Does the clinical outcome of hepatitis C infection vary with the infecting hepatitis C virus type?

Abstract

Whether differences in the natural history of hepatitis C virus (HCV) can be explained by differences in the infecting HCV type is unknown. The aim of this study was to investigate whether the HCV type might influence the clinical outcome of infection. Study serum samples were assembled from 749 individuals enrolled into the UK HCV National Register from which data on clinical outcomes were extracted. HCV-RNA-positive specimens were genotyped and HCV-RNA-negative specimens serotyped. Logistic regression analysis was used to investigate the independent effect of HCV type on viral clearance by comparing patients who were HCV RNA negative (n = 86) with those who were HCV RNA positive (n = 508). The same method was used to investigate whether HCV type was associated with histological stage of liver disease. The prevalence of HCV type 1 among those who cleared infection was 69% and among those who remained HCV RNA positive was 51%: Type 1 infections were more likely to be HCV RNA negative than non-1 types (OR 0.47, 95% CI 0.29-0.78, P = 0.003). Type 1 infections were also more likely to be associated with histological stage scores above the median when compared with non-1 types (OR 2.03, 95% CI 1.07-3.83, P = 0.03). In conclusion, HCV type 1 infection was more often HCV RNA negative, suggesting that spontaneous clearance may occur more commonly with this type. Among the RNA-positive infections, type 1 infection may be more aggressive than types 2/3.

Natural history of chronic hepatitis C: Genotype 1 versus genotype 6

“…There are other studies, however, that show a lack of correlation between viral genotype and disease progression [22][23]. One recent study concluded HCV genotype 1 is associated with a higher rate of spontaneous clearance when compared to genotypes 2 and 3, but among patients who remain HCV RNA positive, genotype 1 behaves in a more aggressive manner [24]. Another study showed HCV genotype 4 to be more aggressive in the post-transplant setting when compared to genotypes 1, 2, and 3 [25].…”

Market uptake of new antiviral drugs for the treatment of hepatitis C

“…Because treatment for genotype 1/4 requires more drugs than treatment for genotype 2/3, our treatment rates for Turkey and Romania are overestimated. On the other hand, in Scandinavia [48][49][50][51][52], Denmark [53] and the UK [54], fewer than 66% of the hepatitis C cases are attributable to genotype 1/4, causing a downward bias in estimated treatment rates. In the case of dose reduction, we assumed a 50% reduction of the original dose [33].…”

Immune complexed (IC) hepatitis C virus (HCV) in chronically and acutely HCV-infected patients

“…To this regard, an important aspect seems to be the virus genome heterogeneity on which is based the classiWcation of HCV into genotypes and subtypes [2]. Indeed, HCV diVerent genotypes and subtypes, which show various geographical worldwide distribution and diVerent sensitivity to interferon (IFN) therapy, may inXuence the diVerence in disease severity [3][4][5] and the tendency to undergo spontaneous recovery [6][7][8] even if this latter issue is also still debated [9,10].…”