Ethnic epidemiological profiles and antiviral therapy among patients infected with hepatitis C virus genotype 4: a multicenter study from Belgium
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Insights
Hepatitis C virus genotype 4 (HCV-4) disproportionately affects Black African populations in Belgium, presenting with distinct clinical features and less severe liver fibrosis. Treatment access remained equitable across ethnic groups in this study.
Area of Science:
- Hepatology and Infectious Diseases
- Epidemiology of Viral Infections
- Clinical Medicine
Background:
- Hepatitis C virus genotype 4 (HCV-4) is the predominant genotype in Central Africa.
- Understanding the epidemiology and clinical presentation of HCV-4 in diverse populations is crucial for effective public health strategies.
- This study focuses on HCV-4 patients in Belgium, comparing Black African and non-Black African cohorts.
Purpose of the Study:
- To compare the epidemiological and clinical characteristics of HCV-4 patients of Black African origin versus other ethnic groups in Belgium.
- To investigate potential differences in access to Hepatitis C virus therapy between these populations.
- To analyze the association of interleukin-28B (IL28B) polymorphism with HCV-4 infection in different ethnic groups.
Main Methods:
- A multicenter study involving 473 HCV-4 patients from seven hospital databases in Belgium.
- Patients were categorized by ethnic origin: Black African (n=331) and non-Black African (n=142).
- Epidemiological, clinical, biological, and histological data were collected and compared; IL28B polymorphism (CC-genotype) was assessed in a subset of patients.
Main Results:
- Black African patients were more likely to be female, older, overweight, and have abnormal glucose metabolism and hypertension.
- These patients had a higher proportion of unknown infection routes, more HCV-4 subtypes, and less severe liver fibrosis.
- Lower prevalence of dyslipidemia, alcohol consumption history, elevated ALT, and IL28B CC-genotype was observed in the Black African group.
- Antiviral treatment rates were similar between the two ethnic groups.
Conclusions:
- HCV-4 infection in Belgium is more prevalent among individuals of Black African origin.
- Black African patients presented with distinct clinical profiles, including more comorbidities and less advanced liver fibrosis.
- Despite differences in disease characteristics and IL28B genotype, access to antiviral therapy was comparable across ethnic groups.
Background:
Hepatitis C virus genotype 4 (HCV-4) is the most prevalent genotype in Central Africa.
Aim:
To compare epidemiology, clinical characteristics and any differences in access to HCV therapy in two populations of HCV-4 patients residing in Belgium.
Methods:
This multicenter study selected 473 HCV-4 patients from seven hospital databases and compared them according to ethnic origin, i.e., Black African (n=331) or not (n=142), for epidemiological, clinical, biological and histological characteristics. Interleukin 28B polymorphism (CC-genotype) was evaluated in a second cohort of 69 Black African and 30 non-Black African patients.
Results:
Compared to other patients, the Black African patients were more likely to be female and were older, commonly overweight, frequently had abnormal glucose metabolism and arterial hypertension ; they were less likely to have dyslipidemia, a history of alcohol consumption or ALT elevation. The route of infection was more frequently unknown in Black African than in other patients. Black African patients had more HCV-4 subtypes, were less frequently of IL28B CC-genotype and had less severe liver fibrosis. The proportion of patients who received antiviral treatment was similar in the two groups.
Conclusion:
In this Belgian cohort, patients with HCV-4 infection were more frequently of Black African origin than of other origin. Infected Black African patients were more commonly -female, older at diagnosis, and had more co-morbidities than other patients; they also had less advanced liver fibrosis than infected non-Black African patients and fewer had a CC genotype.
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