Prevailing HCV genotypes and subtypes among hiv infected patients in Georgia.
Recent analysis of antiretroviral treatment (ART) program data in Georgia showed that end-stage liver disease was a leading cause of death among HIV/HCV co infected patients in 2005. The objective of this retrospective study was to study prevailing genotypes and subtypes of HCV virus in a cohort of HIV infected patients. The investigation revealed that of 1490 patients, 879 (59%) were hepatitis C antibody positive. Detectable HCV RNA was found among 91% of patients. Median liver HCV RNA level was higher than among mono-infected patients. The most prevalent genotypes were genotype 1 (41.6%), followed by genotype 3 (34.7%) and genotype 2 (17.6%), inter (mix) genotype recombinants were found among 5.8 % of patients. The genotype distribution in our study is slightly different from what was seen in Georgia in 2000. The differences of prevailing HCV genotypes among general population and HIV co infected group was probably attributed to the different methods for sample selection used within our study or possible influence of diverse transmission networks among HIV infected group. Another explanation can be the possible shift from predominance of genotype 1 to non 1 genotypes. The higher number intergenotype recombinant forms might be the result of continues parenteral exposure to different HCV genotypes during drug injection paraphernalia. Our study demonstrated high prevalence of HCV infection among HIV-infected patients and revealed 1b as predominant genotype. IDUs were less likely to spontaneously clear the virus than homosexual man and heterosexually infected woman. A greater HCV RNA levels were associated with a greater chance to be infected with HCV genotypes 1. Possible shift from predominance of genotype 1 to non 1 genotypes can be of option. This shift may have a major and beneficial impact on treatment schedules and costs. The higher number intergenotype recombinant forms might be the results of continues parenteral exposure to different HCV genotypes during drug injection paraphernalia. Study results highlights and strengthens the need for careful follow-up of HCV/HIV co infected patients, effective management and therapies against HCV in order to reduce liver related death rates in patients on ART.
Karchava
M
M
Iv. Javakhishvili Tbilisi State University, Faculty of Medicine, Tbilisi.
Sharvadze
L
L
Gatserelia
L
L
Badridze
N
N
Tsertsvadze
T
T
D005260:Female; D005838:Genotype; D005846:Georgia (Republic) / Q000453:epidemiology; D015658:HIV Infections / Q000145:classification / Q000453:epidemiology / Q000235:genetics; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000453:epidemiology