, China
| | - Xiaoshan Li
- Department of Lung Transplants Center, Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Taha Hussein Musa
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Yu Ji
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Bo Wu
- Department of Lung Transplants Center, Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Yan He
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Qian Ni
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Ling Su
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, China
| | - Wei Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - You Ge
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| |
Collapse
|
7
|
Chen Y, Yu C, Yin X, Guo X, Wu S, Hou J. Hepatitis C virus genotypes and subtypes circulating in Mainland China. Emerg Microbes Infect 2017; 6:e95. [PMID: 29089588 PMCID: PMC5717081 DOI: 10.1038/emi.2017.77] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/19/2017] [Accepted: 07/18/2017] [Indexed: 02/07/2023]
Abstract
The hepatitis C virus (HCV) exhibits global genotypic diversity. HCV genotyping plays an important role in epidemiological studies and clinical management. Herein, we report the results of HCV genotype and subtype detection in a large number of clinical samples, as performed by an independent laboratory in China. In total, four HCV genotypes and 18 subtypes were identified among 32 030 patients from 29 provinces and municipalities in China. Five dominant subtypes were detected from 98.84% of the samples: 1b (n=16 713, 52.18%), 2a (n=9188, 28.69%), 3b (n=2261, 7.06%), 6a (n=2052, 6.41%) and 3a (n=1479, 4.62%). Twelve rare subtypes were detected, of which four (that is, 6b, 6j, 6q and 6r) are reported for the first time in the Chinese population. Genotypes 4, 5 and 7 were not detected. Mixed infections of the dominant subtypes were found in a small portion of samples (n=65, 0.203%), in the following combinations: 1b–2a, 1b–3b, 1b–6a, 3a–3b, 1b–3a and 2a–6a. No mixed infections with rare subtypes were found. Males, compared with females, showed higher HCV subtype diversity, a lower percentage of HCV1b and 2a and a higher percentage of rare subtypes and mixed infections. Our analyses revealed the comprehensive distribution patterns of HCV genotypes in the general population of mainland China. HCV genotypic patterns were differentially distributed on the basis of geography, sex and age.
Collapse
Affiliation(s)
- Ying Chen
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, China.,College of Laboratory Medicine, Tianjin Medical University, Tianjin, China
| | - Changshun Yu
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, China.,College of Laboratory Medicine, Tianjin Medical University, Tianjin, China
| | - Xueru Yin
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaolei Guo
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, China
| | - Shangwei Wu
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, China.,College of Laboratory Medicine, Tianjin Medical University, Tianjin, China
| | - Jinlin Hou
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
8
|
Chen F, Zhang J, Guo F, Wen B, Luo S, Yuan D, Lin Y, Ou W, Tang P, Dai G, Li F, Liu W, Qu X. Hepatitis B, C, and D virus infection showing distinct patterns between injection drug users and the general population. J Gastroenterol Hepatol 2017; 32:515-520. [PMID: 27248508 DOI: 10.1111/jgh.13460] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Hepatitis B, C, and D virus (HBV, HCV, and HDV) infections are known to be prevalent in injection drug users (IDUs); however, the relationship between the molecular epidemiologic features of hepatitis virus infection in high-risk individuals and the general population has not yet been established. METHODS In total, 1049 IDUs and 672 individuals who underwent physical examinations at Chenzhou hospital, Hunan Province, China, were enrolled. HBV, HCV, and HDV infections were screened with serologic tests in both populations. HBsAg-positive, anti-HCV IgG-positive, and anti-HDV IgG-positive samples were further confirmed by polymerase chain reaction, quantitative polymerase chain reaction, and DNA sequencing. RESULTS Significantly higher HBV (21.54 vs 16.52%, P = 0.01), HCV (45.95% vs 1.34%, P < 0.001), and HDV (5.62% vs 0.30%, P < 0.001) infections were detected in IDUs compared with the general population. The dual infection of HBV/HCV or HBV/HDV was also significantly higher in IDUs than in the general population. HBV genotype B and HDV genotype II were dominants in both populations. HCV infection showed genotype 6a (49.52%) dominant in IDUs, but genotype 1b accounted for 50% infection, which was followed by genotype 6a (33.33%) in the general population. Higher viral loads were associated with HBV genotype B and HCV genotype 6a compared with non-dominant genotypic infections. CONCLUSIONS HBV and HDV infections shared similar patterns by IDUs and the general populations, and HCV infection exhibited distinct features between two populations. Our results suggest different molecular epidemiologic characteristics of HBV, HCV, and HDV infection in two populations.
Collapse
Affiliation(s)
- Fei Chen
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China.,The Fourth People's Hospital of Changde, Hunan province, China
| | - Jian Zhang
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Fengfan Guo
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Bo Wen
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Shan Luo
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Dongping Yuan
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Yingbiao Lin
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Wensheng Ou
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Ping Tang
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Guozhi Dai
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Fangfang Li
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Wenpei Liu
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Xiaowang Qu
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-throughput Molecular Diagnosis Technology, Affiliated The First People's Hospital of Chenzhou, University of South China, Chenzhou, China
| |
Collapse
|
9
|
Wyles D, Lin J. Clinical Manifestations of Acute and Chronic Hepatitis. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00042-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
10
|
Robaeys G, Bielen R, Azar DG, Razavi H, Nevens F. Global genotype distribution of hepatitis C viral infection among people who inject drugs. J Hepatol 2016; 65:1094-1103. [PMID: 27520879 DOI: 10.1016/j.jhep.2016.07.042] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/28/2016] [Accepted: 07/30/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Hepatitis C viral infection (HCV) after injection drug use is very prevalent. The kind of genotype determines the response to treatment. However, no systematic review update on the global genotype distribution of HCV in people who inject drugs (PWID) is currently available. METHODS A systematic review was performed by using the keywords: Genotype, Hepatitis C, Injection drug user/Intravenous drug user/Substance user/ PWID, Name of countries in Pubmed, Embase and PsycINFO. The results were compared with the review of Gower et al. in 2014, concerning the distribution of HCV genotypes in the general HCV population. RESULTS Using these keywords, 132 studies in 48 countries (from 1995 to 2015) were collected. After grading these results, the data of 48 studies were used to determine the distribution of genotypes in PWID. Genotype 1 is the most prevalent genotype all over the world in PWID. In Europe, genotypes 1, 3 and 4 are highly prevalent. In North and South America and in Australia genotype 1 and 3 are most prevalent. In Asia genotype 2 and 6, and Africa genotype 1a and 4 are mostly observed. Overall, the most important differences comparing with the general population are a lower prevalence of genotype 1b in the PWID population and higher prevalence of genotype 1a and 3. CONCLUSIONS There is a different prevalence of genotype distribution in PWID than in the general population. Genotype 3 is especially highly prevalent in the Western countries. LAY SUMMARY Hepatitis C viral infection after injection drug use is very prevalent. The most important genotype causing HCV infection in PWID globally is genotype 1, as is the case in the general population, but also genotype 3 is highly prevalent in PWID. Genotype 4 is most prevalent in Africa, spreading into Europe, whereas genotype 2 and 6 are more located in Asia. The most important difference comparing to the general population are generally lower prevalence of genotype 1b, and higher prevalence of genotype 1a and 3 in PWID. As the genotype nowadays still determines the treatment, and as there is a different genotype distribution than in the general population, it is important to identify the genotype also in PWID.
Collapse
Affiliation(s)
- Geert Robaeys
- Ziekenhuis Oost-Limburg, Dept. of Gastro-enterology and Hepatology, Schiepse Bos 6, 3600 Genk, Belgium; Hasselt University, Faculty of Medicine and Life Sciences, Martelarenlaan 42, 3500 Hasselt, Belgium; KULeuven, Dept. of Gastro-enterology and Hepatology, Herestraat 49, 3000 Leuven, Belgium
| | - Rob Bielen
- Ziekenhuis Oost-Limburg, Dept. of Gastro-enterology and Hepatology, Schiepse Bos 6, 3600 Genk, Belgium; Hasselt University, Faculty of Medicine and Life Sciences, Martelarenlaan 42, 3500 Hasselt, Belgium.
| | - Darush Ghezel Azar
- Ziekenhuis Oost-Limburg, Dept. of Gastro-enterology and Hepatology, Schiepse Bos 6, 3600 Genk, Belgium; KULeuven, Dept. of Gastro-enterology and Hepatology, Herestraat 49, 3000 Leuven, Belgium
| | - Homie Razavi
- Center for Disease Analysis, 1120 W South Boulder Road, Suite 102, Louisville, CO 80026, USA
| | - Frederik Nevens
- KULeuven, Dept. of Gastro-enterology and Hepatology, Herestraat 49, 3000 Leuven, Belgium
| |
Collapse
|
11
|
Wu Z, Cui L, Zhao W, Yang D, Chen H, Wang R, Wang X, Zhang L, He T. Molecular epidemiology of hepatitis C infections in Ningxia, China: genotype, phylogeny and mutation analysis. Virol J 2016; 13:172. [PMID: 27756381 PMCID: PMC5070218 DOI: 10.1186/s12985-016-0635-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/12/2016] [Indexed: 02/07/2023] Open
Abstract
Background Current prevalence and genotype distribution of hepatitis C virus (HCV) infection remain unknown in Ningxia, northwest China. Methods From June to December 2013, 13,022 individuals were screened in Ningxia HIV/AIDS Sentinel Surveillance System, with their demographic features collected and serum samples tested for HCV antibody. Sero-positive drug users were further subjected to sequencing of NS5B and Core regions of HCV. Results The anti-HCV prevalence was 0.34 % among individuals without history of drug use, while it was 15.80 % among drug users. Of 79 NS5B sequences amplified from drug users, 64 (81.0 %) were male and 51 (64.0 %) were injection drug users (IDUs). Subtype 3a (40.5 %) and 1b (25.3 %) were the most predominant subtypes, followed in frequency by 3b (10.1 %) and 2a (7.6 %). Subtype distribution has no significant difference between injection and non-injection drug users. Based on phylogeographic analysis, HCV strains in Ningxia IDUs were mainly originated from two sites, Yunnan province (in southwest China bordering Myanmar, also known as Burma) and Xinjiang Autonomous Region (in northwest China on the border of Central Asia), which are the two major drug trafficking originates in China. Previously reported drug-resistance mutations were also scanned in this treatment-naïve population. Amino acid substitutions (C316N) associated with direct anti-viral agents (DAA) resistance were identified in the NS5B region in seven samples. Conclusion This study is the first to reveal the existence of multiple genotypes of HCV in Ningxia, an inland province in northwest China, suggesting the rapid spreading of the virus. Electronic supplementary material The online version of this article (doi:10.1186/s12985-016-0635-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Zhonglan Wu
- Ningxia Center for Disease Control and Prevention, Ningxia, 750001, China
| | - Lijia Cui
- Tsinghua University School of Medicine, Beijing, 100084, China
| | - Weiming Zhao
- Ningxia Medical University School of Public Health and Management, Ningxia, 750001, China
| | - Dongzhi Yang
- Ningxia Center for Disease Control and Prevention, Ningxia, 750001, China
| | - Hui Chen
- Ningxia Center for Disease Control and Prevention, Ningxia, 750001, China
| | - Ruiqing Wang
- Wuzhong Center of Disease Control and Prevention, Ningxia, 751100, China
| | - Xuemin Wang
- Ningxia Center for Disease Control and Prevention, Ningxia, 750001, China
| | - Linqi Zhang
- Comprehensive AIDS Research Center, and Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Tsinghua University School of Medicine, Beijing, 100084, China
| | - Tianhua He
- Tsinghua University School of Medicine, Beijing, 100084, China.
| |
Collapse
|
12
|
Gul A, Zahid N, Ahmed J, Zahir F, Khan IA, Ali I. Molecular characterization of Hepatitis C virus 3a in Peshawar. BMC Infect Dis 2016; 16:163. [PMID: 27090517 PMCID: PMC4836082 DOI: 10.1186/s12879-016-1488-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/29/2016] [Indexed: 01/17/2023] Open
Abstract
Background The purpose of this study was to explore molecular epidemiology of HCV genotype 3a in Peshawar based on sequencing and phylogenetic analysis of Core region of HCV genome. Methods Chronically infected Hepatitis C virus infected patients enrolled under the Prime Minister Hepatitis C control program at three Tertiary care units of Peshawar [Khyber Teaching Hospital Peshawar, Lady Reading Hospital Peshawar, Hayat Abad Medical Complex Peshawar] were included in this cross sectional observational study. Qualitative detection of HCV and HCV genotyping was carried out by a modified reverse transcription-polymerase chain reaction (RT-PCR) and type specific genotyping assay. The Core gene of HCV genotype 3a was amplified, cloned and sequenced. The sequences obtained were used for phylogenetic analysis using MEGA 6 software. Results Among the 422 (82.75 %) PCR positive samples, 192 (45.5 %) were identified as having HCV genotype 3a infection. HCV Core gene sequencing was carried out randomly for the characterization of HCV 3a. Nucleotide sequence analysis of the obtained viral genomic sequences based on partial HCV 3a Core gene sequences with reference sequences from different countries showed that our sequences clustered with some local and regional sequences with high bootstrap values. Conclusion HCV 3a is highly prevalent in Peshawar, Pakistan and its phylogenetics based on Core gene sequences indicate the prevalence of different lineages of HCV 3a in Peshawar which may have consequences for disease management strategies causing more economic pressure on the impoverished population due to possible antiviral resistance.
Collapse
Affiliation(s)
- Amina Gul
- Institute of Basic Medical Sciences, Khyber Medical University Peshawar, Peshawar, Pakistan.,Department of Biosciences, COMSATS Institute of Information Technology Islamabad, Islamabad, Pakistan
| | - Nabeela Zahid
- IBGE, The University of Agriculture Peshawar, Peshawar, Pakistan
| | - Jawad Ahmed
- Institute of Basic Medical Sciences, Khyber Medical University Peshawar, Peshawar, Pakistan
| | - Fazli Zahir
- IBGE, The University of Agriculture Peshawar, Peshawar, Pakistan
| | - Imtiaz Ali Khan
- Department of Entomology, The University of Agriculture Peshawar, Peshawar, Pakistan
| | - Ijaz Ali
- Department of Biosciences, COMSATS Institute of Information Technology Islamabad, Islamabad, Pakistan.
| |
Collapse
|
13
|
Li D, Zhu S, Wang T, An J, Wang L, Tao C. Comparison of Elecsys Anti-HCV II Assay With Other HCV Screening Assays. J Clin Lab Anal 2015; 30:451-6. [PMID: 26667603 DOI: 10.1002/jcla.21878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 07/11/2015] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Early detection of hepatitis C virus (HCV) is an important step in preventing progression to cirrhosis and hepatocellular carcinoma. Serologic assays for anti-HCV antibody are valuable first-line tests in the screening and diagnosis of HCV infection. This study's aim was to evaluate the sensitivity and specificity of Elecsys Anti-HCV II assay for HCV screening. DESIGN AND METHODS A total of 1,044 routine sera, 20 known HCV-positive samples, plus 54 preselected weakly positive samples were tested for anti-HCV with Elecsys Anti-HCV II assay, Elecsys Anti-HCV assays, InTec HCV enzymoimmunoassay (EIA), and Livzon Anti-HCV EIA. Interference test was assessed with additional 423 specimens without clinical evidence of HCV infection: preselected HCV weak reactive samples; dialysis samples; anti-HBc (antibody to HBV core antigen) (+), anti-Treponema pallidum (+), and anti-HIV (+) sera; and samples form autoimmune/alcoholic hepatitis or systemic Lupus erythematosus (SLE). Discrepant results were evaluated with recombinant immunoblot assay. The seroconversion panels were evaluated to assess how early each assay could detect HCV infection. RESULTS The specificity (99.81%) of the Elecsys Anti-HCV II assay was less than that with the two EIA comparison methods. However, false-negative results were easily seen in the EIA assays. When serial bleeds of HCV panels were compared with the above-mentioned methods, the assay detected acute HCV infection only 3.5 days after a positive HCV-RNA nucleic acid test and earlier than the comparator assays. CONCLUSION Sensitivities and specificities of the anti-HCV assays were sufficiently high for use in this study. The Elecsys Anti-HCV II assay is suitable for screening and reliable early detection of HCV infection.
Collapse
Affiliation(s)
- Dongdong Li
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Siyuan Zhu
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Tingting Wang
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jingna An
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Lanlan Wang
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Chuanmin Tao
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, P.R. China.
| |
Collapse
|
14
|
A review of the burden of hepatitis C virus infection in China, Japan, South Korea and Taiwan. Hepatol Int 2015; 9:378-90. [DOI: 10.1007/s12072-015-9629-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/30/2015] [Indexed: 12/19/2022]
|
15
|
Ho SH, Ng KP, Kaur H, Goh KL. Genotype 3 is the predominant hepatitis C genotype in a multi-ethnic Asian population in Malaysia. Hepatobiliary Pancreat Dis Int 2015; 14:281-6. [PMID: 26063029 DOI: 10.1016/s1499-3872(15)60363-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Genotypes of hepatitis C virus (HCV) are distributed differently across the world. There is a paucity of such data in a multi-ethnic Asian population like Malaysia. The objectives of this study were to determine the distribution of HCV genotypes between major ethnic groups and to ascertain their association with basic demographic variables like age and gender. METHODS This was a cross-sectional prospective study conducted from September 2007 to September 2013. Consecutive patients who were detected to have anti-HCV antibodies in the University of Malaya Medical Centre were included and tested for the presence of HCV RNA using Roche Cobas Amplicor Analyzer and HCV genotype using Roche single Linear Array HCV Genotyping strip. RESULTS Five hundred and ninety-six subjects were found to have positive anti-HCV antibodies during this period of time. However, only 396 (66.4%) were HCV RNA positive and included in the final analysis. Our results showed that HCV genotype 3 was the predominant genotype with overall frequency of 61.9% followed by genotypes 1 (35.9%), 2 (1.8%) and 6 (0.5%). There was a slightly higher prevalence of HCV genotype 3 among the Malays when compared to the Chinese (P=0.043). No other statistical significant differences were observed in the distribution of HCV genotypes among the major ethnic groups. There was also no association between the predominant genotypes and basic demographic variables. CONCLUSIONS In a multi-ethnic Asian society in Malaysia, genotype 3 is the predominant genotype among all the major ethnic groups with genotype 1 as the second commonest genotype. Both genotypes 2 and 6 are uncommon. Neither genotype 4 nor 5 was detected. There is no identification of HCV genotype according to ethnic origin, age and gender.
Collapse
Affiliation(s)
- Shiaw-Hooi Ho
- Gastroenterology and Hepatology Unit, Department of Internal Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | | | | | | |
Collapse
|
16
|
Duan Z, Jia JD, Hou J, Lou L, Tobias H, Xu XY, Wei L, Zhuang H, Pan CQ. Current challenges and the management of chronic hepatitis C in mainland China. J Clin Gastroenterol 2014; 48:679-86. [PMID: 24921215 PMCID: PMC4162325 DOI: 10.1097/mcg.0000000000000109] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Despite decreasing prevalence, new cases of hepatitis C in China are increasing recently with growing percentage of patients who are with advanced disease, aging, or not eligible for interferon-based treatments. Hepatitis C infection represents a serious public health burden. This review was based on expert's consensus during a medical forum on hepatitis sponsored by the Beijing Wu Jie-Ping Medical Foundation. The literature searches were conducted in PubMed and critical publications in Chinese journals. Data on hepatitis C prevalence, risk factors, viral or host features, and treatment modalities were extracted and reviewed. Recent large-scale surveys reported reducing prevalence of hepatitis C to approximately 0.4% in China, partly because of regulation changes to safer medical practices and illegalizing commercial blood donations. Patient demographics evolved from being dominated by former paid blood donors to include intravenous drug users and others. Although hepatitis C genotype 1 is the most common, other genotypes are emerging in prevalence. The current standard of care is interferon-based without direct acting antivirals. However, many patients failed therapy because of high treatment costs, substantial needs to manage side effects, difficulties with treatment monitoring in the rural areas, and growing populations of elderly and cirrhotic patients. The lack of high efficacy therapies with good safety profile and low disease awareness in China resulted in increasing public burden of advanced hepatitis C disease. Despite significant reduction of hepatitis C prevalence, iatrogenic, nosocomial, and community transmissions are still significant. In addition to promoting disease awareness, interferon-free regimens are needed to reduce the public health burden.
Collapse
Affiliation(s)
| | - Ji-Dong Jia
- Division of Hepatology, Friendship Hospital, Capital Medical University
| | - Jinlin Hou
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lillian Lou
- Hepatitis Consulting at Nexus Development, Palo Alto, CA
| | - Hillel Tobias
- Department of Medicine, Division of Gastroenterology, NYU Langone Medical Center, NYU School of Medicine, New York, NY
| | - Xiao Yuan Xu
- Department of Infectious Diseases, Peking University First Hospital
| | - Lai Wei
- Hepatology Institute, Peking University People’s Hospital
| | - Hui Zhuang
- Department of Microbiology and Center of Infectious Disease, School of Basic Medicine, Peking University Health Science Center, Peking University, Beijing
| | - Calvin Q. Pan
- Department of Medicine, Division of Gastroenterology, NYU Langone Medical Center, NYU School of Medicine, New York, NY
| |
Collapse
|
17
|
Increased prevalence of hepatitis C virus subtype 6a in China: a comparison between 2004-2007 and 2008-2011. Arch Virol 2014; 159:3231-7. [PMID: 25085624 PMCID: PMC4221604 DOI: 10.1007/s00705-014-2185-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 07/16/2014] [Indexed: 02/07/2023]
Abstract
Different hepatitis C virus (HCV) genotypes exhibit differences in disease pathogenesis and progression, as well as disease outcomes and response to therapy. Tracking the change of HCV genotypes in various epidemiological settings is critical for both disease surveillance and the development of improved antiviral treatment. Here, we tracked the changes in the prevalence of the HCV genotypes in China between 2004-2007 and 2008-2011. HCV-RNA-positive sera were collected from volunteer blood donors during the period 2008-2011. The genotypes were determined by phylogenic analysis using the NS5B and E1 sequences. Geographical and demographic distribution patterns related to the HCV genotypes obtained in 2008-2011 were compared with our previous study, which recorded data in the period 2004-2007. Pearson chi-square test and t-test were used to statistically analyze the results. In 2008-2011, HCV subtypes 1b and 6a were detected in 43.8 % (184/420) and 34.3 % (144/420), respectively. The male/female ratio was found to be higher for HCV genotype 6 than for genotypes 1 and 2. When compared with the period of 2004-2007, although no significant difference was found in gender or age for genotypes 1, 2, 3 and 6, the subtype 6a frequency was significantly increased from 11 % to 26.5 % in the blood donors from outside of Guangdong Province in 2008-2011. A pattern of increase in HCV subtype 6a was found in blood donors outside of Guangdong Province, indicating that HCV subtype 6a has rapidly spread from Guangdong to other regions of China over the past 10 years.
Collapse
|
18
|
Mao XR, Zhang LT, Chen H, Xiao P, Zhang YC. Correlation between the genetic variations in interleukin 28B and chronic hepatitis C virus genotypes in the Chinese population. Mol Med Rep 2014; 10:1037-45. [PMID: 24840747 DOI: 10.3892/mmr.2014.2242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 03/05/2014] [Indexed: 12/24/2022] Open
Abstract
Genetic variations at the interleukin 28B (IL-28B) locus and chronic hepatitis C virus (HCV) genotypes are significant factors in predicting the therapeutic outcome for HCV infection. The present study aimed to determine the geographical distribution of HCV genotypes and single nucleotide polymorphisms (SNPs) associated with IL-28B in Chinese patients infected with HCV. The gene frequencies of 13 types of IL-28B SNPs and HCV genotypes were investigated in 1,014 patients infected with HCV, who were recruited from varying regions of China. The correlation between the SNPs of IL-28B, the HCV genotypes and age, gender and geographical location were investigated. The data revealed geographical differences in age, gender and HCV genotypes in the Chinese HCV patients. HCV genotype 1 was distributed extensively and had a higher incidence compared with other HCV genotypes in all regions, with the exception of South (38%) and Northwest China (45.6%). A gender differences also existed (P<0.01). The distribution of genotype 6 was lower compared with other HCV genotypes in the majority of the regions (P<0.01). In middle‑aged patients, the number of male patients was higher than the number of female patients in North and South China, which was the opposite of the results found in the other regions. There were no geographical differences in IL-28B SNPs in Chinese HCV‑infected populations. Notably, there were significant differences between HCV genotype 1 and 2 in the genotype percentages of the majority of SNPs (P<0.01). In conclusion, a geographical distribution in HCV genotypes and a correlation between HCV genotypes and IL-28B SNPs have been identified, and indicate that these variants may be associated with spontaneous and treatment-induced HCV clearance.
Collapse
Affiliation(s)
- Xiao-Rong Mao
- Department of General Surgery, The Second Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| | - Li-Ting Zhang
- Department of Infectious Diseases, The First Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| | - Hong Chen
- Department of Infectious Diseases, The First Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| | - Ping Xiao
- Department of Infectious Diseases, The First Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| | - You-Cheng Zhang
- Department of General Surgery, The Second Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China
| |
Collapse
|
19
|
Absence of neurocognitive impairment in a large Chinese sample of HCV-infected injection drug users receiving methadone treatment. Drug Alcohol Depend 2014; 137:29-35. [PMID: 24508003 PMCID: PMC3961522 DOI: 10.1016/j.drugalcdep.2013.12.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 12/07/2013] [Accepted: 12/28/2013] [Indexed: 01/05/2023]
Abstract
BACKGROUND Prior research has demonstrated neuropsychological (NP) impairment in persons with histories of injection drug use (IDU), hepatitis C virus (HCV) infection, and methadone maintenance treatment (MMT), individually, but little is known about the NP effects of these three risk factors in combination. This issue is particularly important in China, which is addressing its highly HCV-comorbid IDU epidemic with widespread government sponsored MMT, especially in light of recent evidence suggesting that methadone may be neuroprotective in some circumstances. METHODS We administered a comprehensive NP test battery to 195 Chinese heroin IDU individuals taking MMT (IDU+ group), the majority of whom were also HCV+ (87%; n=169), and compared their NP performance to that of 198 demographically comparable, non-IDU Chinese controls (IDU- group). All participants in both groups tested negative for HIV infection, which is also a common comorbidity in the Chinese IDU population. RESULTS The IDU+ group did not have an increased rate of global NP impairment, or perform significantly worse on any individual NP test measure. Within the IDU+ group, liver disease characteristics and reported details of heroin use were not significantly associated with NP performance. CONCLUSION Failure to detect NP impairment in IDU+ subjects with or without HCV infection was surprising, particularly considering the previously demonstrated sensitivity of our NP battery to neurocognitive disorders associated with HIV infection in China. One possible explanation, which should be explored in future research, is the potential neuroprotective effect of methadone in the context of HCV infection and/or heroin withdrawal.
Collapse
|
20
|
Molecular epidemiologic characterization of a clustering HCV infection caused by inappropriate medical care in Heyuan City of Guangdong, China. PLoS One 2013; 8:e82304. [PMID: 24349252 PMCID: PMC3857772 DOI: 10.1371/journal.pone.0082304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 10/22/2013] [Indexed: 01/18/2023] Open
Abstract
Background From November 2011 to January 2012, a number of clustering cases of HCV infection were reported in Zijin County, Heyuan City, Guangdong, China. Most patients in the clustering cases suspected that they could be infected due to inappropriate medical care in the clinic located at the Xiangshui road. However, the molecular epidemiology of the clustering cases remains unknown. Methodology The residents, living at Xiangshui Road, with HCV antibody positive reported from 2011 and 2012 were recruited. A survey of the HCV infected individuals from the clustering cases was conducted. Each participant underwent a questionnaire defining demographic characteristics and health care history. HCV serological test and viral load test were performed to confirm the infection status. Molecular phylogenetic analysis and Bayesian coalescence analysis were conducted to further confirm the HCV subtype distribution and to reconstruct the associated demographic history and time-scaled phylogeny among the clustering cases. Principal Findings The molecular phylogenetic analysis revealed that only two HCV subtypes, 2a and 6a, were found among the clustering cases. There was no close HCV subtype evolutionary relation was observed among patients from the same family. The 6a cluster showed higher viral loads than the 2a cluster. In addition, the Bayesian skyline plot analysis showed that both the HCV 2a and 6a subtype infections among the Heyuan cases experienced an “expansion-diminishment-expansion” featured dissemination. The 2a clustering infection occurred in 2004, and the 6a clustering cases originated in 2006. Conclusions The molecular epidemiological characters imply that the inappropriate medical practices were possibly associated with the clustering HCV cases in Heyuan City during 2011, 2012. Latent HCV subtypes 2a and 6a infection may cause the prevalence and become a new public health issue in Guangdong, China.
Collapse
|
21
|
Jackowiak P, Kuls K, Budzko L, Mania A, Figlerowicz M, Figlerowicz M. Phylogeny and molecular evolution of the hepatitis C virus. INFECTION GENETICS AND EVOLUTION 2013; 21:67-82. [PMID: 24200590 DOI: 10.1016/j.meegid.2013.10.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 10/24/2013] [Accepted: 10/26/2013] [Indexed: 12/14/2022]
Abstract
The hepatitis C virus (HCV) is a globally prevalent human pathogen that causes persistent liver infections in most infected individuals. HCV is classified into seven phylogenetically distinct genotypes, which have different geographical distributions and levels of genetic diversity. Some of these genotypes are endemic and highly divergent, whereas others disseminate rapidly on an epidemic scale but display lower variability. HCV phylogeny has an important impact on disease epidemiology and clinical practice because the viral genotype may determine the pathogenesis and severity of the resultant chronic liver disease. In addition, there is a clear association between the HCV genotype and its susceptibility to antiviral treatment. Similarly to other RNA viruses, in a single host, HCV exists as a combination of related but genetically different variants. The whole formation is the actual target of selection exerted by a host organism and antiviral therapeutics. The genetic structure of the viral population is largely shaped by mutations that are constantly introduced during an error-prone replication. However, it appears that genetic recombination may also contribute to this process. This heterogeneous collection of variants has a significant ability to evolve towards the fitness optimum. Interestingly, negative selection, which restricts diversity, emerges as an essential force that drives HCV evolution. It is becoming clear that HCV evolves to become stably adapted to the host environment. In this article we review the HCV phylogeny and molecular evolution in the context of host-virus interactions.
Collapse
Affiliation(s)
- Paulina Jackowiak
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704 Poznan, Poland
| | - Karolina Kuls
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
| | - Lucyna Budzko
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704 Poznan, Poland
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
| | - Marek Figlerowicz
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704 Poznan, Poland; Institute of Computing Science, Poznan University of Technology, Piotrowo 3A, 60-965 Poznan, Poland.
| |
Collapse
|
22
|
Abstract
Worldwide, an estimated 130-170 million people have HCV infection. HCV prevalence is highest in Egypt at >10% of the general population and China has the most people with HCV (29.8 million). Differences in past HCV incidence and current HCV prevalence, together with the generally protracted nature of HCV disease progression, has led to considerable diversity in the burden of advanced liver disease in different countries. Countries with a high incidence of HCV or peak incidence in the recent past will have further escalations in HCV-related cirrhosis and hepatocellular carcinoma (HCC) over the next two decades. Acute HCV infection is difficult to detect because of the generally asymptomatic nature of the disease and the marginalization of at-risk populations. Around 25% of patients with acute HCV infection undergo spontaneous clearance, with increased rates among those with favourable IL28B genotypes, acute symptoms and in women. The remaining 75% of patients progress to chronic HCV infection and are subsequently at risk of progression to hepatic fibrosis, cirrhosis and HCC. Chronic hepatitis C generally progresses slowly in the initial two decades, but can be accelerated during this time as a result of advancing age and co-factors such as heavy alcohol intake and HIV co-infection.
Collapse
|
23
|
Zhang XH, Cai QX, Hong CX, Lin CS, Zhao ZX. Prevalence of IL-28B and ITPA genotypes in Chinese Han population infected persistently with hepatitis C virus genotype 6 or HCV-1. J Med Virol 2013; 85:1163-9. [PMID: 23918534 DOI: 10.1002/jmv.23561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2013] [Indexed: 12/20/2022]
Abstract
The geographic distribution, demographics, epidemiology, host factors, and clinical characteristics of persistent HCV-6 infection in China need further characterization. This multicenter study enrolled 63 patients with persistent HCV-6 infection and 63 patients with persistent HCV-1 infection as controls. Blood biochemistry, quantitation of HCV RNA levels, and identification of host IL-28B genotypes (rs12979860, rs8099917, and rs12980275) and ITPA genotype (rs1127354) were performed to estimate potential variability in host factors that may affect response to treatment. The mean HCV-6 RNA level (3.8E6 IU/ml) was significantly higher than that in patients infected with HCV-1 (1.7E6 IU/ml; P < 0.001). Patients persistently infected with HCV-6 had a high prevalence of IL-28B rs12979860 CC genotype (92.1%), rs8099917 TT genotype (93.7%), and rs12980275 AA genotype (90.5%). Their prevalence in patients infected with HCV-1 was only modestly lower (82.5%, 84.1%, and 82.5%, respectively; P > 0.05). The inosine triphosphate pyrophosphatase (ITPA) SNP rs1127354 CC genotype was present in 66.7% of patients infected with HCV-6, comparable to that of patients infected with HCV-1 (65.1%; P > 0.05). There were no differences in the liver function, proportion of hepatic cirrhosis patients or patients with increased serum glucose between these two groups. Persistent HCV-6 infection in Chinese Han is found mainly in the southern China. Chinese Han with chronic HCV-1 or HCV-6 infection have IL-28B genotypes, suggesting responsiveness to interferon-based pharmacotherapy. Most patients (67%) possess the ITPA genotype associated with susceptibility to ribavirin-induced hemolysis. The routes of transmission for HCV-6 genotype were more diversified than HCV-1 genotype. The outbreak of HCV-6 infection through blood transfusion progressed faster than HCV-1.
Collapse
Affiliation(s)
- Xiao-Hong Zhang
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | | | | | | | | |
Collapse
|
24
|
|
25
|
Efficacy and safety of low-dose peginterferon alpha-2a plus ribavirin on chronic hepatitis C. Gastroenterol Res Pract 2012; 2012:302093. [PMID: 23258976 PMCID: PMC3519007 DOI: 10.1155/2012/302093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 11/15/2012] [Indexed: 01/13/2023] Open
Abstract
Background. The purpose of this study was to assess the efficacy and safety of low-dose peg-IFN α-2a plus ribavirin on the treatment of patients with chronic hepatitis C virus (HCV) infection. Patients and Methods. A total of 243 HCV patients treated with different doses of peg-IFN α-2a plus ribavirin were stratified into three groups. End-of-treatment response (ETR) and sustained viral response (SVR) were evaluated for efficacy. Adverse events and laboratory abnormalities were conducted for safety. Results. ETR and SVR in group I were obtained in 83.9% and 68.9% of the patients, separately, which was similar to groups II (84.1% and 68.3%) and III (81.7% and 66.7%). The received peg-IFN α-2a dose was not the independent factor-related SVR in our population (OR, 1.31; 95% CI, 0.94–1.81; P = 0.106). The frequency of no adverse events reported in group III (24.7%) was significantly higher than that in group I (11.5%) and group II (12.7%) (P = 0.036). Conclusions. The peg-IFN α-2a 90 μg/week plus ribavirin is as effective as, and better tolerated than, peg-IFN α-2a standard dose with ribavirin in the treatment of chronic hepatitis C. This low-dose combination achieves high SVR rates and may be cost-saving.
Collapse
|
26
|
Dong ZX, Zhou HJ, Wang JH, Xiang XG, Zhuang Y, Guo SM, Gui HL, Zhao GD, Tang WL, Wang H, Xie Q. Distribution of hepatitis C virus genotypes in Chinese patients with chronic hepatitis C: correlation with patients' characteristics and clinical parameters. J Dig Dis 2012; 13:564-70. [PMID: 23107443 DOI: 10.1111/j.1751-2980.2012.00636.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study aimed to explore the most up-to-date distribution of hepatitis C virus (HCV) genotypes in China, especially the association between HCV genotypes and patients' characteristics and clinical parameters. METHODS Sera from 483 HCV antibody-positive patients were genotyped using a HCV genotyping chip assay. The distribution of HCV genotypes, clinical parameters, modes of transmission and duration of infection were determined and the relationships among these parameters were analyzed. RESULTS A total of 424 patients were successfully genotyped. HCV genotypes 1, 2, 3 and 6 were found with a constituent ratio of 72.1%, 12.3%, 10.6% and 5.0%, respectively, in which subtypes 1b (69.1%), 2a (11.6%) and 3a (7.5%) were prevalent. The mean age of patients with genotype 1 and 2 was significantly elder than those with genotype 3 and 6 (P < 0.05). The distribution of HCV genotypes in relation to the mode of HCV transmission was remarkable (P < 0.001). Transfusion of blood and blood products was the main mode of transmission. Most genotype 1 infection (53.1%) was found in the group with a duration of HCV infection of 10-20 years. Genotype 1b was independently associated with age (P = 0.001) and mode of HCV transmission (P = 0.007). CONCLUSIONS The main HCV subtype was genotype 1b in Chinese patients. The prevalence of HCV genotypes was correlated with age and the mode of HCV transmission. Genotype 3a and 6 may become an increasing threat in the future.
Collapse
Affiliation(s)
- Zhi Xia Dong
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Yan Z, Fan K, Fan Y, Wang X, Mao Q, Deng G, Wang Y. Thyroid dysfunction in chinese patients with chronic hepatitis C treated with interferon alpha: incidence, long-term outcome and predictive factors. HEPATITIS MONTHLY 2012; 12:e6390. [PMID: 23087763 PMCID: PMC3475135 DOI: 10.5812/hepatmon.6390] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 06/13/2012] [Accepted: 06/30/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Thyroid dysfunction (TD) represents an extra-hepatic manifestation of chronic hepatitis C (CHC) and it may also be a side effect of interferon-alpha (IFN-α) based treatment. However, previous studies have shown a wide variation in the incidence of TD in patients with CHC. Furthermore, the long-term outcomes and the predictive factors of TD in patients who receive IFN-α based treatment have still not been fully studied. OBJECTIVES The purpose of this study was to describe the incidence and long-term outcomes of TD in Chinese patients with CHC receiving IFN-αbased treatment. We also aimed to identify the predictive factors of TD associated with this type of therapy. PATIENTS AND METHODS A retrospective case-series study of 592 consecutive CHC patients with normal baseline thyroid functions, who received IFN-αbased therapy, was performed. Thyroid function was assessed at baseline and every three months during treatment, as well as in the follow-up after cessation of therapy. The incidence and long-term outcomes of TD were observed. The prevalence of pretreatment thyroid peroxidase antibodies (TPOAb) were assayed in a sex- and age-matched nested case-control study. Multivariable stepwise regression analysis was used to explore the independent effects of the baseline factors, on the incidence of TD. RESULTS At the end of the IFN-αbased therapy, 68 patients (11.5%) in the study had developed TD, 58 patients (85.3%) presented with subclinical TD, and only 10 patients (14.7%) developed overt thyroiditis. The thyroid function of 46 patients (67.8%) spontaneously returned to normal in the six months of follow-up and only three patients (4.4%) had persistent overt TD symptoms after the 24 month follow-up period. Multivariate stepwise analysis suggested that gender and pretreatment TPOAb were the independent factors related to the incidence of TD. Both female patients (OR, 4.31; 95%CI, 2.06-7.31; P = 1.26×10-4) and participants with a positive pretreatment TPOAb (OR = 3.9, 95%CI, 1.72-8.54, P = 0.008) had an increased risk for the development of TD. CONCLUSIONS The incidence of TD in Chinese patients with CHC during IFN-αbased therapy was 11.5%, the majority of which was subclinical, while only a very small group had long-term overt TD requiring ongoing medical therapy. Female gender and pretreatment TPOAb positivity are risk factors for the development of TD during IFN-αbased therapy.
Collapse
Affiliation(s)
- Zehui Yan
- Institute of Infectious Diseases, Southwest Hospital, the Third Military Medical University, Chongqing, China
| | - Ke Fan
- Institute of Infectious Diseases, Southwest Hospital, the Third Military Medical University, Chongqing, China
| | - Yi Fan
- Institute of Infectious Diseases, Southwest Hospital, the Third Military Medical University, Chongqing, China
| | - Xiaohong Wang
- Institute of Infectious Diseases, Southwest Hospital, the Third Military Medical University, Chongqing, China
| | - Qing Mao
- Institute of Infectious Diseases, Southwest Hospital, the Third Military Medical University, Chongqing, China
| | - Guohong Deng
- Institute of Infectious Diseases, Southwest Hospital, the Third Military Medical University, Chongqing, China
| | - Yuming Wang
- Institute of Infectious Diseases, Southwest Hospital, the Third Military Medical University, Chongqing, China
- Corresponding author: Yuming Wang, Institute of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. Tel.: +86-2368754858, Fax: +86-2365334998, E-mail:
| |
Collapse
|