Intravenous drug use – an independent predictor for HCV genotypes 3 and 4 infection among HIV/HCV co-infected patients

Abstract

IntroductionAbout one quarter of human immunodeficiency virus (HIV) infected persons in Serbia have also been found to be hepatitis C virus (HCV) co-infected. In the general population, HCV genotype 1 has been shown to be the most prevalent one. Here, we present the first study on the distribution of HCV genotypes among HIV/HCV co-infected patients in Serbia, in relation to epidemiological and clinical features.Material and methodsThe study included HIV/HCV co-infected and a group of HCV mono-infected patients in the period 1998–2012, with collection of epidemiological, clinical, and behavioral data using a standardized questionnaire. The HCV genotyping to the level of pure genotype was performed by reverse hybridization.ResultsIntravenous drug use (IDU) was found to be significantly more prevalent among the co-infected patients (p < 0.01). HCV genotype 1 was detected in 87% of patients with mono-infection, compared to 46.3% of patients with co-infection (p < 0.01); genotypes 3 and 4 were significantly more common among co-infected patients (6% and 5%, vs. 27% and 25%, respectively). Multivariate logistic regression confirmed IDU, infection with non-1 HCV genotype and HCV viral load over 5 log to be predictors of HIV co-infection.ConclusionsThe HCV genotypes 3 and 4 were found to be significantly more prevalent among HIV/HCV co-infected patients in Serbia, compared to HCV mono-infected patients, but also more prevalent compared to the European HIV/HCV co-infected cohort. History of IDU represents an independent predictor of HCV genotypes 3 and 4 infection, with important implications for treatment.

Comparison of Demographic, Epidemiological, Immunological, and Clinical Characteristics of Patients with HIV Mono-infection Versus Patients Co-infected with HCV or/and HBV: A Serbian Cohort Study

“…Although considered as low prevalence country, the number of new cases is constantly growing and the epidemic in Serbia is among the most abundant in the region [77]. Clinical features and outcome of HIV infection in Serbia have been reported [78,79], however, very few studies have addressed different aspects of co-infection with hepatitis viruses [80,81].…”

Perinatal transmission of hepatitis C virus: an update

“…It was reported that estrogen suppresses the intra-thymic T-cell differentiation while activating the extra-thymic pathways during pregnancy [80, [44,45] In the general population of Serbia about one quarter of human immunodeficiency virus (HIV) infected persons also have HCV coinfection [46] Asia The highest prevalence of HCV is noted in Central Asia (3.8%), East Asia (3.7%), and North Africa/Middle East (3.6%) [47,48] -Saudi Arabia [35,36,49] 0.7% -Yemen [37] 8.5% -Syria, Jordan and Lebanon [35] No data This reflects underestimation of the magnitude of the problem in this region [35] Iraq [38] 3.21% -Egypt [50,51] 8.6% Egypt is one of the areas of highest prevalence of HCV among the population in general and pregnant women in particular [50,51] with genotype 4 being predominant (90%) [52] Sudan [53][54][55] 0.6% Prevalence in pregnant women (0.6%) is lower than that of the general population (2.2-3.0%) [53][54][55] Libya and Maghreb region Lowest in Libya [56][57][58] (< 1%), followed by Tunisia [59][60][61][62], the Kingdom of Morocco [59,63], Algeria [59], and Mauritania [64][65][66] Genotype 4 is the most prevalent in Libya, which is the same as in Egypt, while genotype 1 [57,61,…”

Global elimination of hepatitis C virus infection: Progresses and the remaining challenges

“…Infection with HCV genotype 2 is mainly associated with nosocomial transmission and prior dental treatment[ 1 , 22 ]. Genotype 3 is frequently found in the intravenous drug user communities and in those with history of tattooing and piercing[ 24 , 31 , 32 ]. Genotype 4 is mainly transmitted through high-risk sexual practices, especially among homosexual males, and intravenous drug use[ 1 , 22 ].…”