Distribution of hepatitis C virus genotypes in a diverse US integrated health care population

Kaiser Permanente Division of Research, Oakland, California. .
Journal of Medical Virology (Impact Factor: 2.35). 11/2012; 84(11):1744-50. DOI: 10.1002/jmv.23399
Source: PubMed


Hepatitis C virus (HCV) genotypes influence response to therapy, and recently approved direct-acting antivirals are genotype-specific. Genotype distribution information can help to guide antiviral development and elucidate infection patterns. HCV genotype distributions were studied in a diverse cross-section of patients in the Northern California Kaiser Permanente health plan. Associations between genotype and race/ethnicity, age, and sex were assessed with multivariate logistic regression models. The 10,256 patients studied were median age 56 years, 62% male, 55% White non-Hispanic. Overall, 70% were genotype 1, 16% genotype 2, 12% genotype 3, 1% genotype 4, <1% genotype 5, and 1% genotype 6. Blacks (OR 4.5 [3.8-5.5]) and Asians (OR 1.2 [1.0-1.4]) were more likely to have genotype 1 than 2/3 versus non-Hispanic Whites. Women less likely had genotype 1 versus 2/3 than did men (OR 0.86 [0.78-0.94]). Versus non-Hispanic Whites, Asians (OR 0.38 [0.31-0.46]) and Blacks (OR 0.73 [0.63-0.84]) were less likely genotype1a than 1b; Hispanics (OR 1.3 [1.1-1.5]) and Native Americans (OR 1.9 [1.2-2.8]) more likely had genotype 1a than 1b. Patients age ≥65 years less likely had genotype 1a than 1b versus those age 45-64 (OR 0.34 [0.29-0.41]). The predominance of genotype 1 among all groups studied reinforces the need for new therapies targeting this genotype. Racial/ethnic variations in HCV genotype and subtype distribution must be considered in formulating new agents and novel strategies to successfully treat the diversity of hepatitis C patients. J. Med. Virol. 84:1744-1750, 2012. © 2012 Wiley Periodicals, Inc.

1 Follower
40 Reads
  • Source
    • "Within these, a variable number of sub-groupings are apparent. HCV genotype 1 is most prevalent genotype in the United States, Europe and Japan (Manos et al., 2012; Qattan and Emery, 2012; Wu et al., 2012). HCV genotype 2 is dominant in Korea and Taiwan. "
    [Show abstract] [Hide abstract]
    ABSTRACT: High degree of sequence variations are present throughout in the coding regions of Hepatitis C virus (HCV) genome. However, a high degree of sequence conservation within the 5'untranslated region (UTR) has made this region a target of choice for most of detection assays based on nucleic acid amplification. The current study was designed to determine the HCV genotypes in samples of HCV chronically infected patients in Pakistan. Specific primers targeting 5'UTR region were designed, which were then used for both amplification and sequencing of all isolates. All HCV isolates were sequenced and genotyped based upon phylogenetically informative regions within the 5'UTR of HCV genome. Out of 15 samples, 9 (60 %) samples 5'UTR of HCV genome was successfully sequenced. However, only 6 (66.7 %) samples were assigned genotypes based upon sequence comparison with reference sequences of database. Results of this study revealed that five isolates that were assigned genotype 3a, showed 97 to 99 % sequence conservation to isolates of genotype 3a previously reported from Pakistan as well as from rest of world, grouped together and coincided with their positions in the phylogenetic tree. Moreover, one isolate that was assigned genotype 4a, showed 97 % sequence conservation to isolates of genotype 4a previously reported from rest of world, coincided with its position in the phylogenetic tree. Our findings suggest that direct sequencing analysis of the 5'UTR of HCV genome is a sensitive and efficient approach of HCV genotyping; it may be adopted as a routine diagnostic procedure for HCV genotyping in clinical settings.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Approximately 25 % of persons living with the human immunodeficiency virus (HIV) are coinfected with the hepatitis C virus (HCV). In cohort studies of HIV-HCV coinfection, HCV genotypes 2 and 3 account for 15 %-64 % of disease. Compared with HCV monoinfection, liver disease is accelerated in coinfected patients, and anti-HCV treatment is less successful. This article reviews the current knowledge and recommendations for management of HCV genotype 2 and 3 infection in patients living with HIV. While pegylated interferon (PEG-IFN)/ ribavirin (RBV) remains the standard treatment for HCV genotype 2/3 infection, ongoing clinical trials with more effective therapies will soon be available. In particular, an IFN sparing regimen of sofosbuvir/RBV may become available in 2014. It is also evident that HCV genotypes 2 and 3 respond differently to therapy and should be approached differently both in practice and in clinical trials. Issues including drug-drug interactions between anti-HCV and anti-HIV therapies are addressed.
    Current HIV/AIDS Reports 11/2013; 10(4). DOI:10.1007/s11904-013-0186-4 · 3.80 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hepatitis C (HCV) coinfection is the leading cause of liver-related morbidity and is a leading cause of mortality in human immunodeficiency virus (HIV)-infected individuals in the antiretroviral therapy era. Direct-acting antiviral (DAA) therapies are transforming how HCV is treated with significant improvements in efficacy and tolerability. In this article, DAA agents expected to be available in 2014 are reviewed, including telaprevir, boceprevir, sofosbuvir, simeprevir, faldaprevir, and daclatasvir. Available data regarding clinical efficacy, adverse effects, and drug interactions in HIV-HCV coinfection are discussed. The management of adverse effects of HCV therapy and treatment considerations in patients with cirrhosis are also reviewed.
    Current HIV/AIDS Reports 11/2013; 10(4). DOI:10.1007/s11904-013-0182-8 · 3.80 Impact Factor
Show more