HCV genotypes and age distribution in patients of Vienna and surrounding areas

Background: Chronic hepatitis C (CHC) can result in liver cirrhosis and hep atocellular carcinoma. Determination of the hepatitis C virus (HCV) genotyp e:subtype may be of prognostic value to estimate the risk of development of liver cirrhosis. Objective: The HCV genotype/subtype was determined in pat ients with CHC and possible associations with age, source of HCV transmissi on, duration of HCV infection. and development of liver cirrhosis were inve stigated. Study design: A total of 250 consecutive patients with CHC were s tudied. HCV genotypes/subtypes were determined with a commercially availabl e assay based on the reverse-hybridization principle. Source of HCV transmi ssion and duration of HCV infection were taken from the patient documentati on and liver cirrhosis was diagnosed by clinical, biochemical, and sonograp hic data. Results: HCV genotypes 1, 2, 3, 4, and 5 were found in 74.8, 2.8, 16, 5.2, and 0.4% of the patients. Most frequent subtypes were 1b (54%), 1 a (15.6%), and 3a (15.6%). Patients with genotype 1 (mean, 52.8 years) or 2 (mean, 51.0 years) were significantly older than patients with genotype 3 (mean. 37.2 years) or genotype 4 (mean, 37.2 years). Patients with subtype 1b (mean, 58.1 years) were significantly older than patients with subtype l a (mean, 40.8 years) or 3a (mean, 37.5 years). The main sources of HCV infe ction were intravenous drug abuse in 30.0% of all patients (genotype 1 in 5 3.3%; genotype 3 in 40%) or transfusion of blood and blood products in 21.6 % of all patients (genotype 1 in 83.4%). The source of transmission, howeve r, remained unknown in 44.8% of all patients. The prevalence of genotype 1 was significantly higher in patients with long duration (more than 20 years ) of CHC. In none of the patients with genotype 2 or 3, duration of CHC for more than 20 years was observed. The prevalence of genotype 4 was signific antly higher in patients with short duration (less than 10 years) of CHC. L iver cirrhosis was diagnosed in 13.6% of all patients (97.1% of patients wi th genotype 1). Patients with liver cirrhosis were significantly older comp ared to asymptomatic patients (mean, 63.8 vs. 51.3 years). Conclusion: HCV subtype 1b was found to be the main subtype in the investigated population and is currently the major contributor to liver cirrhosis. Patients infecte d with subtype 1a, however, are at comparable risk for development of liver cirrhosis. In future. subtype 3a and genotype 4 may also become an increas ing problem. (C) 2001 Elsevier Science B.V. All rights reserved.