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Relationship between hepatitis C virus genotypes and sources of infection in patients with chronic hepatitis C
J M Pawlotsky1, L Tsakiris, F Roudot-Thoraval
1Department of Bacteriology and Virology, Hôpital Henri Mondor, Université Paris XII, Créteil, France.
Insights
Two distinct hepatitis C virus (HCV) epidemics exist. Older individuals receiving blood transfusions are mainly infected with HCV genotype 1b, while younger intravenous drug users (IVDUs) are predominantly infected with HCV genotype 3a.
Area of Science:
- Hepatology
- Virology
- Epidemiology
Background:
- Chronic hepatitis C virus (HCV) infection remains a significant global health concern.
- Understanding the interplay between HCV genotypes and transmission routes is crucial for effective public health strategies.
Purpose of the Study:
- To investigate the association between different hepatitis C virus genotypes and their transmission pathways.
- To identify distinct epidemiological patterns of HCV infection within patient cohorts.
Main Methods:
- Analysis of HCV genotypes and transmission histories in 101 patients with chronic hepatitis C.
- Comparison of demographic data (age) and genotype distribution across different transmission groups (blood transfusion recipients, unknown cause, intravenous drug users).
Main Results:
- Patients with a history of blood transfusions or unknown HCV source were older and predominantly infected with HCV genotype 1b.
- Intravenous drug users (IVDUs) were significantly younger and primarily infected with HCV genotype 3a (P < .001).
- HCV genotype 3a transmission has been prevalent for the last 20 years, distinct from older genotypes circulating for up to 40 years.
Conclusions:
- Two independent, ongoing hepatitis C epidemics have been occurring for at least 20 years.
- One epidemic primarily affects older individuals exposed through blood transfusions or unknown sources, predominantly with HCV 1b.
- A second epidemic targets younger IVDUs, characterized by HCV 3a infection, reflecting recent transmission patterns.
Abstract:
This study examined the relationships between hepatitis C virus (HCV) genotypes and the routes of HCV transmission in 101 patients with chronic hepatitis C. Patients who received blood transfusions (43%) and those with chronic hepatitis C of unknown cause (37%) had similar mean ages, age distribution, and HCV genotype distribution (1a, 19% vs. 14%; 1b, 52% vs. 54%; 3a, 10% vs. 9%; other, 19% vs. 23%). Intravenous drug users (IVDUs) were significantly younger and had a different genotype distribution (1a, 33%; 1b, 0; 3a, 63%; other, 5%; P < .001). Transmission of HCV 3a has been observed only over the past 20 years; other genotypes were transmitted up to 40 years ago. These results suggest that for 20 years there have been two independent ongoing hepatitis C epidemics. One affects persons who received blood transfusions or whose source of infection is unknown. These persons are older and are mainly infected by HCV 1b. The second type of infection occurs in IVDUs and infects younger persons, mainly with HCV 3a.