Abstract
BackgroundHepatitis C virus (HCV) genotype (GT) has become an important measure in the diagnosis and monitoring of HCV infection treatment. In the United States (U.S.) HCV GT 1 is reported as the most common infecting GT among chronically infected patients. In Europe, however, recent studies have suggested that the epidemiology of HCV GTs is changing.MethodsWe assessed HCV GT distribution in 460 patients from three HCV-infected high risk populations in San Francisco, and examined patterns by birth cohort to assess temporal trends. Multiple logistic regression was used to assess factors independently associated with GT 1 infection compared to other GTs (2, 3, and 4).ResultsOverall, GT 1 was predominant (72.4%), however younger injection drug users (IDU) had a lower proportion of GT 1 infections (54.7%) compared to older IDU and HIV-infected patients (80.5% and 76.6%, respectively). Analysis by birth cohort showed increasing proportions of non-GT 1 infections associated with year of birth: birth before 1970 was independently associated with higher adjusted odds of GT 1: AOR 2.03 (95% CI: 1.23, 3.34). African-Americans as compared to whites also had higher adjusted odds of GT 1 infection (AOR: 3.37; 95% CI: 1.89, 5.99).ConclusionsAlthough, HCV GT 1 remains the most prevalent GT, especially among older groups, changes in GT distribution could have significant implications for how HCV might be controlled on a population level and treated on an individual level.
Highlights
Hepatitis C virus (HCV) genotype (GT) has become an important measure in the diagnosis and monitoring of HCV infection treatment
The more recent birth cohorts had increasing proportions of non-GT 1 infections compared to less recent birth cohorts, and young injection drug users (IDU) had more GT 3 infections compared to others (Table 1)
Patients born before 1970 had higher adjusted odds of GT 1 infection compared to those born more recently: adjusted odds ratios (AOR) 2.03; age and study group were not included in the final model due to colinearity with birth cohort
Summary
Hepatitis C virus (HCV) genotype (GT) has become an important measure in the diagnosis and monitoring of HCV infection treatment. In the United States (U.S.) HCV GT 1 is reported as the most common infecting GT among chronically infected patients. In Europe, recent studies have suggested that the epidemiology of HCV GTs is changing. There are notable clinical differences in responsiveness to interferon-based therapy for treatment of chronic infection by GT, with GTs 1 and 4 being less responsive and requiring longer it partially explains differences in these outcomes. In the U.S HCV GT 1 has been the most common infecting subtype; over 70% of patients with chronic infection are GT 1 [17,18,19]. In Europe, recent studies have reported more variation in the extent and diversity of HCV GTs, and have shown associations between HCV GT and risk exposure, age, and clinical group [20,21,22,23,24]. In the U.S, race/ethnicity have been found to be independently associated with GT in the NHANES general population sample [19] and in other samples [18], but none have examined temporal changes in circulating infecting GTs
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