Changing HCV genotypes distribution in Poland—Relation to source and time of infection
Introduction
The hepatitis C virus (HCV) is a major cause of infectious hepatitis worldwide. In Poland anti-HCV antibody prevalence is estimated to be 1.4% (World Health Organization, 1999), indicating about 560,000 infected individuals. Liver failure due to HCV infection is the most frequent reason for liver transplantation in Poland (Malkowski et al., 2005). Although the data on HCV epidemiology in Eastern Europe are scarce, the available literature and expert opinions indicate that nosocomial infections prevail and intravenous drug use (IVDU) remains an important mode of HCV acquisition (Chlabicz et al., 2004, Naoumov, 1999).
Hepatitis C virus is a single stranded RNA-virus classified into 6 major genotypes (1–6), which are subdivided into many subtypes (1a, 1b, 1c, 2a, 2b, etc.). An early study indicated that the most prevalent HCV subtype in Poland was 1b (80%), followed by 1a (12%), 3a (3%) and 4c4d (3%) (Stanczak et al., 1999). The predominance of genotype 1b in Poland is the reason for the unsatisfactory sustained viral response to antiviral treatment.
Studies indicate there is an association between HCV genotypes and the mode of HCV acquisition. Genotype 3a is associated with intravenous drug use (IVDU) and genotype 1b is seen more often in patients who acquire HCV through blood transfusion (Bourlière et al., 2002, Dal Molin et al., 2002, Mathei et al., 2005). However, the prevalence of HCV subtypes in a given population is not constant, and may vary with introduction of new subtypes and with changes in mode of HCV acquisition (Schrőter et al., 2002).
The aim of this study was to describe the distribution of HCV genotypes in relation to demographic characteristics, presumptive route of transmission, and year of infection among patients with chronic hepatitis C infection in North-Eastern Poland.
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Clinical
The study group included patients with chronic liver disease being evaluated for antiviral treatment at the Department of Infectious Diseases of Medical University of Bialystok (Podlaskie voiewodship, northeastern Poland) in 2002–2006. This is the largest hepatology centre in the Podlaskie Region (1,200,000 inhabitants) and where the majority of patients with chronic hepatitis are referred. All patients were interviewed extensively by one of the two researchers (S.C. and A.G.) with the use of a
Results
HCV genotype was determined for 179 samples. Of those patients 12.9% had a history of IVDU, 17.9% received transfusions before 1993, and 69.3% were infected by other routes (Table 1). For statistical analysis samples were classified as belonging to genotype 1, genotype 3, genotype 4, or mixed. There were significantly more males among IVDU patients when compared with the TRANSF group. IVDU patients were also significantly younger when compared with TRANSF or OTHER groups. Overall the genotype
Discussion
The relative proportion of HCV genotypes in Poland has changed in the past two decades. Although HCV genotype 1b was still the most prevalent, the frequency of genotype 3 exceeded 30%, which is much higher than previously recorded in the adult Polish population. In a 1995–1999 study of 1385 samples from patients with chronic hepatitis C (majority of HCV infections were probably not related to IVDU) only 3% had type 3 (Stanczak et al., 1999). The preponderance of IVDU-related infections with
Acknowledgement
The project was supported by research grant no. 3-56784-L from Medical University of Bialystok.
References (16)
- et al.
Distribution of hepatitis C virus genotypes in German patients with chronic hepatitis C: correlation with clinical and virological parameters
J Hepatol
(1997) - et al.
Medical procedures and the risk of iatrogenic hepatitis C infection: case-controlled study in north-eastern Poland
J Hosp Infect
(2004) - et al.
An immunoassay for specific amplified HCV sequences
J Virol Methods
(1991) Hepatitis C virus infection in Eastern Europe
J Hepatol
(1999)- et al.
Molecular epidemiology of hepatitis C infection in U.S. veteran liver transplant recipients: evidence for decreasing relative prevalence of genotype 1B
Am J Gastroenterol
(1999) - et al.
Distribution of hepatitis C virus genotypes in Poland
J Hepatol
(1999) - et al.
Hepatitis C virus genotypes among intravenous drug users in Italy
Hepatol Res
(1997) - et al.
Epidemiological changes in hepatitis C virus genotypes in France: evidence in intravenous drug users
J Viral Hepat
(2002)
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