[Genotypes of hepatitis C virus: their relationship with risk factors, the severity of liver disease, and the serologic response].
BACKGROUND
The objective of our study was to ascertain the prevalence of different HCV genotypes between the hepatitis C patients in the health area of Monforte de Lemos, Spain, as well as the possible influence of risk factors on their distribution and their relation with hepatic disease and with the serologic response.


METHODS
We have studied 128 patients with hepatitis C. Of these, 41 were intravenous drug users (IVDU), 19 had received transfusions, 7 were hemodialyzed and in 61 the risk factors were unknown. Antibodies against HCV were detected by second-generation enzyme immunoassay (EIA) and confirmed by immunoblot. RNA-HCV presence was studied by reverse transcription-PCR (RT-PCR), and a reverse hybridization test of the amplifications was used for the genotyping.


RESULTS
Hepatitis C genotypes 1b (46.1 [8.6%]), 1a (23.4 [7.3%]) and 3a (13.3 [5.9%]) were the most frequently encountered genotype. Genotype 1a (48.8 [15.3%]) was the most prevalent genotypes in IVDU patients, while 1b was the most frequent in patients of unknown risk factors (62.3 [12.1%]). Alanine-aminotransferase (ALT) was elevated in 66.6 (17.7%) of patients with genotype 1a, in 87.5 (8.6%) of patients with genotype 1b (p = 0.0367) and in 94.1 (11.2%) of patients with genotype 3a (p = 0.0347). Subtype 1b was present in 6 of 7 cases of cirrhosis (85.7%) and in 7 of 12 cases of active chronic hepatitis (58.3%). No significant statistical differences were observed between the genotypes and the specific IgM response against core antigen of HCV, neither we observed differences in the serologic response against C1, C2, NS3 and NS4 peptides.


CONCLUSIONS
Hepatitis C genotypes 1a and 3a were the most prevalent genotypes between IVDU patients while genotype 1b was the most frequent between non-IVDU patients. Genotype 1b was associated to severe liver disease. Percentage of positivity or the reactivity against HCV peptides was independent of the genotype encountered in the patient.
Alonso Alonso
P
P
Laboratorio del Hospital Comarcal, Monforte de Lemos, Lugo.
Orduña
A
A
San Miguel
A
A
Domínguez
E
E
Gutiérrez
P
P
Lorenzo
B
B
Zarzosa
P
P
Angel Bratos
M
M
Rodríguez Torres
A
A
D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D007124:Immunoenzyme Techniques; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology
D018937:Hepatitis C Antibodies; D012367:RNA, Viral
Genotipos del virus de la hepatitis C: relación con los factores de riesgo, con la gravedad de la enfermedad hepática y con la respuesta serológica.