Different genotypes of hepatitis C virus are associated with different severity of chronic liver disease

Abstract

The presence of the "Japanese type" NS4 region was investigated in two series of patients (53 from Italy and 58 from Japan) with hepatitis C virus (HCV)-related chronic liver disease. The two populations were homogeneous as regard to age, male/female ratio, histological diagnosis, and serum aminotransferase activities. Genomic amplification was carried out by "nested" polymerase chain reaction (PCR) with a pair of primers synthesized according to the sequence of JK-1 isolated in Japan. The presence of viral replication was confirmed further by PCR amplification of the 5'NC region. The NS4 region of the Japanese strain was detected in 24 sera (45%) from Italy and in 44 (71%) from Japan. NS4-positive patients were significantly older and showed an ALT serum level significantly lower (P < 0.01) than NS4 negative cases in each group. Cirrhosis was significantly (P < 0.0007) more common in NS4-positive than in NS4-negative patients. The HCV genotype was subsequently obtained according to Okamoto. All the NS4-positive patients were infected by Type II, whereas in NS4-negative patients all four genotypes were present though Type II still constituted the majority. Cirrhosis was associated exclusively with Type II both in NS4-positive and -negative subjects. These data indicate that, although the positivity for NS4 "Japanese" region seems to be associated with a more aggressive liver disease, the most prevalent Type II predicts more specifically those who are likely to develop cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Survey of major genotypes and subtypes of hepatitis C virus using RFLP of sequences amplified from the 5' non-coding region

“…In North America, type la was the most frequent genotype infecting blood donors in Pittsburgh; varying proportions of type la to lb have been found in NANB patients elsewhere in the USA and in Canada (Andonov & Chaudhary, 1994) [65 % and 34 % (this study); 68 % and 82 % in other studies respectively], while type 3a infection was rare (4.7 %), consistent with previous reports Andonov & Chaudhary, 1994;Murphy et al, 1994). Although types la and lb have been described as the 'American' and 'Japanese' types (Pozzato et al, 1991(Pozzato et al, , 1994, these terms are misleading as type lb accounts for 13-27 % of HCV infections in North America, and is the predominant genotype in many countries in Europe Viazov et al, 1994). Similarly, type la is not confined to America.…”

Which patients with hepatitis C develop liver complications?

“…However, we clearly showed in the multivariate analysis that the apparent influence of HCV genotype is confounded by interactions with age, advanced hepatic fibrosis score, and poor hepatic synthetic function, all key determinants for liver-related complications. Some studies have suggested that genotype 1b is associated with faster disease progression, higher prevalence of cirrhosis and HCC, early disease recurrence after liver transplantation, and poor response to interferon therapy, 3,[47][48][49][50][51][52][53] but in another study there were no differences in survival according to genotype. 15 On the basis of the present findings, HCV genotype does not appear to be an independent determinant for life-threatening events in hepatitis C.…”

Lack of correlation between hepatitis C virus genotypes and clinical course of hepatitis C virus-related cirrhosis

“…Six patients (16.6%) showed a persistent normalization of ALT that was maintained after therapy, and only 2 (5.5%) became uals. [15][16][17]27,28 These assumptions have been reached mainly in whom severity and stage of chronic liver disease were not found to show a definitive association with the genotype of by following the observation that the distribution of HCVgenotypes differs in relation to the type of patients investi-infecting-HCV. This is true at least for patients who present with evidence of liver disease, as were those included in our gated.…”

“…Indeed several authors have described a higher prevalence of infection by HCV-1b in patients with more advanced study, and does not exclude the possibility that in the subgroup of HCV carriers, who have normal ALT, HCV-2 may liver disease, such as cirrhosis and HCC, as compared to control populations of patients with chronic hepatitis type C be more frequently detected, as recently shown by Prati et al 32 In the present study, we have also tried to address the that has not yet evolved into the cirrhotic stage. 16,[18][19][20] Other studies have shown that patients with mild forms of chronic issue of whether the course and the outcome of chronic liver disease, at least in cirrhotic patients, is significantly influhepatitis C, such as those with persistent infection and normal transaminases, are often infected by genotypes other enced by the type of HCV with which they are infected. For this purpose, a cohort of 109 cirrhotic patients, who were than that of HCV-1b, such as HCV-2 or HCV-3.…”

“…[9][10][11][12][13][14] Some evidence has been provided cirrhosis who were followed up prospectively, allowing that the genotype of HCV may be one of the factors influencfor the assessment of the role of the HCV-genotype on ing the severity and outcome of liver disease. [15][16][17] Genotype disease outcome and on the development of hepatocellu1b, the most prevalent variant found in several parts of the lar carcinoma (HCC). HCV-1 was detected in 147 (46%)…”