Hepatitis C virus genotypes in Estonia

Area of Science:

• Virology
• Epidemiology
• Molecular Biology

Background:

• Hepatitis C virus (HCV) infection remains a significant global health concern.
• Understanding the distribution of HCV genotypes and subtypes is crucial for effective treatment and public health strategies.
• Estonia's specific HCV epidemiology required detailed investigation.

Purpose of the Study:

• To determine the distribution of hepatitis C virus (HCV) geno(sub)types in Estonian patients.
• To compare the efficacy of two genotyping methods: multiplex PCR and RFLP.
• To analyze the epidemiological dynamics of HCV subtypes in Estonia.

Main Methods:

• Genotyping of HCV RNA-positive sera from 215 Estonian patients.
• Utilized multiplex PCR with subtype-specific primers (core region) and RFLP analysis (5' NCR region).
• Compared results from both methods for accuracy in identifying single and mixed infections.

Main Results:

• Subtype 1b was the most prevalent (56.3%-64.2%), followed by 3a (13.9%-22.3%) and 2a (5.6%-6.5%).
• Multiplex PCR and RFLP showed high concordance (84.7%), with PCR being more effective for mixed infections.
• Epidemiological analysis suggested an increasing trend for subtype 3a and a decreasing trend for subtype 1b.

Conclusions:

• HCV subtype 1b is dominant in Estonia, but subtype 3a is emerging.
• Combined use of multiplex PCR and RFLP enhances genotyping accuracy, especially for mixed infections.
• The observed shift in subtype prevalence necessitates ongoing surveillance and potential adaptation of treatment guidelines.