Epidemiological trends of HCV subtypes in China

While China has made notable progress toward the World Health Organization's goal of hepatitis elimination, substantial challenges continue to persist. In recent years, the prevalence of hepatitis C virus (HCV) in China has remained high. Understanding the distribution and trends of HCV genotypes is crucial for effective disease management. This study systematically analyzes the distribution and changes in various HCV subtypes across China, utilizing data from 29,874 cases identified through high-quality detection methods in 123 articles published between 1994 and 2024. Our findings indicate that the five most prevalent HCV subtypes are 1b, 3b, 6a, 2a, and 3a. The 1b subtype is primarily found in Guangdong (26.71%), Heilongjiang (25.16%), Yunnan (8.42%), Guizhou (6.85%) and Hubei (5.52%). The 2a subtype is concentrated in Heilongjiang (55.85%), Guangdong (8.35%) and Yunnan (6.7%), while subtypes 3b, 3a, and 6a are more common in southern provinces such as Yunnan, Guizhou, and Guangdong. Importantly, the distribution of subtypes in Southern and Southwestern China differs significantly from other areas, with genotypes 3 and 6 comprising over 50% of cases. This study highlights the need for ongoing surveillance and targeted strategies in HCV management to adapt to the evolving landscape of viral genotypes in China.