Changes in the distribution of hepatitis C virus (HCV) genotypes over time in Spain according to HIV serostatus: implications for HCV therapy in HCV/HIV-coinfected patients.
BACKGROUND
Changes in the prevalence of distinct hepatitis C virus (HCV) genotypes and subtypes over time have not been explored in detail.


METHODS
A retrospective analysis was carried out in all specimens from subjects with chronic hepatitis C sent for testing to a reference laboratory in Spain since 1998-2004.


RESULTS
A total of 1226 distinct subjects were analyzed. The most frequent HCV genotype was 1 (64.1%), followed by 3 (20.9%) and 4 (11.7%). The most frequent HCV subtype was 1b (32.4%). A total of 797 patients (65%) were HIV-positive. Although genotype 1 was the most frequent, it represented 74.6% of HIV-negative and 58.5% of HIV-positive patients (p<0.01). While HCV subtype 1a was the most frequent among HIV-positive subjects (32.1%), 1b was the most common in HIV-negative patients (53.8%). There was a significant increase in the prevalence of genotype 4 and conversely a decline in genotype 3 among HIV-positive patients over time.


CONCLUSIONS
Genotype 1 is the most frequent HCV variant circulating in Spain. Genotypes 3 and 4 are significantly more prevalent in HIV/HCV-coinfected than in HCV-monoinfected patients. However, HCV-3 has declined and HCV-4 is increasing in the former group. These findings are relevant given their different susceptibility to interferon-based therapies.
Department of Infectious Diseases, Hospital Carlos III, Calle Sinesio Delgado 10, 28029 Madrid, Spain. belenrbsg@hotmail.com
Belén
B
Ramos
Marina
M
Núñez
Carlos
C
Toro
Julie
J
Sheldon
Javier
J
García-Samaniego
Pilar
P
Ríos
Vincent
V
Soriano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D005838:Genotype; D006679:HIV Seropositivity / Q000150:complications*; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013030:Spain / Q000453:epidemiology
D000998:Antiviral Agents; D007372:Interferons