Influence of age and date of infection on distribution of hepatitis C virus genotypes and fibrosis stage

Abstract

The objective of this study was to assess the influence of age and date of acquisition of hepatitis C virus (HCV) infection on the distribution of genotypes and the progression of fibrosis in HCV-infected patients who were born in Spain and had their habitual place of residence in this country. Genotypic analysis was performed in 375 patients in whom it was possible to establish the year of HCV infection because the mode of transmission was known (transfusion, injection drug use, blood donor, or epidemic outbreak). In 298 patients with liver biopsy, fibrosis stage was related to age at infection, duration of infection, alcohol consumption, and HCV genotype. HCV subtype 1b was almost exclusively detected among transfusion recipients, but the onset of intravenous drug addiction was associated with the introduction of HCV genotypes other than 1b among injecting users with subsequent spread to other exposure risk groups. Fibrosis progression was influenced by alcohol consumption, increased duration of infection, and older age at infection. In summary, spread of intravenous drug use determined HCV infection by genotypes other than 1b. The risk of fibrosis progression was influenced more by age at viral acquisition and alcohol consumption than by the infecting genotype.

Determinants of liver disease progression in children with chronic hepatitis C virus infection

“…Available data suggest an association between the duration of infection and fibrosis progression [1,12,16,20,24]. The same observation was made in our study: duration of infection (but not age at liver biopsy or age at acquisition of infection) was an independent positive predictor of fibrosis.…”

The changing epidemiology of hepatitis C virus infection in Europe

“…Despite the current levels of blood safety, many European countries are facing the long-term effects of the past epidemic of transfusion-associated hepatitis C. In several cohort studies from Central and Southern Europe, patients with transfusion-associated infection account for 20-30% of patients older than 50 (mostly infected with genotype 1b) with advanced chronic hepatitis, cirrhosis and hepatocellular carcinoma [50,[74][75][76][77][78][79][80][81]. With the current blood transfusion safety, and the availability of recombinant clotting factors, newly diagnosed haemophilia and thalassemia patients are no longer at risk for HCV infection.…”

“…Similarly, among 214 consecutive patients diagnosed with acute hepatitis C at 12 Italian medical centres between 1999 and 2004, an invasive procedure was involved in transmission in 32% [84]. In a prospective study conducted between 2000 and 2002, at a tertiary-care liver unit in Barcelona, six of 1540 hospita- Only data from representative cohorts including more than 250 patients evaluated after 1999 are depicted [22,32,[76][77][78]80,[83][84][85]118,119,151,160,161,[191][192][193][194][195][196].…”

Alcohol and Hepatitis C

“…In a smaller cross-sectional study, Pessione et al [46] evaluated alcohol consumption and liver fi brosis in 233 patients with HCV infection and previous liver biopsy. By multivariate analysis, the liver fi brosis was related to age of the patient and average daily alcohol consumption ( fi g. 2 ) [46] , a fi nding reiterated by recent studies [47][48][49] . A retrospective study from Sweden evaluated the effect of moderate lifetime alcohol consumption ( !…”