Genotypes of HCV: Their Relationship with Risk Factors, the Severity of Liver Disease, and the Serological Response


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TITLE: Genotypes of hepatitis C virus: their relationship with risk factors, the severity of liver disease, and the serologic response

BACKGROUND: The objective of our study was to ascertain the prevalence of different HCV genotypes between the hepatitis C patients in the health area of Monforte de Lemos, Spain, as well as the possible influence of risk factors on their distribution and their relation with hepatic disease and with the serologic response.

PATIENTS AND METHODS: We have studied 128 patients with hepatitis C. Of these, 41 were intravenous drug users (IVDU), 19 had received transfusions, 7 were hemodialyzed and in 61 the risk factors were unknown. Antibodies against HCV were detected by second-generation enzyme immunoassay (EIA) and confirmed by immunoblot. RNA-HCV presence was studied by reverse transcription-PCR (RT-PCR), and a reverse hybridization test of the amplifications was used for the genotyping.

RESULTS: Hepatitis C genotypes Ib (46.1 [8.6%]), la (23.4 [7.3%]) and 3a (13.3 [5.9%]) were the most frequently encountered genotype. Genotype la (48.8 [15.3%]) was the most prevalent genotypes in IVDU patients, while Ib was the most frequent in patients of unknown risk factors (62.3 [12.1%]), Alanine-aminotransferase (ALT) was elevated in 66.6 (17.7%) of patients with genotype la, in 87.5 (8.6%) of patients with genotype Ib (p = 0.0367) and in 94.1 (11.2%) of patients with genotype 3a (p = 0.0347). Subtype Ib was present in 6 of 7 cases of cirrhosis (85.7%) and in 7 of 12 cases of active chronic hepatitis (58.3%). No significant statistical differences were observed between the genotypes and the specific IgM response against core antigen of HCV, neither we observed differences in the serologic response against C1, C2, NS3 and NS4 peptides,

CONCLUSIONS: Hepatitis C genotypes la and 3a were the most prevalent genotypes between IVDU patiens while genotype Ib was the most frequent between non-IVDU patients. Genotype Ib was associated to severe liver disease. Percentage of positivity or the reactivity against HCV peptides was independent of the genotype encountered in the patient.

AUTHOR: Alonso PA, Orduna A, San Miguel A, Dominguez E, Gutierrez P, Lorenzo B, Zarzosa P, Bratos MA, Torres AR
SOURCE: MEDICINA CLINICA 110: (18) 681-686 MAY 23 1998

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