Hepatitis C virus infection in Taiwan

Area of Science:

• Hepatology
• Virology
• Epidemiology

Background:

• Hepatitis C virus (HCV) is a significant cause of chronic liver disease globally.
• Understanding HCV epidemiology in Taiwan is crucial for public health interventions.
• Hepatitis B virus (HBV) is endemic in Taiwan, necessitating co-infection studies.

Purpose of the Study:

• To investigate the prevalence and epidemiology of HCV infection in Taiwan.
• To determine the association of HCV with various liver diseases, including HBsAg-positive and HBsAg-negative chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC).
• To analyze the genetic relatedness of the Taiwanese HCV strain to other global isolates.

Main Methods:

• Radioimmunoassay and enzyme immunoassay were used to detect anti-HCV antibodies.
• Prevalence studies were conducted in volunteer blood donors, hemophiliacs, parenteral drug abusers, and patients with chronic liver disease.
• Prospective study of post-transfusion hepatitis (PTH) and molecular characterization of the HCV genome using reverse transcription polymerase chain reaction (RT-PCR).

Main Results:

• Anti-HCV prevalence was high in hemophiliacs (90%) and parenteral drug abusers (81%).
• HCV was significantly associated with HBsAg-negative chronic hepatitis (65%), cirrhosis (43%), and HCC (63%).
• HCV accounted for 60% of hepatitis cases in a prospective PTH study, with 77% developing chronic infection. The Taiwanese HCV strain showed 80-92% homology to international isolates.

Conclusions:

• HCV plays a minor role in HBsAg-positive liver disease but is strongly associated with HBsAg-negative chronic liver disease and HCC in Taiwan.
• HCV is a significant cause of post-transfusion hepatitis and frequently leads to chronic infection.
• The Taiwanese HCV strain shares genetic similarities with Japanese isolates, suggesting regional viral evolution patterns.