Hepatitis C Virus Genotypes In Patients Research Articles

Effectiveness of Sofosbuvir Combined with Direct Acting Antivirals in Hepatitis C Patients in a Tertiary Teaching Hospital in Qatar: A Retrospective Observational Study

Background: Hepatitis C virus (HCV) infection is associated with significant morbidity and mortality. The effectiveness of sofosbuvir, as a new direct-acting antiviral (DAA) for chronic HCV infection, needs to be assessed and evaluated among patients with or without cirrhosis with all HCV genotypes.
 Aims: This study was conducted to determine the effectiveness of chronic HCV treatment as part of a combination therapy for all HCV genotypes in patients with or without cirrhosis.
 Study Design: A retrospective observational study.
 Methodology: All patients who received sofosbuvir treatment from the Pharmacy Department of Hamad General Hospital during a 12-month period (between 2014 and 2015) were included. Patients were observed up to 12 weeks after treatment course completion. Data were analyzed descriptively and compared using a paired t-test (alpha=0.05).
 Results: A total of 95 patients received sofosbuvir. All of these patients received sofosbuvir in combination with other antiviral medications. All HCV genotypes were included; 1a and 4 were the most dominant genotypes (37% and 30.5%, respectively). Half of the patients were treatment naïve. All patients achieved undetectable virus ribonucleic acid (RNA) starting from week 4 of the treatment. A sustained virological response at 12 weeks (SVR12) after completion of the treatment period was maintained in 95% of patients. Relapse was mostly observed in patients with genotype 1a (40%); no patients with HCV genotype 3 exhibited relapse.
 Conclusion: The SVR12 after sofosbuvir treatment was maintained in most patients, regardless of genotype, HCV complications HCV or co-administered drugs.

The distribution of hepatitis C virus genotypes in patients with hepatocellular carcinoma

Background: Hepatic cirrhosis develops within 20-30 years in approximately 20% of individuals chronically infected with hepatitis C virus (HCV).
 Aims and Objective: This study aimed to determine the distribution of HCV genotypes in patients with HCV-associated HCC in our region and thus to contribute to the epidemiology of HCV.
 Materials and Methods: HCC patients referred to the virology laboratory for HCV genotype identification between January 2013 and April 2018 were included in this study. Genotyping of HCV was performed by a commercial reverse hybridization line probe-based assay.
 Results: Seventeen patients who were diagnosed with HCC and whose HCV genotypes were analyzed were included in this study. Genotype 1 was detected in all 17 patients with HCC. When evaluating subtypes of genotype 1, genotype 1b was detected in 16 (94%) of the patients. The HCV subtyping in one patient (6%) could not be performed.
 Conclusion: As a result, genotype 1b, one of the major risk factors for HCC, was detected in 94% of the patients included in this study. This study, consistent with the literature, shows a high association between the development of HCC and genotype 1b in patients with chronic HCV.

Hepatitis C virus genotype analysis in patients with chronic hepatitis in North Eastern Bulgaria

Background: The main objective of this study was to analyse the spread of hepatitis C virus (HCV) genotype in patients with chronic liver disease; commenting on the molecular characterization of HCV and gender and age in Varna, Bulgaria. Across Europe and the world, HCV is a significant economic concern and public health crisis. Defined by genotype variations, HCV is the leading cause of chronic liver disease, liver related morbidity, and mortality worldwide. Active examination for asymptomatic patients is essential, initiating early treatment aimed at the specific HCV genotype, effective outcomes, and reducing transmission and mortality in Bulgaria.Methods and materials: Nucleic acid extraction and amplification were performed with commercially available test kits on 115 patients blood samples collected from March 2018 to October 2018. Male (n = 58) (50.43%, 95% CI = 41.29%–59.57%) and female (n = 57) (49.57%, 95% CI = 41.29%–59.57%) samples were equally distributed (mean age = 51.4 years; SD = ±16.5 years; range = 17–87 years old).Results: Genotype 1b predominated (73%, 95% CI = 64.89%–81.11%), followed by high prevalence of 1a (13.9%, 95% CI = 7.58%–20.22%) and 3 genotypes (11.3%, 95% CI = 5.51%–17.09%). Genotypes 2 and 4 were equally the least prevalent (0.9%, 95% CI = −0.83%–2.63%). In genotype 1b, 60.7% were women and 39.3% were men; in genotype 1a, 25% were women and 75% were men; and in genotype 3, only 7.7% were women and 92.3% were men. Males were most prevalent in genotypes 1a (75%) and 3 (92.3%), while women were most prevalent in genotype 1b (60.7%).Conclusions: HCV genotype lb is the predominant variant within the epidemiological pattern of HCV genotypes in patients with chronic liver diseases in North Eastern Bulgaria.

Distribution of hepatitis C virus genotypes and subtypes in Croatia: 2008-2015.

Hepatitis C virus (HCV) genotyping is an important part of pre-treatment diagnostic algorithms as it guides the choice of therapeutic regimens. The aim of this study was to analyse the distribution of HCV genotypes in patients with chronic hepatitis C from Croatia in the period 2008-2015. The study enrolled 3,655 anti-HCV positive patients with available results of HCV genotyping from the three largest national HCV genotyping laboratories. The majority of HCV-infected individuals enrolled in the study were male (70.7%). Analysis of age distribution in a subset of 2,164 individuals showed a mean age of 40.9 years (SD 11.77 years). Croatian patients were mostly infected with HCV genotype 1 (56.6%), followed by genotype 3 (37.3%), genotype 4 (4.2%) and genotype 2 (1.8%). Genotype 1 subtyping in a subset of 1,488 patients showed 54% (803/1,488) of 1b infections and 46% (685/1,488) of 1a infections. Percentages of genotype 1 were the highest in Central/Northwestern and Eastern Croatia and the lowest in the Central/Southern Adriatic Region. Genotype 3 was most frequently found in the Central/Southern Adriatic Region (49.1%) but represented only 17.5% of infections in Eastern Croatia (p < 0.001). The results of this nine-year retrospective analysis on the distribution of HCV genotypes and subtypes in 3,655 HCV-infected individuals from Croatia showed that the majority of infections can be attributed to genotypes 1 and 3 with absence of major changes in the molecular epidemiology of the two most frequent HCV genotypes infection in Croatia in the past 20 years.

Distribution of Hepatitis C Virus Genotypes in Istanbul, Turkey

Purpose: The hepatitis C virus (HCV) has seven main genotypes and multiple subtypes. The distribution of HCV genotypes varies across geographical regions worldwide. Updated estimates of HCV genotype distributions have a critical importance for developing strategies to manage or eliminate HCV infection. The aim of this study was to determine the distribution of HCV genotypes in patients with HCV admitted to a university hospital in Istanbul, Turkey. Materials and Methods: A total of 412 HCV RNA positive patients with 46.6% of males and 53.4% of females between January 2013 and September 2016 were included in the study. Genotyping of HCV of the study population was performed by a commercial reverse hybridisation line probe-based assay. Results: Genotype 1 (82.5%) was dominant genotype, followed by genotype 3 (10.7%), genotype 2 (4.6%) and genotype 4 (2.2%). Among patients with genotype 1, subtype 1a, 1b and undetermined subtype were 6.3%, 38.8% and 37.4%, respectively. It was observed that genotype proportion was dependent on gender and age of the patients. Genotype 1 and genotype 2 were more prevalent in females, whereas genotypes 3 and 4 were more prevalent in males. Genotype 1 in the older patients and genotype 3 in the younger patients were more prevalent. Conclusion: The majority of patients with HCV infection had genotype 1 (82.5%), followed by genotype 3, 2 and 4. Monitoring the change in HCV genotype distribution is critical for the development of effective strategies for HCV elimination.

Effect of hepatitis C virus genotype on antiviral therapy in patients with human immunodeficiency virus/hepatitis C virus coinfection

Objective To investigate the effect of hepatitis C virus (HCV) genotype on antiviral therapy in patients with human immunodeficiency virus (HIV)/HCV coinfection in Henan province. Methods A total of 129 patients were coinfected with HIV and HCV, among whom, 70 were HCV 1b genotype and 57 HCV 2a genotype. And 131 patients were HIV single infection. Immunological failure rate, virological suppression, CD4+ T lymphocyte counts and liver and renal function after antiretroviral therapy (ART) were compared among the three groups. Flow cytometry was used to count CD4+ T lymphocytes and polymerase chain reaction amplification was used to detect HIV RNA. The liver and renal function were tested by automatic biochemical analysis. Statistical analysis was conducted by χ2 test, analysis of variance and LSD-t method. Results Immunological failure rate in HCV 1b group, HCV 2a group and HIV single infection group were 7.14% (5/70), 15.79% (9/57) and 9.92% (13/131), respectively. There was no significant statistical difference among the three groups (χ2=2.59, P>0.05). The CD4+ T lymphocyte counts in three groups were (614±258), (529±245), and (518±243) cells/μL, respectively. The difference was statistically significant (F=3.17, P 0.05). The levels of aspartate transaminase, alanine aminotransferase and total bilirubin in HCV 1b group and HCV 2a group were all significantly higher than those in HIV single infection group (F=27.38, 15.22 and 7.33, respectively, all P 0.05). Conclusions The main HCV genotypes in patients with HIV/HCV coinfection by blood transmission are HCV 1b and HCV 2a in Henan province. HIV/HCV coinfection does not affect the effect of ART, but could aggravate the liver damage in acquired immune deficiency syndrome patients. Key words: Human immunodeficiency virus; Hepacivirus; Genotype; Antiviral therapy; Effect analysis

A Single-step Multiplex Quantitative Real Time Polymerase Chain Reaction Assay for Hepatitis C Virus Genotypes.

The variable response of hepatitis C virus (HCV) genotypes towards anti-viral treatment requires prior information on the genotype status before planning a therapeutic strategy. Although assays for typing or subtyping of HCV are available, however, a fast and reliable assay system is still needed. The present study was planned to develop a single-step multiplex quantitative real time polymerase chain reaction (qPCR) assay to determine HCV genotypes in patients' sera. The conserved sequences from 5' UTR, core and NS5b regions of HCV genome were used to design primers and hydrolysis probes labeled with fluorophores. Starting with the standardization of singleplex (qPCR) for each individual HCV-genotype, the experimental conditions were finally optimized for the development of multiplex assay. The sensitivity and specificity were assessed both for singleplex and multiplex assays. Using the template concentration of 102 copies per microliter, the value of quantification cycle (Cq) and the limit of detection (LOD) were also compared for both singleplex and multiplex assays. Similarly, the merit of multiplex assay was also compared with sequence analysis and restriction fragment length polymorphism (RFLP) techniques used for HCV genotyping. In order to find the application of multiplex qPCR assay, it was used for genotyping in a panel of 98 sera positive for HCV RNA after screening a total number of 239 patients with various liver diseases. The results demonstrated the presence of genotype 1 in 26 of 98 (26.53%) sera, genotype 3 in 65 (66.32%) and genotype 4 in 2 (2.04%) sera samples, respectively. One sample showed mixed infection of genotype 1 and 3. Five samples could not show the presence of any genotype. Genotypes 2, 5 and 6 could not be detected in these sera samples. The analysis of sera by singleplex and RFLP indicated the results of multiplex to be comparable with singleplex and with clear merit of multiplex over RFLP. In addition, the results of multiplex assay were also found to be comparable with those from sequence analysis. The sensitivity, specificity, Cq values and LOD values were compared and found to be closely associated both for singleplex and multiplex assays. The multiplex qPCR assay was found to be a fast, specific and sensitive method that can be used as a technique of choice for HCV genotyping in all routine laboratories.

Effectiveness of hepatitis C antiviral treatment in a USA cohort of veteran patients with hepatocellular carcinoma

Hepatitis C virus (HCV) treatment for patients with hepatocellular carcinoma (HCC) was uncommon before direct-acting antiviral (DAA) medications. Real-world effectiveness of DAAs for HCV in patients with HCC is unclear. We describe rates of sustained virologic response (SVR) with DAA regimens by HCV genotype in patients with a history of HCC. We identified patients who initiated antiviral treatment between January 1, 2014 and June 30, 2015 in the national Veterans Affairs health care system. Regimens included sofosobuvir, ledipasvir/sofosbuvir, and paritaprevir/ritonavir/ombitasvir and dasabuvir with or without ribavirin. HCC patients were divided into those who were treated with liver transplantation after HCC diagnosis ("HCC/LT" group) and those treated with other modalities prior to antiviral therapy ("HCC" group). Of 17,487 HCV treatment recipients, 624 (3.6%) had prior HCC, including 142 with HCC/LT and 482 with HCC. Overall SVR was 91.1% in non-HCC, 74.4% in HCC, and 94.0% in HCC/LT. Among HCC patients, genotype 1 had the highest SVR overall (79.1% in HCC and 96.4% in HCC/LT), and genotype 3 the lowest (47.0% in HCC and 88.9% in HCC/LT). After adjustment for confounders, the presence of HCC was associated with lower likelihood of SVR overall (AOR 0.38 [95% CI 0.29, 0.48], p<0.001). HCV can be cured with DAAs in the majority of patients with prior HCC, and in virtually all HCC patients post-liver transplant. Deferral of HCV treatment until the post-transplant setting may be considered among HCC patients listed for transplantation. Over three-quarters of patients with hepatocellular carcinoma who have hepatitis C can achieve viral cure with direct-acting antiviral drugs. Among patients with hepatocellular carcinoma who subsequently received liver transplantation, over 90% of patients can achieve viral cure.

ENGLISH

Hepatitis C virus (HCV) infection has reached epidemic proportions. Worldwide, more than one million new cases of infection are reported annually, and HCV is believed to be more prevalent than hepatitis B virus infection. The study was carried out to genotyping of Hepatitis C virus (HCV) in patients of Basra province /Iraq. This study included 102 HCV infected patients 49 males and 53 females the age groups between 5-75 years. The selection of the patients for genotyping were based on the presence of HCV RNA in plasma by using Real Time-PCR, then detected HCV genotyping by using reverse transcription polymerase chain reaction (RT-PCR).The results showed prevalence of genotypes 1a, 1b, 2 and 3a in 37.25%, 17.65%, 4.90% and 0.98% respectively. Also these study determinate mixing genotypes (14.7%). Furthermore, distribution of HCV genotypes on studied groups showed high prevalence of 1a genotype in digestion system patients (14.71%), hemodialysis unit patients (11.76%), oncology children/child hospital (5.88%) and Center of hereditary blood disease patients (4.90%), then 1b genotype (9.80%) in digestion system patients, (3.92%) in hemodialysis unit patients, (0.98%) in oncology children/child hospital and (2.94%) in Center of hereditary blood disease patients. Also a 2 genotype was found only in digestion system patients (3.92%), hemodialysis unit patients (0.98%). while 3a genotype has 0.98% in digestion system patients only. Based on these results, it could be concluded genotype (1a and 1b subtypes) was a predominant of HCV genotypes in patients.

Epidemiological Distribution and Genotype Characterization of the Hepatitis C Virus Among HIV Patients in Kashan, Iran.

BackgroundParenteral transmission is a common route of transmission for both human immunodeficiency virus (HIV) and hepatitis C virus (HCV); therefore, hepatitis C viral infection is highly prevalent among people infected with HIV.ObjectivesThis study was designed to examine the epidemiology and describe the clinical manifestation as well as the HCV genotypes in patients from the city of Kashan, Iran, who are coinfected with HIV and HCV.Patients and MethodsThis descriptive study was conducted in 2014 in the city of Kashan. The population consisted of all the HIV-infected patients who were referred to the behavioral counseling center and jail in Kashan. Demographic information and HCV- and HIV-related risk behaviors were obtained through the use of an interviewer-assisted questionnaire. After the participants gave written informed consent to participate, 10 cc venous blood samples were collected. The serum samples were screened for HCV infection using an enzyme-linked immunosorbent assay (ELISA). In the event of a positive test for HCV, the RNA was then amplified by polymerase chain reaction (PCR) amplification. The HCV subtypes were determined via the direct sequencing of the amplicons. All data analysis was performed using SPSS version 16.0 for the descriptive statistics, and then the chi-square test and Pearson coefficient were performed for additional analysis.ResultsThe results of the analysis indicated that 54 (85%) of the 63 HIV-infected patients were males who were also HCV positive and who had less than a high school level education. There was a significant association between HCV infection and both occupation (P < 0.0001) and level of education (P < 0.05). All the HIV/HCV coinfected cases had a history of illicit drug use, while 92.6% had a history of imprisonment and 40.7% had high risk sexual contacts. Overall, genotype 1 was found in 75.9% of HCV patients, while genotype 3 was found in 24.1%. Some 94.4% of HCV patients had subtype A. There were no clinical symptoms of chronic hepatitis C.ConclusionsThe majority of HIV-infected persons in the city of Kashan were also HCV positive. Genotype 1 was the predominant type, alongside subtype A. Considering the high prevalence of HCV among the HIV-infected persons, as well as the impact of occupation, education, illicit drug use, and imprisonment on the incidence of both infections, health policy makers must introduce health programs and plans to reduce the prevalence of these infections.

Distribution of HCV Genotypes in Patients of with Chronic Hepatitis C in the Eastern Anatolia Region

OZET Objectives: Hepatitis C is a blood-borne virus affecting a large number of people all over the world. Hepatitis C virus (HCV) is one of the important causative agents of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Its viral genotypes variability affects response to interferon treatment. Therefore, identification of viral genotypes is key to management and treatment of hepatitis C infection. In our region, there has been no study on genotyping of the virus yet. This study was designed to determine the prevalence of HCV genotypes in our region. Materials and Methods: This study was conducted on the serum specimens of patients with chronic hepatitis C in the provinces of the Eastern Anatolia Region who attended Ataturk University between January 2011 and February 2014. Anti-HCV antibodies in the serum specimens were identified using an enzyme immunoassay kit (Dia. Pro Diagnostic Bioprobes Srl, Milan, Italy) and automatic analyzer, (Radim/ Alisei®, Calenzano-Firenze, Italy). HCV-RNA load was detected by quantitative PCR (Qiagen©, Germany). HCV genotypes were determined by pyrosequencing method using Pyromark Q24 kit and automatic analyzer (Qiagen©, Germany). Results: Four different HCV subgenotypes including 1b (87.0%), 1a (8.3%), 3a (3.7%) and 4d (1%) have been identified in seven different provinces within the Eastern Anatolia Region. Genotype 1 was found to be the most common major genotype. Conclusion: The prevalence of HCV genotypes in patients in the Eastern Anatolia Region was reported for the first time. We assume that the results obtained from this study may contribute to regional epidemiological data on HCV genotypes and to the treatment strategies for patients with hepatitis C in our region. (Viral Hepatitis Journal 2014; 20(3): 91-94)

Molecular epidemiology of different hepatitis C genotypes in serum and peripheral blood mononuclear cells in jahrom city of iran.

Background:The Hepatitis C Virus (HCV) is considered essentially hepatotropic, yet the virus compartments have also been found in important extra hepatic sites. Detection of HCV RNA in extra hepatic reservoirs such as peripheral blood mononuclear cells (PBMCs) is important for determining disease progression and treatment effectiveness.Objectives:The present study aimed to determine different HCV genotypes in patients' plasma and PBMC specimens, in Jahrom city of Iran.Patients and Methods:Blood samples of 137 patients with established HCV were collected at the Honari clinic. These patients were anti-HCV and plasma HCV RNA positive. After plasma RNA extraction and obtaining a pellet of approximately 3-5 × 106 PBMCs, Real-time PCR was performed, using specific-genotype primers. Finally, data analysis was done by the Statistical Package for Social Sciences (SPSS) software.Results:Subtype 3 was the most common genotype in plasma (57.7%) and PBMCs (51.1%). Subtype 1a was detected in 36.5% and 30.7% of plasma samples and PBMCs, respectively whereas subtype 4 was not detected in any of the cases. There was a genotype difference between plasma and PBMCs of 12.4% of patients. In four patients no genotype was detected in their plasma but genotype 3 was detected in the PBMCs.Conclusions:It is suggested that determination of the target genotype by plasma subtyping for choosing the proper antiviral therapy is essential but may result in therapy failure. HCV genotyping in PBMC samples, along with plasma specimens, might be more beneficial. Therefore determining the HCV genotype in PBMCs, before beginning the therapy is useful due to the possibility of occult infection detection.

Determination of hepatitis C virus genotypes among HCV positive patients in Shahrekord, Iran

Hepatitis C is one of the most common causes of the liver failure and cancer and represents a major public health problem. Recent studies have focused on whether different hepatitis C virus (HCV) genotypes, are associated with different profiles of pathogenicity, infectivity and response to antiviral therapy. Genotyping system based on polymerase chain reaction (PCR) of the core region with genotype-specific PCR primers for the determination of HCV genotypes 1a, 1b, 2a, 2b, 3a, 3b, 4, 5a, and 6a was developed. Different genotypes have been reported in different parts of the world. Genotype 1 is difficult to treat, while genotypes 2 and 3 are easy to treat. Therefore, identification of HCV genotype in patients is necessary to begin and follow up the treatment. In this study, viral genomic of 94 patients extracted from sera were detected by nested-real time (RT) PCR. PCR products were digested with proper enzymes and studied by restriction fragment length polymorphism (RFLP). The results of PCR-RFLP were as follows: 1a (54.26%), 1b (11.71%), 3a (27.66%), 2a (2.12%) and 4 (4.25%). This indicates that a high percentage of HCV infected patients. Key words: Genotyping, Hepatitis C Virus, PCR, RFLP, Iran.

CD4+/CD8+ ratio of liver-derived lymphocytes is related to viraemia and not to hepatitis C virus genotypes in chronic hepatitis C.

The pathogenic mechanisms that lead to chronic hepatitis C are unknown. As hepatitis C virus (HCV) has been shown to induce T cell response, we assessed whether a particular T lymphocyte subset could be preferentially detected in the liver of patients with chronic hepatitis C in relation to viraemia or HCV genotypes. The immunophenotypes of liver-derived lymphocytes were analysed in 26 patients by flow cytometry and immunohistochemistry. Viraemia was quantified by branched DNA assay. Using this assay, HCV RNA was not detectable in six patients. HCV RNA was detected in 20 patients, and titres ranged from 8 to 137 x 10(6) Eq/ml. Genotyping was performed using a line probe assay. Type 1a, 1b, 2a, 3a and 4a were found to infect 2, 10, 2, 7 and 3 patients, respectively. The CD4+/CD8+ ratio of liver-derived lymphocytes was significantly higher (P < 0.01) in patients with detectable viraemia than in patients without detectable viraemia. In contrast, neither the percentage of gamma/delta T lymphocytes nor that of CD2+CD57+ cells was different in the groups. When comparing the CD4+/CD8+ ratio, the percentage of gamma/delta T lymphocytes or CD2+CD57+ cells according to genotype, the differences were not significant. These results suggest that the CD4+/CD8+ ratio of liver-derived lymphocytes is related to viraemia but not to HCV genotypes in patients with chronic hepatitis C, and that T lymphocytes may be involved in the pathogenesis of liver lesions in chronic hepatitis C.

Distribution of hepatitis C virus genotypes in Jeju Island

The hepatitis C virus (HCV) genotype affects clinical outcomes of HCV infection, in terms of the response to antiviral therapy and progression of chronic liver diseases, and shows geographic differences in distribution. The aim of this study was to elucidate the HCV genotypes in patients with chronic HCV infection in Jeju, which is an island off the Korean peninsula. The study population consisted of 162 patients with anti-HCV antibodies and HCV-RNA. HCV genotypes were determined using genotype specific primers. HCV genotype 2a predominated (62.3%), followed by genotype 1b (34.0%) and 2b (3.7%). The prevalence of genotypes differed significantly with age, with HCV genotypes 1 and 2 being more frequent in older and younger subjects (P=0.035), respectively. HCV-RNA levels were higher in patients with genotype 1 than in those with genotype 2 (P=0.001). HCV genotype was not significantly related to sex, clinical diagnosis and potential risk factors. HCV genotype 2a is most common in Jeju, followed by genotype 1b. Our results suggest that the distribution of the HCV genotype differs between regions in Korea.

Distribution of HCV Genotypes in Patients with End-Stage Renal Disease According to Type of Dialysis Treatment

The objective of this study was to investigate the effects of types of dialysis treatments on hepatitis C virus infection and the epidemiologic properties of hepatitis C virus (HCV) infection at three Baskent University hospitals, in Ankara, Adana, and Izmir, Turkey, in 655, 326, and 118 patients with end-stage renal disease, respectively. One hundred thirty patients with HCV viremia among 271 patients with end-stage renal disease seropositive for HCV were included in this cross-sectional study. HCV RNA-positive patients were classified according to the renal replacement therapies (hemodialysis or continuous ambulatory peritoneal dialysis), and viral load, transaminase levels, and distribution of genotypes were compared between these subgroups. In the continuous ambulatory peritoneal dialysis group, 26 of 165 patients (16%) were serum anti-HCV positive, and 11 of 26 patients (42%) were serum HCV RNA positive. Twenty-six percent of the patients undergoing hemodialysis were anti-HCV positive, and 49% were HCV RNA positive. The prevalence of genotype 1b was 68% and 73% for patients in the continuous ambulatory peritoneal dialysis and hemodialysis groups, respectively. No significant differences were found between the genotype 1b and the non-1b groups or between different dialysis types with regard to age and sex and serum aspartate transaminase, alanine aminotransferase, and HCV RNA levels. We conclude that HCV seropositivity may differ between different types of dialysis treatments, although viral load and genotypes may be similar in persons with end-stage renal disease and those without.

Hepatitis C virus and lichen planus

Data sources Medline (1966–June 2003) provided the primary data source, with references from identified papers then being reviewed for additional studies. Study selection Studies were included if they reported prevalence of hepatitis C virus (HCV) in people who have oral lichen planus (OLP), compared clinical and histological features of OLP in patients who were or were not infected with HCV, reported presence of HVC within OLP lesions; or were studies of HCV genotypes in patients who had OLP lesions. Data extraction and synthesis The available studies varied widely in design, population and distribution of confounders so could not be combined in any meaningful meta-analysis. Data were, therefore, summarised and tabulated. Results In total, 32 studies were identified, of which 14 were descriptive, reporting prevalence, and 18 were case–control. HCV prevalence varied from 0 to 62% in individuals who had OLP. OLP prevalence varied from 1.6 to 20% in HCV-infected subjects. Important biases, including selection and investigator bias were identified within the studies. Conclusions No firm conclusions can be drawn from this review because of the diverse nature of the available studies and the biases contained therein.

Hepatitis C virus infection in a Brazilian population with sickle-cell anemia.

Patients with sickle-cell anemia submitted to frequent blood transfusions are at risk of contamination with hepatitis C virus (HCV). Determination of HCV RNA and genotype characterization are parameters that are relevant for the treatment of the viral infection. The objective of the present study was to determine the frequency of HCV infection and the positivity for HCV RNA and to identify the HCV genotype in patients with sickle-cell anemia with a history of blood transfusion who had been treated at the Hospital of the HEMOPE Foundation. Sera from 291 patients were tested for anti-HCV antibodies by ELISA 3.0 and RIBA 3.0 Chiron and for the presence of HCV RNA by RT-PCR. HCV genotyping was performed in 19 serum samples. Forty-one of 291 patients (14.1%) were anti-HCV positive by ELISA and RIBA. Both univariate and multivariate analysis showed a greater risk of anti-HCV positivity in those who had started a transfusion regime before 1992 and received more than 10 units of blood. Thirty-four of the anti-HCV-positive patients (34/41, 82.9%) were also HCV RNA positive. Univariate analysis, used to compare HCV RNA-negative and -positive patients, did not indicate a higher risk of HCV RNA positivity for any of the variables evaluated. The genotypes identified were 1b (63%), 1a (21%) and 3a (16%). A high prevalence of HCV infection was observed in our patients with sickle-cell anemia (14.1%) compared to the population in general (3%). In the literature, the frequency of HCV infection in sickle-cell anemia ranges from 2 to 30%. The serological screening for anti-HCV at blood banks after 1992 has contributed to a better control of the dissemination of HCV infection. Because of the predominance of genotype 1, these patients belong to a group requiring special treatment, with a probable indication of new therapeutic options against HCV.

Evaluation of a new assay for hepatitis C virus genotyping and viral load determination in patients with chronic hepatitis C

A new method for hepatitis C virus (HCV) genotyping that analyzes products generated with the HCV Amplicor Monitor Test has been developed. One hundred and sixty-two Japanese patients with chronic hepatitis C, including 59 patients with hemophilia, were tested for HCV genotypes and viral loads with this new test, and the results were compared with those of a genotyping assay that involved direct sequencing of the E1 region. HCV genotypes and viral loads were also compared between patients with and without hemophilia. There were no discrepancies between the two methods in determining genotypes 2a, 2b, and 3a. However, two patients infected with 1a were mistyped as 1b with the new assay. One patient not classified by this assay was genotype 4. Genotypes found in patients without hemophilia were 1b, 2a, and 2b. Genotypes 1a, 3a, and 4, which were minor variants in Japan, were detected only in patients with hemophilia. In addition, J type, which is a subtype of 1b that originated in Japan, was found at low frequency in hemophiliacs. Thus, the HCV genotypes in patients with hemophilia are likely to be of foreign origin. Overall, this new assay was accurate except for genotype 1a and 4, and allowed simultaneous assessment of genotype and viral load.

HCV genotypes in patients with chronic hepatitis C in Croatia

The determination of hepatitis C virus (HCV) genotype is an important epidemiological parameter in patients with chronic hepatitis C, while its clinical significance is still a matter of debate. The HCV genotypes in a group of 203 Croatian patients with chronic hepatitis C were examined. Genotypes were correlated to different risk factors, age, duration of the disease, liver histology activity and level of viremia. HCV-RNA was detected in each serum by means of reverse transcription PCR. Genotypes were determined from the amplificate by reverse hybridization in a line probe assay. The level of viremia was assessed by branched DNA (bDNA) signal amplification. The most common genotype was 1b (61.1% of patients), followed by 3a (26.1%), and 1a (10.8%). Other genotypes such as 2a and 4 were only rarely found in our patients (2%). Genotype 1b was most commonly acquired via blood transfusion, while genotype 3a was strongly related to intravenous drug use. Genotype 1b was associated with older age (mean 42.6 vs 29.3 years), longer duration of the disease (mean 6.0 vs 3.5 years), higher histologic activity score (mean 13.2 vs 10.6) and higher viremia (mean 9.06 vs 5.93 Meq/ml) at statistically significant levels (p < 0.001) when compared to genotype 3a. The prevalence of HCV genotypes follows the patterns of southeastern European countries, except for a lower prevalence of genotype 2. The observation that genotype 1b is associated with higher viremia and more severe liver injury is confirmed.