Prevalence and changes in hepatitis C virus genotypes among multitransfused persons with hemophilia

The purpose of this study was to determine hepatitis C virus (HCV) genotype s and their relationship to HCV RNA levels over time in a cohort of multitr ansfused hemophiliacs, Following reverse transcription and polymerase chain reaction amplification of HCV RNA, the product DNAs were genotyped by usin g the line probe assay, HCV RNA was quantified by the branched-chain DNA as say. Genotyping was done on 109 serum samples from 32 subjects. Genotype 3a had the highest prevalence (41%), followed by genotypes la (31%) and 1b (1 3%), Changes in genotypes were observed in 18 (58%) of the subjects >3-15 y ears of age. Changes were more common in human immunodeficiency virus (HIV) -positive subjects (13/17) than in HIV-negative subjects (5/15) (P = .014), HCV RNA increased 30-fold in HIV-positive subjects whose genotypes changed . Consensus nucleotide sequencing confirmed genotype changes in 2 patients, We conclude that genotype changes are common in hemophiliacs with chronic HCV, particularly in those who are coinfected with HIV.