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Chronic hepatitis C virus in the state of Piauí, northeastern Brazil
Kelson Nobre Veras1, Kelson Sousa Jacobina, Vítor Y Rocha Soares
1Health Municipal Foundation, Federal University of Piauí, Teresina, Piauí, Brazil. kelsonveras@hotmail.com
Insights
Hepatitis C virus (HCV) genotype distribution in Piauí, Brazil, showed a near-equal mix of genotypes 1 and 3. Patients had stable liver disease, with genotype 1 showing higher viral loads and GGT levels.
Area of Science:
- Hepatology
- Virology
- Epidemiology
Background:
- Genotype distribution of Hepatitis C Virus (HCV) is crucial for treatment efficacy, as genotype 1 exhibits lower response rates.
- Understanding HCV genotypes in specific regions like Northeast Brazil is vital for public health initiatives.
Purpose of the Study:
- To characterize the clinical and laboratorial profiles of chronic hepatitis C (CHC) patients in Piauí, Brazil.
- To determine the distribution of HCV genotypes and subtypes in this Brazilian state.
- To assess the relationship between HCV genotypes and clinical parameters like viral load and liver enzyme levels.
Main Methods:
- A retrospective cross-sectional study was conducted from April 1999 to August 2005.
- Data from 153 CHC patients in Piauí were analyzed, including demographic, clinical, laboratorial, and histopathological information.
- HCV genotyping was performed, and viral loads and gamma-glutamyltransferase (GGT) levels were compared across genotypes.
Main Results:
- Genotypes 1 and 3 of HCV were homogeneously distributed (50.0% and 49.0%, respectively), with subtype 3a being the most frequent (49.0%).
- Patients with HCV genotype 1b had significantly higher viral loads compared to 1a and 3a subtypes.
- Genotype 1 showed statistically higher average gamma-glutamyltransferase levels than genotype 3.
- The majority of patients presented with mild to moderate histopathological liver disease (necroinflammatory activity and fibrosis).
Conclusions:
- HCV treatment candidates in Piauí generally have clinically stable liver disease.
- The study confirmed a nearly equal prevalence of HCV genotypes 1 and 3 in the region.
- No significant demographic or clinical differences were observed among the different HCV genotypes or subtypes studied.
Abstract:
Knowledge of genotype distribution of hepatitis C virus (HCV) has clinical importance due to genotype 1 lower response to treatment compared with genotypes 2 and 3. The goal of this survey was to describe clinical and laboratorial profiles of patients with chronic hepatitis C (CHC) in the State of Piauí, as well as to expand the overall awareness of the distribution of HCV genotyping in Northeast of Brazil. A retrospective cross-sectional study was carried out between April 1999 and August 2005. A total of 153 patients were included, 119 (77.8%) males and 34 (22.2%) females; mean age = 48.01 +/- 9.11 years. We observed a homogeneous distribution between genotypes 1 (50.0%) and 3 (49.0%), while the most frequent subtype noticed was 3a (49.0%). The mean viral load among patients with subtype 1b (1,232,476 UI/mL) was significantly superior to the subtype 1a (391,204 UI/mL; p = 0.010) and to the subtype 3a (594,228 UI/mL; p = 0.047). The average levels of gamma-glutamiltransferase of genotype 1 (144 mg/dL) had statistical differences when compared to genotype 3 (74 mg/dL; p = 0.014). Most patients showed mild to moderate degrees of histopathological necroinflammatory activity and hepatic fibrosis (79.0% and 56.2%, respectively). We concluded that most candidates to treatment of CHC in the State of Piauí presented with clinically stable hepatic illness; the distribution of genotypes 1 and 3 was virtually homogeneous; and there was no significant demographic or clinical differences among genotypes or subtypes of HCV.
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