Genetic variation of hepatitis C virus in a cohort of injection heroin users in Wuhan, China

Abstract

Since the majority of heroin abusers use injection as the primary route of admission, heroin abuse contributes significantly to the transmission of hepatitis C virus (HCV). We determined HCV infection and its genotype distribution among injection heroin users in Wuhan, the largest city in the central China. Eight hundred seventy eight (84%) out of 1046 serum specimens from the injection drug users were positive for HCV antibody. Out of randomly selected 122 specimens positive for HCV antibody, seventy-eight (64%) had detectable HCV RNA with genotype 6a as the predominant strain (50%), followed by 3b (32.2%), 1a (8.1%), 1b (6.5%), and 3a (3.2%). HCV RNA levels in male heroin users were significantly higher (P = 0.013) than those in the female subjects. Although there was no significant difference in HCV RNA levels among the specimens positive for HCV 6a and 1a/1b, the samples with 6a or 1a/1b contained higher levels of HCV RNA than the specimens positive for HCV 3b (P = 0.019, P = 0.012, respectively). These findings indicate that there is a high prevalence of HCV infection with genotypes 6a and 3b as predominated strains among injection heroin users in Wuhan, China. KeywordsHepatitis C Virus; Genotype; Wuhan; China; Injection Heroin Abuser Hepatitis C virus (HCV) is estimated to chronically infect more than 170 million people worldwide, causing a spectrum of liver disease ranging from an asymptomatic carrier state to end-stage liver disease. While HCV infection through contaminated blood products decreased dramatically due to improved HCV screening tests, injection drug users (IDUs) became the primary source of new HCV infection (Alter, 1997;Alter, 1999;Thomas et al., 1994). IDUs comprise the largest risk group for HCV infection (Alter, 1999;Lauer and Walker, 2001;Mathei et al., 2002). Rates of HCV infection among past and current IDUs are extremely high *Corresponding Author: Wen-Zhe Ho, Dr. Wen-Zhe Ho,Division of Allergy & Immunology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, 34th Street & Civic Center Boulevard, Philadelphia, Pennsylvania 19104, Phone: 1-215-590-4462, Fax: 1-215-590-2025, E-mail: ho@email.chop.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Thomas et al., 1995). Although HCV infection is epidemically worldwide, there is a large degree of geographic variability in its distribution. HCV genotypes have unique patterns of geographic distribution, which is associated with differences in response to interferon treatment (Pascu et al., 2004;Teo and Hayes 2004). Sequence comparisons of variants from ...

Migration Patterns of Hepatitis C Virus in China Characterized for Five Major Subtypes Based on Samples from 411 Volunteer Blood Donors from 17 Provinces and Municipalities

“…In relation to a previous finding that 3b was detected more often among IDUs than among other people (31), we may speculate that its migration from the southwest to other regions was primarily by transmission via the IDU network. This is consistent with the known drug trafficking routes in Yunnan Province that link the Golden Triangle in Southeast Asian countries to China (17,27,31). This is also consistent with the finding that IDUs have played important roles in mediating the migration of HIV-1 across China (32).…”

“…In this study, we found that groups C and D are also unique to China. We further revealed that eight sequences from patients (sequences with GenBank accession numbers AY835104, AY835105, AY835106, AY835107, JX676856, JX677041, JX676903, and JX677124) and two from blood donors (sequences with GenBank accession numbers GQ205717 and GQ205748) in our other studies (4,6,12) were classified into group C, while 13 IDU sequences detected in Xinjiang (from isolates XJB2, XJB8, XJB9, XJB12, XJB13, XJB16, XJB17, XJB21, XJB27, XJB31, XJB34, XJB38, and XJXU2) (26) and four sequences detected from IDUs in Hubei (sequences with GenBank accession numbers EF185933, EF185970, EF185990, and EF185989) (27) were classified into group D (see Fig. S3 in the supplemental material).…”

The Current Hepatitis C Virus Prevalence in China May Have Resulted Mainly from an Officially Encouraged Plasma Campaign in the 1990s: a Coalescence Inference with Genetic Sequences

“…Figure 2C shows an ML tree including E1 sequences from 104 subtype 3b isolates. In addition to the 13 in this study, 20 were from our previous studies (24)(25)(26) and 71 were from reference reports, and all were from intravenous drug users (IDUs); 44 were from Guangxi Province (27), 24 from Hubei (29), and 3 from Jiangsu (30). Two monophyletic clusters were observed, but they did not show significant bootstrap support.…”

“…To estimate the HCV epidemic history, five sequence data sets were assembled, which comprised the sequences of subtypes 1b, 2a, 3a, 3b, and 6a. The majority of these sequences were from this study and our previous reports (24)(25)(26), while a small portion were from the reference literature (27)(28)(29)(30). Among the latter, many were from our collaborators, with whom we communicated about the sequencing procedures and sampling dates.…”

“…To test these hypotheses, we determined the HCV sequences in the samples collected from 423 patients in Guangzhou city, one of the major cities in China, where a considerable portion of the residents are immigrants or migrants from across the country (25). Based on the determined sequences, we performed phylogenetic analyses for a standard HCV classification, followed by subjecting them to BEAST inferences, in combination with the sequences from our previous studies (24)(25)(26) and those reported by others (27)(28)(29)(30). Because the last two sequence collections were sampled in different provinces, they represent the HCV strains prevalent in the country.…”