DISTRIBUTION OF HEPATITIS-C VIRUS GENOTYPES IN GERMAN PATIENTS WITH CHRONIC HEPATITIS-C - CORRELATION WITH CLINICAL AND VIROLOGICAL PARAMETERS

Background/Aims: The hepatitis C virus genotypes have been shown to be differently distributed between distinct geographical areas and to be associated with different clinical presentations, In the present stud y we investigated the distribution of HCV genotypes in 379 German pati ents with chronic hepatitis C in relation to age, sex, route of infect ion, liver histology and viremia. Methods: Typing of HCV was done usin g restriction fragment length polymorphism analysis as well as a DNA e nzyme immunoassay, HCV RNA concentrations were determined by quantitat ive polymerase chain reaction, Liver biopsies were performed in 187 pa tients and the histological activity was graded by the Knodell score. Results: Seventy percent were infected with genotype 1 (20% subtype 1a , 80% subtype 1b), 4% with genotype 2 and 26% with genotype 3 (all sub type 3a), Genotype 3a and 1a infection was significantly associated wi th intravenous drug abuse, In contrast, genotype 1 predominated in pat ients with post-transfusion hepatitis and infection of unknown origin, A changing relative prevalence of HCV genotypes in relation to age wa s also observed. Patients with genotype 3 infection showed significant ly lower HCV RNA levels and a lower mean histological activity score a s compared to patients with genotype 1 and genotype 2, However, using multivariate analysis, only age and mode of transmission but not histo logical activitiy score were shown to be independent variables. Conclu sions: Our study confirms previous reports from other countries that H CV variants can be classified into a relatively small number of discre te genotypes, and that the subtype 1b clearly predominates, However, w e found evidence that there is a changing relative prevalence of HCV g enotypes in relation to age, and that the mode of transmission is refl ected in the predominance of certain genotypes.