Changing Epidemiology of Hepatitis C Virus Genotype among Patients with Human Immunodeficiency Virus/Hepatitis C Virus Co-Infection in China.
BACKGROUND
Co-infection with hepatitis C virus (HCV) has become the most common cause of death in human immunodeficiency virus (HIV) infected patients on antiretroviral therapy. The distribution of HCV genotypes varies with geographical regions and time, and limited studies have focused on the HCV genotype in HIV/HCV co-infection.


METHODS
The distribution of HCV genotypes was evaluated in 414 patients with HIV/HCV co-infection in three regions (South, Central and Northwest) of China from 2008 to 2010. The NS5B region of HCV was characterized using nested reverse transcription polymerase chain reaction. Nucleotide sequences obtained were subjected to phylogenetic analysis, and genotypes were assigned using published reference genotypes.


RESULTS
Genotype 3 was the most prevalent HCV strain (36.2%), followed by genotype 6 (30.0%), genotype 1 (28.5%), genotype 2 (5.1%), and genotype 5 (0.2%). The distribution varied geographically. Genotype 6 (37.6%) was the predominant strain while genotype 1 (20.2%) was less common in the South compared to the Central and Northwest regions (all P < 0.001). The distribution also varied temporally. There was no significant difference in genotype distribution in Guangdong (a province in the South region), between patient cohorts from 2005-2008 and 2009-2010. However, outside Guangdong, genotypes 3 and 6a became significantly more prevalent (22.4% vs.42.2%, P< 0.001; 8.0% vs. 19.8%, P = 0.004), and genotype 1 less prevalent (54.4% vs.26.6%, P< 0.001) over time.


CONCLUSIONS
The most dramatic shift in genotypic distribution was the movement of HCV genotypes 3 and 6a outside of Guangdong in HIV/HCV co-infected patients. This movement appeared closely associated with transmission via injected drug use.
Department of Infectious Disease, Guangzhou No. 8 People's Hospital, Guangzhou Medical University, Guangzhou, China.
Weilie
W
Chen
Department of Infectious Disease, Guangzhou No. 8 People's Hospital, Guangzhou Medical University, Guangzhou, China.
Baolin
B
Liao
Department of Infectious Disease, Guangzhou No. 8 People's Hospital, Guangzhou Medical University, Guangzhou, China.
Fengyu
F
Hu
Department of Infectious Disease, Guangzhou No. 8 People's Hospital, Guangzhou Medical University, Guangzhou, China.
Jingmin
J
Nie
Department of Infectious Disease, Guangzhou No. 8 People's Hospital, Guangzhou Medical University, Guangzhou, China.
Yun
Y
Lan
Department of Infectious Disease, Yunnan Provincial Infectious Disease Hospital, Yunnan, China.
Huiqin
H
Li
Department of Infectious Disease, Guangxi Zhuang Autonomous Region Longtan Hospital, Guangxi, China.
Ruichao
R
Lu
Department of Infectious Disease, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Yanqing
Y
Gao
Department of Infectious Disease, Xinjiang No. 6 People's Hospital, Xinjiang, China.
Yuxia
Y
Song
Department of Infectious Disease, Zhenzhou No. 6 People's Hospital, Zhenzhou, China.
Qingxia
Q
Zhao
Department of Infectious Disease, the Second Xiangya Hospital, Zhongnan University, Changsha, China.
Yuhuang
Y
Zheng
Department of Infectious Disease, Guangzhou No. 8 People's Hospital, Guangzhou Medical University, Guangzhou, China.
Xiaoping
X
Tang
Department of Infectious Disease, Guangzhou No. 8 People's Hospital, Guangzhou Medical University, Guangzhou, China.
Weiping
W
Cai
D000328:Adult; D002681:China; D060085:Coinfection / Q000453:epidemiology / Q000235:genetics* / Q000821:virology; D005260:Female; D005838:Genotype; D006678:HIV / Q000235:genetics* / Q000472:pathogenicity; D015658:HIV Infections / Q000453:epidemiology / Q000235:genetics* / Q000821:virology; D016174:Hepacivirus / Q000235:genetics* / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000235:genetics
D012367:RNA, Viral