Hepatitis C Virus Genotype and Subtype Distribution in Patient Specimens Tested at the University of Texas Medical Branch, Galveston, Between January 2011 and November 2014

Abstract

Hepatitis C virus (HCV) genotype/subtype data are routinely generated in clinical laboratories to guide treatment. Genotype data can also inform genotype distribution and molecular epidemiology of HCV infections in patient populations and geographical regions that clinics/laboratories serve. The aim of this study was to determine the distribution of HCV genotypes/subtypes and their association with demographic characteristics among the patients that were routinely tested in the Molecular Diagnostics Laboratory at The University of Texas Medical Branch (UTMB) at Galveston. Among the 6573 patients tested between January 2011 and November 2014, the most frequent HCV genotype/subtype was 1a (65.3%), followed by 3a (11.5%), 1b (10.4%), and 2b (8.8%). Combined, genotype 4 and genotype 6 were found in less than 1% of this cohort. Approximately 1.3% of the patients presented multiple genotypes/subtypes. Factors independently associated with genotypes and subtypes were race/ethnicity, sex, and patient age.

Race, Age, and Geography Impact Hepatitis C Genotype Distribution in the United States

“…We note that these rates were consistent between the full cohort and the living/uncured cohort. A similarly high rate of 1b in black/African American patients was shown in a recent study from a single health center in Texas, 3 a region not represented in our sample. To our knowledge, an epidemiological explanation for the dramatic over-representation of this subtype within African Americans has not been reported.…”

“…In this cohort of over 10,000 US patients, we observed marked variation in genotype and subtype distribution across site-level and patient-level characteristics. Results from previous studies confined to single-state populations (California 1 and Texas 3 ) have suggested that genotype distribution varies by both geography and demographics, although it is not possible to directly compare these cohorts. These studies are also limited by a lack of clinical data or restricted to univariate analyses.…”

“…However, there have been few studies of HCV GT/ST distribution in the United States, and these have been confined to single health systems or limited by small sample sizes, large proportions of male patients, and incomplete description of subtypes. 1–3 Furthermore, these studies also have not examined how various clinical factors, such as liver biochemistries, may vary across genotype and subtype. More comprehensive genotype and subtype data are necessary to guide HCV prevention, screening, and treatment efforts in the United States.…”

Association of HCV Infection with C-Reactive Protein: National Health and Nutrition Examination Survey (NHANES), 2009–2010

“…HCV genotype serves as a prognostic factor that is related to the chronicity of the infection. The most common HCV genotypes in the U.S. population were genotypes 1, 2, and 3 [23]. HCV genotype 1 has been reported to be more aggressive, as it increases the risk for hepatocellular carcinoma, and has a higher tendency to chronicity [23].…”

Genetic implications of viral hepatitis-associated hepatocellular carcinoma

“…Similarly, HCV plays critical role in hepatocarcinogenesis either indirectly through immunemediated chronic inflammation or by disrupting the host immune-regulatory pathways [7]. HCV genotype 1b has been reported to be independently associated with higher risk of HCC [8]. Unlike in hepatitis C virus (HCV) infection, the relationship between different HBV genotypes and risk of future disease is not well established.…”