Hepatitis C virus genotypes: distribution and clinical significance in patients with cirrhosis type C seen at tertiary referral centres in Europe.
The aim of this study was to evaluate the distribution and clinical significance of hepatitis C virus (HCV) genotypes in European patients with compensated cirrhosis due to hepatitis C (Child class A) seen at tertiary referral centres. HCV genotypes were determined by genotype-specific primer PCR in 255 stored serum samples obtained from cirrhotics followed for a median period of 7 years. Inclusion criteria were biopsy-proven cirrhosis, absence of complications of cirrhosis and exclusion of all other potential causes of chronic liver disease. The proportion of patients with types 1b, 2, 3a, 1a, 4 and 5 were 69%, 19%, 6%, 5%, 0.5% and 0.5%, respectively. Kaplan-Meier 5-year risk of hepatocellular carcinoma (HCC) was 6% and 4% for patients infected by type 1b and non-1b, respectively (P=0.8); the corresponding figures for decompensation were 18% and 7% (P=0.0009) and for event-free survival were 79% and 89% (P=0.09), respectively. After adjustment for baseline clinical and serological features, HCV type 1b did not increase the risk for HCC [adjusted relative risk=1.0 (95% confidence interval=0.47-2.34)], whereas it increased the risk for decompensation by a factor of 3 (1.2-7.4) and decreased event-free survival by a factor of 1.7 (0.9-3.10). In conclusion, type 1b and, to a lesser extent, type 2, are the most common HCV genotypes in European patients with cirrhosis. HCV type 1b is not associated with a greater risk for HCC, but increases the risk for decompensation by threefold in patients with cirrhosis.
Fattovich
G
G
Servizio Autonomo Clinicizzato di Gastroenterologia, University of Verona, Policlinoco G.B. Rossi, Piazzale L. Scuro 10, 37134 Verona, Italy.
Ribero
M L
ML
Pantalena
M
M
Diodati
G
G
Almasio
P
P
Nevens
F
F
Tremolada
F
F
Degos
F
F
Rai
J
J
Solinas
A
A
Mura
D
D
Tocco
A
A
Zagni
I
I
Fabris
F
F
Lomonaco
L
L
Noventa
F
F
Realdi
G
G
Schalm
S W
SW
Tagger
A
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D018572:Disease-Free Survival; D005060:Europe / Q000453:epidemiology; D005260:Female; D016174:Hepacivirus / Q000737:chemistry / Q000145:classification / Q000235:genetics*; D006526:Hepatitis C / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000235:genetics; D012737:Sex Factors; D018709:Statistics, Nonparametric; D065227:Transfusion Reaction; D016896:Treatment Outcome
D000914:Antibodies, Viral; D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral