The nationwide distribution and trends of hepatitis C virus genotypes in mainland China

Abstract

Comprehensive data on hepatitis C virus (HCV) genotypes distribution is critical for treatment regimen selection, vaccine design, and drug development. This study aimed to understand the dynamic distribution of HCV genotypes in Mainland China. Three hundred sixty-two studies published from January 1993 to December 2017 involving 64 891 samples (5133 injecting drug users, 2748 volunteer blood donors, 1509 former paid plasma donors, 160 sexually encounters, and 1992 human immunodeficiency virus (HIV)/HCV coinfection patients) were eligible for the quantitative synthesis estimation. Pooled proportion of HCV genotypes (and 95% confidence intervals [CIs]) was estimated through the Freeman-Tukey double arcsine transformation by period, region, and risk group. A sharp decline of the subtype 1b was observed in all regions except in northwestern and central regions. The genotypes 3 and 6 showed an obvious increase in southern and southwestern regions and have already spread nationwide. After 2010, subtype 1b was the most dominant variant in all regions and risk groups, accounting for 54.0% (95% CI, 51.9-56.1) of all national infections. Subtype 2a was the second most prevalent strain in all regions except in the south and southwest, with 15.4% (95% CI, 13.1-17.8) national infections. The subtype 6a in southern region and 3b and 3a in southwestern region had a higher proportion of infections than that in other regions. In addition, the genotypes 3 and 6 are already prevalent in almost all risk groups. The distribution of HCV genotypes were sharply shifting in China in the past three decades. The HCV subtype 1b posed a sharp decline, whereas genotypes 3 and 6 played an increasing role in the regional and populational HCV pandemic.

Molecular surveillance of HIV, HBV, and HCV amongst blood donors in five Chinese regions

“…The predominant genotype was 1b (N=29, 48%), followed by 6a (N=10, 17%), 2a (N=6, 10%), 3a (N=6, 10%) and small proportion of 3b, 6 and 1a (Table 5). The distribution of HCV classifications was concordant with a previous national wide investigation of HCV in mainland China, which reported the major HCV genotypes were 1b and 2a, accounting for 54.5% and 16.7%, respectively (35). In our study, 6a was a second major genotype.…”

Sustained Virologic Response Rates of Sofosbuvir and Velpatasvir in Patients with Hepatitis C Genotype 3: A Meta-Analysis

“…In our opinion, the global distribution and prevalence of HCV-genotype 3b have not been defined. However, it has been reported in recent articles that the estimated prevalence rates of HCV subtype 3b in Pakistan and in China are 8.20% and 7.06%, respectively, whereas the frequencies of GT3 cases are significantly higher in South Asia and China (30,31). These results support the notion that upfront genotype testing may be unnecessary before treating HCV-GT3 patients with the SOF/VEL regimen, although the HCV subtype 3b may be suboptimal to it.…”

Direct-acting Antiviral Regimens for Patients with Chronic Infection of Hepatitis C Virus Genotype 3 in China

“… 7 China has around 10 million HCV-infected patients, 7 with the most common genotypes being GT1b (52.2–62.8%) and GT2a (16.7–28.7%). 7 , 9 – 11 GT3 comprises 8.7% to 11.7% of all the local infections, 7 , 9 , 11 with both incidence and prevalence showing an increasing trend in recent years. 10 , 11 For instance, one retrospective study conducted at a hospital in Shanghai, China found that the percentage of GT3-infected patients increased from 13.4% in 2011 to 22.6% in 2014.…”

“… 7 , 9 – 11 GT3 comprises 8.7% to 11.7% of all the local infections, 7 , 9 , 11 with both incidence and prevalence showing an increasing trend in recent years. 10 , 11 For instance, one retrospective study conducted at a hospital in Shanghai, China found that the percentage of GT3-infected patients increased from 13.4% in 2011 to 22.6% in 2014. 12 Geographically, GT3 has spread from the south and southwest regions to the entire country over the last two decades, 11 , 13 albeit with an uneven distribution across different regions; up to 38% of HCV-infected patients in the southwest region are of GT3, while that percentage is only 3% in the northeast region.…”