Risk factors for Hepatitis C virus (HCV) transmission and efficiency of antiviral therapy in chronically infected patients

Abstract

Background: This study monitored the prevalence and genotype distribution of HCV in patients suspected for infection as well as risk factors for infection and transmission of HCV in northeast Croatia. Methods: From January 2009 to December 2011, 405 plasma specimens of patients suspected for HCV infection were tested by the COBAS TaqMan HCV test v2.0 (Roche Diagnostics) ; 77 HCV- positive samples were genotyped using the Linear Array HCV Genotyping test (Roche) ; 33 HCV- positive patients with unfavorable liver tests were further treated with anti-viral therapy and monitored at weeks 28 and 53. Risk factors for HCV infection and transmission were analyzed from patient-filled questionnaires (age, sex, risk behavior etc.) and their clinical data (age at initial HCV infection, degree of liver inflammation and fibrosis). Results: Out of 405 tested patients, 198 (48.8%) were HCV-positive and the highest prevalence of infection was found in men and women between 30 and 40 years of age. HCV genotype distribution in northeast Croatia was similar to other European regions: G1 was the most common (66.6%), followed by G3 (22.1%), G4 (10.4%), and G2 (1.3%) ; genotypes G5 and G6 were not detected. Viral therapy evaluated at week 53 demonstrated that 58 % of patients were virus- free, 12 % had lower viral load while 12 % showed no change in viral load. Moreover, HCV G1-infected patients showed a delayed response to antiviral therapy when compared to G3 and G4-infected patients: 31 % G1-, 40 % G3- and 50 % G4-infected patients were virus-free at week 28 ; 58 % G1-, 60 % G3- and 50 % G4-infected patients were virus- free at week 53. Significant risk factors for HCV infection and transmission in northeast Croatia include history of blood transfusion, surgery before the year 1993, and body piercing in 31-40 year-old men (p<0.05). Conclusion: Our results strengthen the importance of early testing for HCV infection in men showing the symptoms of chronic hepatitis (muscle pain, appetite loss, history of jaundice) since they are statistically more often intravenous drug, piercing, and tattoo users then women in our region.