HEPATITIS-C VIRUS - EPIDEMIOLOGY AND GENOTYPES IN THE NORTH-EAST OF ENGLAND

The epidemiology of hepatitis C virus (HCV) infection was studied in a n English teaching hospital over an 18 month period. A total of 104 HC V antibody positive patients were referred for further investigation. They were divided into those diagnosed through screening (blood donors and intravenous drug abusers) and those diagnosed for other reasons, and their mean ages, known risk factors for HCV transmission, genotype s, and liver biopsy histology were analysed. Screened patients were si gnificantly younger than the others. No significant difference in age was found between genotypes. Most patients genotyped (69%) were genoty pe 1. Intravenous drug abusers had a higher proportion of subtype 1a, and patients who acquired HCV through blood transfusion had a higher p roportion of subtype 1b. Liver biopsy specimens were scored using a hi stological activity index for liver inflammation and fibrosis. Patient s with subtype Ib had significantly more severe liver disease than oth er genotypes when the histological activity index scores for fibrosis were analysed (p<0.05). Liver disease worsened significantly with age according to all three histological activity index scores (portal acti vity: p<0.01, acinar activity: p<0.001, fibrosis: p<0.0001). Liver dis ease worsened with increased duration of infection (p<0.002), and pati ents who also abused alcohol presented at a significantly younger age (cirrhosis, p<0.05, hepatocellular carcinoma, p<0.02).