Southeast Asian patients with chronic hepatitis C: The impact of novel genotypes and race on treatment outcome

Dev, Anouk; McCaw, Rhonda; Sundararajan, Vijaya; Bowden, Scott; Sievert, William

doi:10.1053/jhep.2002.36781

Cited by 87 publications

(92 citation statements)

References 41 publications

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“…The prevalence of HCV genotype 6 in our patients with core sequencing HCV genotype testing was 41% and similar to that of HCV genotype 1 (42%). In contrast, in our subset of 122 patients who had HCV genotype testing done with the INNO-LiPA assay, the prevalence of HCV genotype 6 was much lower (15%) and the total prevalence of HCV genotype 1 was 71%, consistent with previous studies that reported mistyping of HCV genotype 6 as genotype 1 by the INNOLiPA assay [18,22,23]. Our study, however, was not intended to directly address the discordance rate of HCV genotyping between the core sequencing and the INNO-LiPA test, as this has been previously described [18], but rather to describe the prevalence of the different genotypes in SEA patients with CHC by using the gold standard method, which is the core sequencing test.…”

Section: Discussionsupporting

confidence: 90%

“…In contrast, in our subset of 122 patients who had HCV genotype testing done with the INNO-LiPA assay, the prevalence of HCV genotype 6 was much lower (15%) and the total prevalence of HCV genotype 1 was 71%, consistent with previous studies that reported mistyping of HCV genotype 6 as genotype 1 by the INNOLiPA assay [18,22,23]. Our study, however, was not intended to directly address the discordance rate of HCV genotyping between the core sequencing and the INNO-LiPA test, as this has been previously described [18], but rather to describe the prevalence of the different genotypes in SEA patients with CHC by using the gold standard method, which is the core sequencing test. Accurate HCV genotyping is important, as HCV genotypes have been known to be among the most important predictors for treatment outcomes to standard peginterferon and ribavirin therapy, at least for patients with genotypes 1 and 2/3 [25][26][27][28].…”

Section: Discussionsupporting

confidence: 90%

“…Patients with HCV genotype 6 appear to present with similar clinical characteristics as those with genotype 1 or 2/3. Although HCV genotype 6 has been reported in patients from Asia, its prevalence and clinical characteristics have not been well described in a large patient sample by using an accurate genotyping method such as core sequencing test [18][19][20][21]. Our study included more than 300 SEA patients with CHC and a total of 181 patients with HCV genotype testing by core sequencing.…”

Section: Discussionmentioning

confidence: 99%

“…Although there have been a few studies reporting the presence of HCV genotype 6 in patients from Southeast Asia, the sample size in these studies are generally small and thus limiting their conclusions on the prevalence and clinical characteristics of HCV genotype 6 relative to the other commonly known genotypes such as genotypes 1 and 2/3 [16,[18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors, genotype 6 prevalence, and clinical characteristics of chronic hepatitis C in Southeast Asian Americans

Nguyen

Vutien

Trinh³

et al. 2010

Hepatol Int

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Purpose Although infection with hepatitis C virus (HCV) affects 32 million individuals from Southeast Asia, little is known about the mode of HCV acquisition and the epidemiology of chronic hepatitis C (CHC) in these individuals. Our goal was to examine risk factors for HCV acquisition, prevalence, and clinical characteristics of HCV genotype 6 compared with genotypes 1 and 2/3 in Southeast Asian (SEA) patients. Methods We performed a cross-sectional study of 308 consecutive SEA Americans with CHC evaluated by five gastroenterologists from January 2000 to December 2008 at two community clinics in northern California via medical record review, using a case report form. Results A significant proportion of patients (41%) could not recall any specific risk factors for HCV acquisition. The most commonly reported risk factor in patients who reported at least one risk factor was history of surgeries (34%), followed by blood transfusion (25%) and acupuncture (13%). Among patients with core sequence testing for HCV genotype (n = 181), the most common HCV genotypes were genotype 1 (42%) and genotype 6 (41%), followed by genotype 2/3 (17%). There were no major differences in the clinical and virological characteristics between the different genotype groups (1 vs. 2/3 vs. 6). Conclusion HCV genotype 6 is as common as genotype 1 in SEAs. Commonly known risk factors for HCV acquisition were not readily identifiable in a large proportion of SEA Americans (41%) and may not be useful in identifying at-risk individuals for HCV screening in this population.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors, genotype 6 prevalence, and clinical characteristics of chronic hepatitis C in Southeast Asian Americans

Nguyen

Vutien

Trinh³

et al. 2010

Hepatol Int

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“…Whereas HCV genotypes 2 and 3 are responsive to the therapy in 70-80% of cases, genotypes 1 and 4 are considered to be difficult to eradicate with sustained virological response (SVR) rates around 50% (4,5,21). The SVR rate for genotype-6 infection is higher than that seen in genotype 1 infection but lower than that of genotypes 2 and 3 (22)(23)(24). Due to these facts, determining HCV genotype prior to considering a specific therapy protocol is of utmost importance.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Virus Subtype 6a Infection in an Iranian Patient: A Case Report

Moghadam

Mohebbi

Hosseini

et al. 2013

Jundishapur J Microbiol

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Hepatitis C virus (HCV) isolates have been divided into six major genotypes, each of them further divided into several subtypes. Previous studies have shown that the most frequent genotype in Iranian patients with HCV infection is 1a, followed by 3a, 1b and 4. Infections with genotype 6 isolates have not previously been observed in these patients. In this report, we will describe the first diagnosis of HCV genotype-6 infection in Iran. The case was a 62-year-old man with positive anti-HCV antibody. Alanine aminotransferase and aspartate aminotransferase levels were 14 and 32 IU/L respectively. Viral RNA was extracted from plasma. HCV RNA level was determined using real-time reverse transcription polymerase chain reaction (PCR). Following the synthesis of the complementary DNA, 5'-UTR/core region of the HCV genome was amplified and subjected to direct sequencing. Genetic distances were estimated and phylogenetic tree was constructed. HCV viral load was 9,572,718 IU/mL. The mean inter-genotypic distance between the case sequence and the corresponding sequences of other genotype 6 isolates was 3.7%. In the phylogenetic tree, the 5'-UTR/core sequence of the subject was located in a cluster representing HCV subtype 6a. The patient was infected with HCV subtype 6a. Prior to this case, there have been no previous reports on the isolation of this genotype/subtype from any other Iranian patient. Previous epidemiological studies provide valuable information about the distribution patterns of different HCV genotypes. However, infection with genotypes other than common ones should be flagged by specialists and diagnostic laboratories, especially in patients with high-risk behavioral backgrounds.

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High incidence of hepatitis C virus reinfection in a cohort of injecting drug users

et al. 2008

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An estimated 170 million people worldwide carry the hepatitis C virus (HCV), and in more developed countries the prevalence and incidence of HCV is particularly high among injecting drug users (IDUs). Spontaneous clearance of HCV infection and reinfection is well recognized but the level of protection against further infection conferred by HCV infection and clearance remains uncertain. We conducted a prospective study of HCV infection in IDUs recruited in Melbourne, Australia, using a much shorter median testing interval than in previous studies. Incidences of naive infection and reinfection were calculated by the person-year method and Cox proportional hazards regression used to adjust for covariates. A significantly higher HCV incidence rate was measured in previously infected IDUs (46.8% per year) compared with HCV-naive IDUs (15.5% per year). The hazard ratio for previously infected IDUs compared to HCV-naive IDUs, after adjustment for time-dependent covariates, was 2.54 (95% confidence interval, 1.11-5.78, P > ͦzͦ < 0.05). Viral persistence after reinfection appeared similar to that following naive infection. Conclusion: Our data suggest that HCV infection in IDUs is more likely following prior infection and clearance than in HCV-naive individuals, implying no increased immunity against further infection. This result has important implications for the future development of an HCV vaccine. T he hepatitis C virus (HCV) infects an estimated 170 million people worldwide, and is a significant cause of morbidity and mortality due to cirrhosis and hepatocellular carcinoma. 1 Injecting drug users (IDUs) are the population subgroup at greatest risk of HCV infection in more developed countries, with prevalence rates of 45% or greater per year 2,3 and incidence rates of 25% per year or higher being common. 4,5 HCV differs from the hepatitis B virus and many other infectious viral agents in that infection and the generation of an immune response does not necessarily protect an individual from HCV reinfection or superinfection. Whether infection with HCV and subsequent clearance is even partially protective against further infection is yet to be definitively resolved.In 2002, Mehta et al. 6 reported that previously infected IDUs were significantly less likely to be reinfected, even after accounting for risk behavior. Further reports supported this finding: Grebely et al. 7 reported a significantly lower incidence of HCV reinfection in IDUs than in naive individuals; and Dove et al. 8 detected no reinfections in a small group of ongoing IDUs with previous HCV clearance. A retrospective study by Micallef et al. 9 reported the incidence of HCV reinfection in IDUs was higher than naive infection-31 out of 100 person-years (PYs) (95% confidence interval [CI], 17-62) compared to 17 out of 100 PYs (95% CI, 14-2) although with adjustment for HCV risk behavior variables, the incidence ratio was only marginally greater and was not statistically significant (incidence rate ratio, 1.11; P ϭ 0.8).The importance of the reinfection is...

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Southeast Asian patients with chronic hepatitis C: The impact of novel genotypes and race on treatment outcome

Cited by 87 publications

References 41 publications

Risk factors, genotype 6 prevalence, and clinical characteristics of chronic hepatitis C in Southeast Asian Americans

Risk factors, genotype 6 prevalence, and clinical characteristics of chronic hepatitis C in Southeast Asian Americans

Hepatitis C Virus Subtype 6a Infection in an Iranian Patient: A Case Report

High incidence of hepatitis C virus reinfection in a cohort of injecting drug users

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