title: Epidemiology and treatment of hepatitis C genotypes 5 and 6.
abstract: Chronic hepatitis C infection is a major global health problem. The WHO estimates the number of infected people worldwide to be approximately 170 million. The estimated number of hepatitis C virus (HCV)-infected people in Canada is approximately 250,000, with approximately 5000 Canadians newly infected each year. Based on the identification of genomic differences, HCV has been classified into six genotypes; genotype may influence the outcome of antiviral therapy. HCV genotypes 1, 2 and 3 are widely distributed throughout the world and have been the focus of the majority of epidemiological, natural course and treatment studies. Although HCV genotypes 5 and 6 are prevalent in certain geographical areas, they are studied less extensively. HCV genotypes 5 and 6 are uncommon in Canada and account for less than 5% of HCV-infected Canadians. However, immigration and travel can alter the epidemiology of these uncommon genotypes. The present article reviews and summarizes the available data regarding the epidemiology and treatment of HCV genotypes 5 and 6. Genotype 5 is endemic in the northern part of South Africa while genotype 6 is reported primarily in Asia. Available data show that 48 weeks of treatment with a combination of pegylated interferon and ribavirin lead to a higher sustained virological response compared with HCV genotypes 1 and 4. None of the approved direct-acting antiviral agents is currently recommended for the treatment of HCV genotypes 5 or 6.
authors: Department of Medicine, Armed Forces Hospital, Muscat, Oman.
authors: Khalid
authors: K
authors: Al Naamani
authors: Siham
authors: S
authors: Al Sinani
authors: Marc
authors: M
authors: Deschênes
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002170:Canada / Q000453:epidemiology; D005838:Genotype; D014943:Global Health; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
references: Hepatol Res. 2007 May;37(5):337-45
references: 17441806
references: J Infect Dis. 2003 Apr 1;187(7):1071-4
references: 12660921
references: Am J Gastroenterol. 1999 Jun;94(6):1619-26
references: 10364034
references: J Med Virol. 2005 Apr;75(4):538-49
references: 15714489
references: N Engl J Med. 2011 Mar 31;364(13):1195-206
references: 21449783
references: Am J Gastroenterol. 2008 May;103(5):1131-5
references: 18477343
references: Proc Natl Acad Sci U S A. 1991 Mar 15;88(6):2451-5
references: 1848704
references: Liver Int. 2010 Mar;30(3):342-55
references: 20015149
references: Clin Infect Dis. 2008 Nov 15;47(10):1260-9
references: 18834319
references: J Clin Microbiol. 1994 Aug;32(8):2031-4
references: 7989565
references: J Med Virol. 2008 Oct;80(10):1712-9
references: 18712825
references: Epidemiol Infect. 2009 Jan;137(1):79-84
references: 18346288
references: J Viral Hepat. 2012 Jun;19(6):423-30
references: 22571904
references: J Clin Microbiol. 1997 Jul;35(7):1772-6
references: 9196191
references: N Engl J Med. 2001 Jul 5;345(1):41-52
references: 11439948
references: J Clin Microbiol. 1995 Jun;33(6):1679-81
references: 7650216
references: Trop Gastroenterol. 1997 Oct-Dec;18(4):153-5
references: 9612095
references: Hepatology. 2002 Nov;36(5):1259-65
references: 12395338
references: J Gen Virol. 1995 Sep;76 ( Pt 9):2323-7
references: 7561772
references: J Infect Dis. 2004 Apr 15;189(8):1397-400
references: 15073676
references: Am J Gastroenterol. 2001 Oct;96(10):3042-3
references: 11693355
references: Nat Genet. 2009 Oct;41(10):1100-4
references: 19749758
references: Nature. 2009 Sep 17;461(7262):399-401
references: 19684573
references: N Engl J Med. 2011 Jun 23;364(25):2405-16
references: 21696307
references: J Gen Virol. 1996 Feb;77 ( Pt 2 ):293-301
references: 8627233
references: J Viral Hepat. 2008 May;15(5):383-6
references: 18086180
references: Can Commun Dis Rep. 1995 Jul 30;21(14):129-32
references: 7670431
references: Aliment Pharmacol Ther. 2006 Aug 15;24(4):593-600
references: 16907892
references: J Hepatol. 1996 May;24(5):622-4
references: 8773919
references: J Med Virol. 2011 May;83(5):815-9
references: 21412790
references: J Clin Microbiol. 2007 Apr;45(4):1102-12
references: 17287328
references: Hepatology. 2005 Oct;42(4):962-73
references: 16149085
references: J Hepatol. 2012 May;56(5):1012-1018
references: 22266603
references: J Med Virol. 1999 May;58(1):44-8
references: 10223544
references: J Hepatol. 1996 Jan;24(1):109-13
references: 8834033
references: Aliment Pharmacol Ther. 2007 Nov 15;26(10):1437-46
references: 17900267
references: J Clin Microbiol. 1996 Feb;34(2):417-23
references: 8789027
references: Hepatology. 2010 Nov;52(5):1573-80
references: 21038410
references: Nat Genet. 2009 Oct;41(10):1105-9
references: 19749757
references: J Infect Dis. 2008 Sep 15;198(6):808-12
references: 18657036
references: J Viral Hepat. 2005 Jul;12(4):405-13
references: 15985012
references: J Clin Microbiol. 1996 Nov;34(11):2815-8
references: 8897188