title: Molecular epidemiology of hepatitis C among drug users in Flanders, Belgium: association of genotype with clinical parameters and with sex- and drug-related risk behaviours.
abstract: The aim of this study was to determine the genotypic variation of hepatitis C among drug users in Flanders and to relate the distribution of genotypes to the characteristics of the population. Hepatitis C virus RNA (HCV-RNA) quantification and genotyping was performed on stored samples from 161 anti-HCV-positive injecting and non-injecting drug users. Information on sociodemographic status, drug-related risk behaviour and sexual risk behaviour was available for each drug user. HCV-RNA was present in 152 of 161 samples (94.4%). Genotype 1 was predominant (48.7%), followed by genotype 3 (41.2%), genotype 4 (8.8%) and genotype 2 (1.4%). In the multivariate analysis, lack of a history of injecting drug use was confirmed as a statistically significant predictor for infection with genotype 1. Predictors for infection with genotype 3 were the presence of anti-HBc antibodies and a history of injecting drug use. Being tattooed emerged as a statistically significant predictor for infection with genotype 4. The 94.4% prevalence of HCV-RNA among anti-HCV-positive drug users was considerably higher than the 54-86% chronicity rate found globally among HCV-infected patients. The results of this study suggest the existence of separate transmission networks for injecting drug users and non-injecting drug users. Finally, the results suggest that tattooing practices play a role in the spread of HCV among drug users.
authors.affiliation: Department of General Practice, Katholieke Universiteit Leuven, Kapucijnenvoer 33 Blok J, 3000, Leuven, Belgium. catharina.mathei@pandora.be
authors.forename: C
authors.initials: C
authors.lastname: Matheï
authors.forename: E
authors.initials: E
authors.lastname: Wollants
authors.forename: J
authors.initials: J
authors.lastname: Verbeeck
authors.forename: M
authors.initials: M
authors.lastname: Van Ranst
authors.forename: G
authors.initials: G
authors.lastname: Robaeys
authors.forename: P
authors.initials: P
authors.lastname: Van Damme
authors.forename: F
authors.initials: F
authors.lastname: Buntinx
mesh_terms: D000328:Adult; D001530:Belgium / Q000453:epidemiology; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics* / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology; D016485:Needle Sharing / Q000706:statistics & numerical data; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications*
chemical_list: D012367:RNA, Viral