title: Changes in hepatitis C virus infection routes and genotype distribution in a Lithuanian cohort with chronic hepatitis C.
abstract: BACKGROUND
  We evaluated the distribution of hepatitis C virus genotypes and determined their association with routes of infection according to the sex and age of the study subjects.
  
  
  METHODS
  We studied 1158 patients with chronic hepatitis C. Hepatitis C virus antibodies were detected with a microparticle enzyme immunoassay, hepatitis C virus ribonucleic acid was identified via polymerase chain reaction, and hepatitis C virus genotypes were determined with a line probe assay. An anonymous questionnaire completed by all subjects included the date of chronic hepatitis C diagnosis, the age and sex of the patient, the hepatitis C virus genotype and subtype, and possible routes of infection.
  
  
  RESULTS
  Of the patients studied, 50.9% had more than 1 possible route of infection, 41.2% had a single route of infection, and 7.9% had an unknown route of infection. The most common hepatitis C transmission routes were intravenous drug use and tattoos in younger patients and surgery or long or multiple hospitalizations in older patients. The genotype distribution was as follows: genotype 1, 65.0% of patients; genotype 2, 26.3%; and genotype 3, 8.7%. The transmission of genotype 1 was associated primarily with surgery and that of genotype 3 was linked with intravenous drug use.
  
  
  CONCLUSIONS
  Today, the main routes of hepatitis C virus transmission are intravenous drug use and tattoos. Some hepatitis C infections are associated with surgery or are acquired from a family member. The shift in transmission pathways predetermined the shift in hepatitis C virus genotypes from 1 to 3.
authors.affiliation: Centre of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Lithuania. valentina.liakina@santa.lt
authors.forename: Valentina
authors.initials: V
authors.lastname: Liakina
authors.forename: Danute
authors.initials: D
authors.lastname: Speiciene
authors.forename: Algimantas
authors.initials: A
authors.lastname: Irnius
authors.forename: Jonas
authors.initials: J
authors.lastname: Valantinas