Abstract
Chronic hepatitis C is a leading cause of end-stage liver disease and, with a worldwide prevalence of up to 3%, is a pandemic infectious disease. Austria, like most western European countries can be considered as a low prevalence country. This analysis aimed to assess the distribution of hepatitis C virus (HCV) genotypes in patients with chronic HCV infection in Upper Austria. Between September 1992 and December 2006, we identified 1,318 consecutive patients who tested positive for HCV RNA. Genotyping was routinely performed in 1,239 of the 1,318 patients, and in a subgroup of 617 patients data on the source of transmission were collected. Additionally we obtained data on liver histology and body mass index in a subsample of 273 of the 617 patients. Hepatitis C genotypes 1, 2, 3, 4, 6 and co-infections were found in 80.4%, 4.5%, 12.3%, 2.7%, 0.1% and 0.2% of the patients, respectively. There was a highly significant age difference in relation to gender at the time of diagnosis of chronic hepatitis C, with women being older than men (men: 45.0 years; women: 49.3 years; p<0.0001). The number of new cases of chronic hepatitis C decreased substantially over the last decade, but although risk factors for obtaining HCV are well established, we did not find a decrease in the age of first diagnosis. Besides consistent screening in defined risk groups it is important to raise awareness for risk factors for HCV acquisition and liver disease progression.
Highlights
Chronic hepatitis C is one of the leading causes of liver cirrhosis and end-stage liver disease, resulting in liver failure, hepatocellular carcinoma, liver transplantation and premature death
After we began diagnosing hepatitis C virus (HCV) infections in September 1992, we identified 19 chronic hepatitis C patients by December 1992
Overall our results show a change in the number of cases diagnosed over time reaching a maximum between 1996 and 1999 (121-124 patients per year) and a drop between 2000 and 2006 (10). This decline in new HCV cases is in line with Austrian reporting data published by the Federal Ministry of Health, Family and Youth [22], it has to be mentioned that the reporting data are biased by underreporting as shown by Strauss et al [12]
Summary
Chronic hepatitis C is one of the leading causes of liver cirrhosis and end-stage liver disease, resulting in liver failure, hepatocellular carcinoma, liver transplantation and premature death. 50% of patients with progressive hepatitis can be cured if the infection is diagnosed in time and treatment is available [1]. Cofactors such as alcohol intake, obesity and underlying liver-related diseases (e.g. haemochromatosis) play a major role in the progression of the liver disease [2]. Infections with hepatitis C virus (HCV) are pandemic with a worldwide prevalence of up to 3% [3,4]. There is a large variation regarding the genotype distribution worldwide, the most prevalent in Europe and North America being genotype 1 [5]. The knowledge of genotypes in chronic hepatitis C is crucial for the choice of the therapeutic regimen and for the therapeutic outcome, because genotypes 2 and 3 are curable in more than 80%, whereas genotypes 1 and 4 are curable in only 40-50% of cases [6]
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