THE CHANGING RELATIVE PREVALENCE OF HEPATITIS-C VIRUS GENOTYPES - EVIDENCE IN HEMODIALYZED PATIENTS AND KIDNEY RECIPIENTS

Background/Aims: Hepatitis C Virus (HCV) infection by the genotype 1b is significantly associated with a lower rate of response to interfero n alfa and with severe liver disease (cirrhosis and hepatocellular car cinoma). This may reflect different intrinsic properties of this genot ype 1b and/or chronological differences in the epide mioIogy of HCV ge notypes. To address the issue of variations in genotypes prevalence, w e studied in the present report the HCV genotypes of 60 hemodialyzed a nd kidney recipients according to the date of hemodialysis. Methods: A nti-HCV antibodies were tested by a second-generation assay (enzyme-li nked immunosorbent assay 2 and recombinant immufioblot assay 2). HCV R NA was detected by reverse-transcription polymerase chain reaction. Ge notyping was performed by hybuidization of type-specific probes to the amplified product from the 5' untranslated region. Results: Genotype 1b accounted for move than two thirds of HCV infection in patients who underwent dialysis before 1977 but less than one third in those hemod iaiyzed after 1985. In contrast, other genotypes (3a, 4a, 5a) appeared in the 1980s. Conclusions: These data, obtained in an homogenous grou p of patients, show a changing pattern of HCV genotype prevalence over time and should be considered when discussing the potential clinical implications of HCV genetic variability.