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

Vince, Adriana; Lepej, Snježana Židovec; Bingulac-Popović, Jasna; Miletić, Manuela; Kuret, Sendi; Sardelić, Sanda; Vrakela, Ivana Baća; Kurelac, Ivan

doi:10.21101/cejph.a5021

Cited by 6 publications

(8 citation statements)

References 15 publications

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“…Anti-HCV antibodies were detected in 0.9% of individuals in 2010–2011 [ 15 ]. HCV genotypes were analyzed in patients with chronic hepatitis C in the period 1996–2005 and 2008–2015 [ 29 , 30 ]. There were no substantial changes in the molecular epidemiology of the two most frequent HCV genotypes in Croatia in the past 20 years.…”

Section: General Populationmentioning

confidence: 99%

Seroprevalence Trends and Molecular Epidemiology of Viral Hepatitis in Croatia

Vilibić-Čavlek

Lepej

Ferenc

et al. 2023

Life

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Viral hepatitis is a significant cause of morbidity and mortality worldwide. In Croatia, hepatitis B virus (HBV) and hepatitis C virus (HCV) are widely distributed, especially in some high-risk groups such as people who inject drugs (PWID), prisoners, and highly promiscuous groups. The seroprevalence of HBV ranges from 7.0% in the general population to 38.8% in PWID, depending on the region. The seroprevalence of HCV is highest among PWID (29–75.5%) as compared to 0.9% in the general population. Analyzing the distribution of HCV genotypes, no substantial changes in the molecular epidemiology of the two most frequent HCV genotypes (1 and 3) in the past 20 years were observed. However, the predominance of subtype 1b compared to subtype 1a as detected in 1996–2005 was not confirmed in 2008–2015. Hepatitis A virus (HAV) incidence was high in the past with a decreasing trend since the 2000s, except for an outbreak in 2017–2018 as part of the large European outbreak, which was mainly among men who have sex with men. Hepatitis E virus (HEV) is an emerging virus detected for the first time in Croatia in 2012. The seroprevalence of HEV is high among hemodialysis patients (27.9%) and liver transplant recipients (19.3–24.4%). In addition, higher seroprevalence rates were observed in animal-related professions (e.g., veterinarians, 15.2%; hunters, 14.9%). All detected HEV strains belonged to genotype 3.

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Section: General Populationmentioning

confidence: 99%

Seroprevalence Trends and Molecular Epidemiology of Viral Hepatitis in Croatia

Vilibić-Čavlek

Lepej

Ferenc

et al. 2023

Life

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“…Previous studies of HCV epidemiology in Croatia were mainly focused only on the prevalence and distribution of various HCV genotypes and subtypes, while this study broadens this knowledge by including transmission and phylodynamic analyses. The most common HCV genotypes in the Croatian general population were found to be GT1 and GT3, with no major changes in molecular epidemiology in the last 20 years [ 12 , 31 ]. In this study, we observed higher median age of GT1b-infected patients (61 years) compared with GT1a (43 years) and GT3a (44 years), which is similar to data from a previous national study and could be attributed to predominantly iatrogenic mode of HCV transmission in GT1b which was significantly reduced in the last 30 years [ 11 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…HCV genotype distribution in Croatia varies according to different population groups and regions. Genotype 1 (GT1) is the most prevalent among the general population (57–80%), followed by genotype 3 (GT3) (13–48%), while the prevalence of genotype 2 (GT2) (1–2%) and 4 (GT4) (4–7%) is low [ 11 , 12 ]. HCV transmission via blood transfusion and unsafe medical procedures was significantly reduced after the introduction of blood donation screening for HCV in the 1990s [ 11 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology and Baseline Resistance of Hepatitis C Virus to Direct Acting Antivirals in Croatia

et al. 2022

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Molecular epidemiology of hepatitis C virus (HCV) is exceptionally complex due to the highly diverse HCV genome. Genetic diversity, transmission dynamics, and epidemic history of the most common HCV genotypes were inferred by population sequencing of the HCV NS3, NS5A, and NS5B region followed by phylogenetic and phylodynamic analysis. The results of this research suggest high overall prevalence of baseline NS3 resistance associate substitutions (RAS) (33.0%), moderate prevalence of NS5A RAS (13.7%), and low prevalence of nucleoside inhibitor NS5B RAS (8.3%). Prevalence of RAS significantly differed according to HCV genotype, with the highest prevalence of baseline resistance to NS3 inhibitors and NS5A inhibitors observed in HCV subtype 1a (68.8%) and subtype 1b (21.3%), respectively. Phylogenetic tree reconstructions showed two distinct clades within the subtype 1a, clade I (62.4%) and clade II (37.6%). NS3 RAS were preferentially associated with clade I. Phylogenetic analysis demonstrated that 27 (9.0%) HCV sequences had a presumed epidemiological link with another sequence and classified into 13 transmission pairs or clusters which were predominantly comprised of subtype 3a viruses and commonly detected among intravenous drug users (IDU). Phylodynamic analyses highlighted an exponential increase in subtype 1a and 3a effective population size in the late 20th century, which is a period associated with an explosive increase in the number of IDU in Croatia.

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“…In 2019 HCV elimination was achieved in liver transplant patients. A plan for prevention and control of viral hepatitis is ready and waiting for the final approval by the Ministry of Health, so Croatian experts are optimistic regarding HCV elimination by 2030 [14,15].…”

Section: Discussionmentioning

confidence: 99%

How close are we to hepatitis C virus elimination in Central Europe?

Flisiak¹,

Fraňková²,

Grgurević³

et al. 2020

ceh

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Aim of the study: To collect and analyse data obtained from HCV opinion leaders/experts from central European countries, on factors which can affect the WHO target of HCV elimination by 2030. Material and methods: Data were collected from opinion leaders/experts involved in management of HCV infections in Central European countries which participated in 9 th Conference of the Central European Hepatologic Collaboration (Warsaw, 10-11 October 2019). A dedicated questionnaire collected current information related to HCV elimination in Bulgaria, Croatia, the Czech Republic, Hungary, Latvia, Lithuania, Poland and Slovakia. Results: The HCV prevalence rate in particular countries varied from 0.2% to 1.7%. In most central European countries all the HCV infected population is eligible for reimbursement of treatment. However, in some countries there are still some limitations related to the stage of the disease and people who inject drugs. All countries have access to at least one pangenotypic regimen. The most common barrier to HCV elimination in all countries is insufficient political will to establish priority for HCV. None of the reporting countries has established a national screening programme. Conclusions: Access to therapy for HCV is similar and the majority of patients in Central Europe can be treated according to the current guidelines. Unfortunately there are still some limitations and a lack of political will to implement national screening programmes. According to collected data HCV elimination will not be possible in the region by 2030.

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

Cited by 6 publications

References 15 publications

Seroprevalence Trends and Molecular Epidemiology of Viral Hepatitis in Croatia

Seroprevalence Trends and Molecular Epidemiology of Viral Hepatitis in Croatia

Molecular Epidemiology and Baseline Resistance of Hepatitis C Virus to Direct Acting Antivirals in Croatia

How close are we to hepatitis C virus elimination in Central Europe?

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