Comparative study of patients with chronic hepatitis C virus infection due to genotypes 1 and 3 referred for treatment in southeast Brazil

Aline G Vigani, Maria H Pavan, Raquel Tozzo, Eduardo S L Gonçales, Adriana Feltrin, Viviane C Fais, Maria S K Lazarini, Neiva S L Gonçales, Fernando L Gonçales Jr, Aline G Vigani, Maria H Pavan, Raquel Tozzo, Eduardo S L Gonçales, Adriana Feltrin, Viviane C Fais, Maria S K Lazarini, Neiva S L Gonçales, Fernando L Gonçales Jr

Abstract

Background: The progression of liver disease in patients with chronic hepatitis C virus (HCV) infection is influenced by host and viral factors. Distinct clinical outcomes in patients infected with different HCV genotypes have been described in the literature. However, the association between specific HCV genotype and clinical outcome remains unclear. We set out to study the natural history of HCV genotype 1 and 3 infections in Campinas, São Paulo state, Brazil, focusing on epidemiological, clinical, biochemical, and histological characteristics.

Methods: Patients with HCV infection referred for treatment between January 2003 and December 2006 were included in this study. We collected epidemiological, clinical, and laboratorial data using standard forms.

Results: A total of 283 patients were included; genotype 1 was identified in 163 (57.6%) patients, genotype 3 in 112 (39.6%), genotype 2 in 7 (2.5%), and genotype 4 in 1 (0.35%). Patients with genotype 2 and 4 were excluded from analysis. Multivariate analysis showed that intravenous energetic drug, positive cryoglobulin, and cirrhosis were independently and significantly associated with HCV genotype 3 (p < 0.05).

Conclusion: Genotype 3 currently seems to be associated with intravenous energetic drug, high frequency of cryoglobulinemia, and advanced liver disease in our region. Understanding the distribution of the different HCV genotypes can elucidate transmission of HCV and support optimal prevention strategies.

References

    1. Armstrong GL, Alter MJ, McQuillan GM, et al. The past incidence of hepatitis C virus infection: implications for the future burden of chronic liver disease in the United States. Hepatology. 2000;31:777–782. doi: 10.1002/hep.510310332.
    1. EASL International Consensus Conference on Hepatitis C Consensus Statement. J Hepatol. 1999;30:956–961. doi: 10.1016/S0168-8278(99)80154-8.
    1. Consensus Conference Treatment of hepatitis C. Guidelines. Gastroenterol Clin Biol. 2002;26:B312–B320.
    1. Codes L, Freitas LAR, Santos-Jesus R, et al. Comparative study of Hepatitis C virus genotypes 1 and 3 in Salvador, Bahia. Braz J Infect Dis. 2003;7:409–17. doi: 10.1590/S1413-86702003000600009.
    1. Silva GF, Nishimura NF, Coelho KIR, Soares EC. Grading and staging chronic hepatitis C and its relation to genotypes and epidemiological factors in Brazilian blood donors. Braz J Infect Dis. 2005;9:142–9.
    1. Alberti A, Chemello L, Bevebnú L. Natural history of hepatitis C. J Hepatol. 1999;31:17–24. doi: 10.1016/S0168-8278(99)80369-9.
    1. Poynard T, Bedossa P, Opolon P, et al. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The Lancet. 1997;349:825–32. doi: 10.1016/S0140-6736(96)07642-8.
    1. Simmonds P. Viral heterogeneity of the hepatitis C virus. J Hepatol. 1999;31:54–60. doi: 10.1016/S0168-8278(99)80375-4.
    1. Zein NN, Rakela J, Krawitt EL, et al. Hepatitis C virus genotypes in the United States: epidemiology, pathogenicity, and response to interferon therapy. Ann Intern Med. 1996;125:634–639.
    1. McOmish F, Yap PL, Dow BC, et al. Geographical distribution of hepatitis C virus genotypes in blood donors: an international collaborative survey. J Clin Microbiol. 1994;32:884–92.
    1. Zein NN. Clinical significance of hepatitis C genotypes. Clin Microbiol Rev. 2000;13:223–235. doi: 10.1128/CMR.13.2.223-235.2000.
    1. Bedossa P, Poynard T, The METAVIR cooperative study group An algorithm for the grading of activity in chronic hepatitis C. Hepatology. 1996;24:289–293. doi: 10.1002/hep.510240201.
    1. Simmonds P. Genetic diversity and evolution of hepatitis C virus – 15 years on. J Gen Virol. 2004;85:3173–3188. doi: 10.1099/vir.0.80401-0.
    1. Campiotto S, Pinho JRR, Carrilho FL, et al. Geographic distribution of hepatitis C virus genotypes in Brazil. Braz J Med Biol Res. 2005;38:41–49. doi: 10.1590/S0100-879X2005000100007.
    1. Pawlotsky JM, Tsakiris L, Roudot-Thoraval E, et al. Relationship between hepatitis C virus genotypes and sources of infection in patients with chronic hepatitis C. J Infect Dis. 1995;171:1607–1610.
    1. Liakina V, Speiciene D, Irnius A, Naraskeviciene , et al. Prevalence of cryoglobulinemia in patients with chronic HCV infection. Med Sci Monit. 2002;8:CR31–CR36.
    1. Frangeul L, Musset L, Cresta P, et al. Hepatitis C virus genotypes and subtypes in patients with hepatitis C, with and without cryoglobulinemia. J Hepatol. 1996;25:427–432. doi: 10.1016/S0168-8278(96)80200-5.
    1. Willems M, Sheng L, Roskams T, et al. Hepatitis C virus and its genotypes in patients suffering from chronic hepatitis C with or without a cryoglobulinemia-related syndrome. J Med Virol. 1994;44:266–71. doi: 10.1002/jmv.1890440310.
    1. Zehender G, De Maddalena C, Bernini F, et al. Compartmentalization of hepatitis C virus quasispecies in blood mononuclear cells of patients with mixed cryoglobulinemic syndrome. J Virol. 2005;79:9145–56. doi: 10.1128/JVI.79.14.9145-9156.2005.
    1. Parise ER, de Oliveira AC, Ferraz ML, et al. Cryoglobulinemia in chronic hepatitis C: clinical aspects and response to treatment with interferon alpha and ribavirin. Rev Inst Med Trop S Paulo. 2007;49:67–72. doi: 10.1590/S0036-46652007000200001.
    1. Silini E, Bottelli R. Hepatitis C virus genotypes and risk of hepatocellular carcinoma in cirrhosis: a case control study. Gastroenterology. 1996;111:1999–205. doi: 10.1053/gast.1996.v111.pm8698200.
    1. Zeuzem S, Franke A, Lee JH, et al. Phylogenetic analysis of hepatitis C virus isolates and their correlation to viremia, liver function tests, and histology. Hepatology. 1996;24:1003–1009. doi: 10.1002/hep.510240505.
    1. Manns MP, McHutchison JG, Gordon SC, et al. Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet. 2001;358:958–965. doi: 10.1016/S0140-6736(01)06102-5.
    1. Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med. 2002;26:975–82. doi: 10.1056/NEJMoa020047.

Source: PubMed

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