Hepatitis C genotypes in Australian haemophilia patients

Baker, Ross; Smith, Julie; Eikelboom, John W.; Leahy, Bradley J.; Kay, Ian; Lavis, N.; Palladino, Silvano; Cheng, Wendy; Price, Jamie; Mews, Catherine

doi:10.1111/j.1445-5994.1996.tb00626.x

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…Previous prevalence surveys of chronic HCV infection in Australia between 1997 and 2000 resulted in reported ranges of 20% to 38% for genotype 3 and 52% to 65% for genotype 1 (18)(19)(20)(21)(22)(23)(24). In contrast to those studies, the findings reported here indicate an apparent increase in the transmission of genotype 3 (51% of incident infections).…”

Section: Discussioncontrasting

confidence: 56%

“…Genotype 4 is prevalent in the Middle East and Africa, and high prevalences of genotypes 5 and 6 have been reported in South Africa and Asia, respectively (17,18). The genotypes most commonly reported among chronically infected individuals in Australia are genotypes 1 (52% to 65%) and 3 (20% to 38%), with low prevalences of genotypes 2, 4, and 6 (approximately 5% to 9%, 0% to 6%, and 0.6% to 2%, respectively) (19)(20)(21)(22)(23)(24)(25). It should be noted, however, that these prevalence surveys were conducted in the 1990s and predominantly screened chronically infected individuals who had likely contracted the virus years to decades prior to testing; therefore, the results of those studies do not necessarily represent the viruses currently being transmitted (26).…”

mentioning

confidence: 99%

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Incident Hepatitis C Virus Genotype Distribution and Multiple Infection in Australian Prisons

Walker

Teutsch

et al. 2016

J Clin Microbiol

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Hepatitis C virus (HCV) is a highly diverse pathogen that is classified into seven distinct genotypes. Simultaneous or sequential reinfection with multiple HCV genotypes is recognized in high-risk populations, such as injecting drug users (IDUs). Multiple infection is of clinical concern as different genotypes have various sensitivities to current antiviral therapies. Therefore, a better understanding of the frequency of multiple infection and of the genotypes currently being transmitted is clinically relevant. An Australian cohort of IDUs (n ‫؍‬ 123), identified with primary incident infection, was followed for multiple infection by regular HCV RNA testing between 2005 and 2013. A total of 354 samples were tested. Sequencing of primary incident infections revealed that genotype 3a was the most common circulating genotype, followed by genotype 1a. Examination of longitudinally collected samples identified complex patterns of multiple infection, including reinfection and superinfection. In those with multiple infection, there was no apparent evidence of homotypic immunity conferring protection against reinfection of the same subtype. This study revealed frequent multiple infection in a high-risk prisoner cohort, illustrating the complex nature of HCV infection and reinfection and highlighting the need for pan-genotypic antiviral therapies.

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Section: Discussioncontrasting

confidence: 56%

mentioning

confidence: 99%

Incident Hepatitis C Virus Genotype Distribution and Multiple Infection in Australian Prisons

Walker

Teutsch

et al. 2016

J Clin Microbiol

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“…Fifty per cent of subjects were exposed to HCV via contaminated blood clotting factors (male subjects with X-linked Haemophilia) whereas the remaining 50% represented individuals that acquired HCV infection predominantly via intravenous drug use (IDU). For subjects with Haemophilia modelling shows the likelihood of infection with more than one viral strain [ 15 ] and data from studies on intravenous drug users (IVDU) show that the level of repeat exposure to diverse viral strains is high [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Anti-Hepatitis C Virus T-Cell Immunity in the Context of Multiple Exposures to the Virus

et al. 2015

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Characterisation of Hepatitis C virus (HCV)-specific CD8+ T-cell responses in the context of multiple HCV exposures is critical to identify broadly protective immune responses necessary for an effective HCV vaccine against the different HCV genotypes. However, host and viral genetic diversity complicates vaccine development. To compensate for the observed variation in circulating autologous viruses and host molecules that restrict antigen presentation (human leucocyte antigens; HLA), this study used a reverse genomics approach that identified sites of viral adaptation to HLA-restricted T-cell immune pressure to predict genotype-specific HCV CD8+ T-cell targets. Peptides representing these putative HCV CD8+ T-cell targets, and their adapted form, were used in individualised IFN-γ ELISpot assays to screen for HCV-specific T-cell responses in 133 HCV-seropositive subjects with high-risk of multiple HCV exposures. The data obtained from this study i) confirmed that genetic studies of viral evolution is an effective approach to detect novel in vivo HCV T-cell targets, ii) showed that HCV-specific T-cell epitopes can be recognised in their adapted form and would not have been detected using wild-type peptides and iii) showed that HCV-specific T-cell (but not antibody) responses against alternate genotypes in chronic HCV-infected subjects are readily found, implying clearance of previous alternate genotype infection. In summary, HCV adaptation to HLA Class I-restricted T-cell responses plays a central role in anti-HCV immunity and multiple HCV genotype exposure is highly prevalent in at-risk exposure populations, which are important considerations for future vaccine design.

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“…One important characteristic in this group of patients is that a significant proportion has a mixed-genotype infection due to multiple exposures to contaminated blood products over a period of years [ 24 ]. Overall, HCV genotype 1 seems to be the dominant one (Iran 72.7%, Australia 65%, USA 46.2%) followed by genotype 3 (27.3%, 30% and 42% respectively) [ 25 - 27 ].…”

Section: Epidemiologymentioning

confidence: 99%

Hepatitis C infection in patients with hereditary bleeding disorders: epidemiology, natural history, and management

Papadopoulos¹,

Argiana²,

Deutsch

2017

aog

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Hereditary bleeding disorders include a group of diseases with abnormalities of coagulation. Prior to 1990, infection with hepatitis C virus (HCV) was mainly transmitted via pooled plasma products as a treatment for hereditary bleeding disorders. Anti-HCV positivity in these patients may be as high as >70% in some areas, while some of them have also been coinfected with human immunodeficiency virus. Since about 20% of HCV-infected patients clear the infection naturally, chronic HCV infection represents a significant health problem in this group of patients. Mortality due to chronic HCV infection is estimated to be >10 times higher in patients with hemophilia than in the general population, and is mainly due to liver cirrhosis and hepatocellular carcinoma. The antiviral treatment of HCV in patients with hereditary bleeding disorders is not different from that of any other infected patients. Nevertheless, many patients with hereditary bleeding disorders have declined (Peg)interferon-based treatment because of side effects. In recent years, multiple orally administrated direct-acting antivirals (DAAs) have been approved for HCV treatment. Unfortunately, there is not much experience from treating these patients with DAA regimens, as major studies and real-life data did not include adequate numbers of patients with inherited hemorrhagic disorders. However, the available data indicate that DAAs have an excellent safety profile with a sustained virological response rate of >90%.

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Hepatitis C genotypes in Australian haemophilia patients

Cited by 7 publications

References 13 publications

Incident Hepatitis C Virus Genotype Distribution and Multiple Infection in Australian Prisons

Incident Hepatitis C Virus Genotype Distribution and Multiple Infection in Australian Prisons

Anti-Hepatitis C Virus T-Cell Immunity in the Context of Multiple Exposures to the Virus

Hepatitis C infection in patients with hereditary bleeding disorders: epidemiology, natural history, and management

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