HEPATITIS-C GENOTYPES IN AUSTRALIAN HEMOPHILIA PATIENTS

Background: Differences in the hepatitis C virus (HCV) genotype influe nce the severity of HCV related liver disease and response to interfer on therapy. HCV infection is frequent in Australian haemophilia patien ts who have been exposed repeatedly to multiple HCV genotypes through non HCV virally inactivated clotting factor concentrates. The distribu tion of the various HCV genotypes in Australian haemophilia patients i s unknown. Aim: To examine the HCV genotype distribution and clinical features of HCV associated liver disease in Australian haemophilia pat ients. Methods: Forty patients with bleeding disorders who were known to be both HCV antibody and polymerase chain reaction (PCR) positive w ere evaluated by direct sequencing of the PCR products for the HCV gen otype. Results: Genotype 1 was found in 65% of patients (26/40), type 2 in 5% (2/40) and type 3 in 30% (12/40). No genotypes 4 to 6 were fou nd. There was no association between the HCV genotype and the severity of haemophilia, alanine transaminase levels, or the presence of porta l hypertension. Unlike European, Asian and American studies where the majority of type 1 infection is subclass Ib, in Australian haemophilia patients it is subclass la (73% - 19/26) which may have a better prog nosis and response to interferon. Conclusions: Despite patients with h aemophilia being exposed to multiple HCV genotypes, it appears that th ere is no selection advantage of one genotype over another. Australian haemophilia patients with HCV have a different genotype distribution to that reported in other countries and care should be observed in int erpreting non Australian studies concerning HCV.