Planning for the healthcare burden of hepatitis C infection: Hepatitis C genotypes identified in England, 2002-2007.
BACKGROUND
Identification of HCV genotype is a prerequisite for anti-viral treatment in England. Treatment length and sustained virological response rates vary by genotype. Therefore knowledge of circulating HCV genotypes is important for health-care providers.


OBJECTIVE
To describe the HCV genotypes identified in English laboratories and to investigate changes over time; sub-analysis of young adults (15-24 years) to provide information on recently circulating genotypes.


METHODS
Data from the national reference laboratory and 19 English laboratories participating in the sentinel surveillance of hepatitis testing study were analysed. Multinomial regression was used to investigate trends in genotypes identified between 2002 and 2007.


RESULTS
HCV genotypes were available for 18,031 individuals. The majority (89%) of people were genotypes 1 and 3; 3a was the single largest subtype. Half of people born between 1960 and 1989 were genotype 3a and the majority of South Asian people were genotype 3a. People born pre-1940 were nine times more likely to have genotype 1b than 3a. The proportion of 1b infections, relative to 3a, declined over time, but, after adjusting for birth cohort, this effect disappeared. There was no evidence of a relative change in 1a infections.


CONCLUSIONS
This is the largest study of genotypes identified in England to date. Changes in genotypes over time were due to decreased genotyping of older individuals. As the population ages, the proportion of more difficult to treat genotypes may decline, leading to possible cost-savings for health-care providers, with a higher chance of achieving sustained virological response.
Brant
Lisa J
LJ
Health Protection Agency Centre for Infections, Immunisation Hepatitis and Blood Safety Department, 61 Colindale Avenue, London NW9 5EQ, UK. lisa.brant@hpa.org.uk
Ramsay
Mary E
ME
Tweed
Emily
E
Hale
Antony
A
Hurrelle
Martin
M
Klapper
Paul
P
Ngui
Siew Lin
SL
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics*; D055815:Young Adult
D012367:RNA, Viral