Distribution Pattern of Hepatitis C Virus Genotypes and Correlation with Viral Load and Risk Factors in Chronic Positive Patients

Abstract

Objective: Hepatitis C virus (HCV) has emerged as a leading cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma worldwide. The purpose of this study was to describe the distribution pattern of HCV genotypes in chronic hepatitis patients in the Campania region of southern Italy and estimate their association with risk factors and viral load. Materials and Methods: 404 consecutive HCV ribonucleic acid-positive patients were included in the study. HCV genotyping was carried out by the HCV line probe assay test and viral load estimation by the TaqMan real-time PCR system. Results: The predominant genotype was 1 (63.6%), followed by genotype 2 (29.4%), 3 (6.2%) and 4 (0.8%). Subtype 1b was more frequent in females than in males. Conversely, genotype 3 was more frequent in males. No significant difference was observed in age distribution of HCV genotypes. Surgery and dental therapy were the most frequent risk factors for genotype 1 and intravenous drug abuse and tattooing for genotype 3. Patients with genotype 1 more frequently showed high HCV viral load when compared to those with genotypes 2 and 3. Conclusion: The present study revealed that HCV genotypes 1 and 2 accounted for over 95% of all HCV infections in the Campania region, and genotype 1 was more frequently associated with a higher viral load when compared to genotypes 2 and 3.

Distribution of Hepatitis C Virus Genotypes and Subtypes in the Metropolitan Area of Naples, Italy, in the Era of Interferon-Free Regimens

“…Our data also seem to confirm the existence of 2 transmission patterns of the HCV genotypes in Italy, as already reported by other authors [21,26,28] . The first is characterized by infections with subtypes 1b and 2a/2c, mainly in adults aged over 60 years, consistent with healthcarerelated practices in the past.…”

Hepatitis C Virus (HCV) genotypes distribution among hepatocellular carcinoma patients in Southern Italy: a three year retrospective study

“…Although our study is simply a retrospective analysis and prevents us to make any hypothesis about mechanisms of HCC progression, our data clearly shows that a significantly higher percentage of HCC patients (83.7%) shows HCV-RNA in their sera compared to the control group (61.4%) (p < 0.001), suggesting that HCC patients have a risk of HCV active infection almost 1 and half times higher than patients without HCC, even if we did not find any correlation between high levels of viremia and advanced liver stage, as reported by other authors [38,67]. The role of genotypes 1b and 3 in increasing the risk of HCC development has been widely questioned recently and even though numerous studies have often suggested their association with the HCC carcinogenetic progression [68][69][70][71][72][73][74], especially in patients with underlying cirrhosis, [38][39][40][41][75][76][77], probably for the strict correlation existing between these subtypes and liver damage, no consensus has emerged yet.…”

“…Although in our area, as we previously reported [37,38], genotype 1b is the most common subtype, our data show that its prevalence in HCC patients is significantly higher (67.9%) if compared to the control group (54.4%) (p < 0.001), suggesting that HCC patients have a risk to be infected by subtype 1b quite 2 times greater than patients without HCC. Although a minority of treated control group patients achieved SVR, in order to minimize the potential confounding effect of SVR, we adjusted the estimates for SVR achievement, and we also provided a separate multivariate analysis that excluded all patients who had achieved SVR.…”

“…As we previously described, genotype 1b, historically the most prevalent not only in Italy but in the whole of Europe, is the most common genotype also in Southern Italy, followed by genotype 2 [37,38].…”

“…The role of genotypes 1b and 3 in increasing the risk of HCC development has been widely questioned recently and even though numerous studies have often suggested their association with the HCC carcinogenetic progression [68][69][70][71][72][73][74], especially in patients with underlying cirrhosis, [38][39][40][41][75][76][77], probably for the strict correlation existing between these subtypes and liver damage, no consensus has emerged yet. Whether HCV 1b genotype contains specific nucleotide sequences that may be associated with direct pathogenesis or may trigger a stronger inflammatory response still needs to be extensively investigated.…”