HEPATITIS-C VIRUS GENOTYPES - EPIDEMIOLOGIC AND CLINICAL ASSOCIATIONS

In a cohort of 292 chronic hepatitis C patients living in the Benelux countries the relationship between viral genotype and geographical ori gin, route of transmission, clinical characteristics and severity of l iver disease was analyzed. HCV-RNA isolates could be classified by the Line Probe Assay (LiPA) as la, Ib, 2, 3, 4 or 5 in 286 (98%) cases. P atients of European origin were predominantly infected with HCV subtyp e Ib (164/254, 65%, CI 58-70%), as were patients of Asian origin (7/13 , 54%). Patients originating from Surinam (South America) had predomin antly type 2 (9/10, 90%), whereas Africans were mainly infected with t ype 4 (7/9, 77%). Blood transfusion was the mode of transmission in 14 2 (50%) patients, intravenous drug abuse (IVDA) in 40 (14%), occupatio nal needle accident or tattoo in 11 (4%); no obvious source of infecti on was found in 93 (33%). In patients infected by blood transfusion, s ubtype Ib was predominant (70%, CI 61-77%), whereas subtypes la and 3 were predominant in those infected by IVDA (25% and 45%, respectively, p<0.001). Cirrhosis was observed in 68 (24%) patients; in multivariat e analysis, factors independently related to cirrhosis were: the durat ion of infection, age and prior hepatitis B. No significant relationsh ip was found between the severity of fibrosis or liver inflammation an d the HCV (sub)types. In summary, in this large cohort of patients in the Benelux countries the hepatitis C virus (sub)type present was clea rly related to the country of origin and the route of transmission, bu t not to the severity of liver disease.