Genotype distribution and risk factors in patients with chronic hepatitis C infection
Year 2021,
, 50 - 56, 30.04.2021
Arzu Altunçekiç Yıldırım
,
Celali Kurt
,
Ali Seydi Alpay
,
Ahmet Doğan
Abstract
Objective: Hepatitis C virus (HCV) is a common infection around the world and an important public health problem. Determination of HCV genotype is important epidemiologically and for treatment approaches. In this study, the aim was to assess the genotype distribution and associated risk factors for patients monitored at our center in northern Turkey.
Methods: A cross-sectional study was carried out of patients with confirmed HCV infection. Our study retrospectively assessed 175 patients with chronic hepatitis C diagnosis in the Infectious Diseases clinic from 2016-2019 and with antiviral treatment administered. The samples were tested by type specific genotyping assay. The relationship between demographic characteristics and potential risk factors and genotype was investigated.
Results: Genotype 1b was identified as the dominant genotype (95%). In 5% of patients, non-1b genotypes were present (genotype 1a, 3 and mixed). Genotype 1b was more common in patients over 50 years of age, while the patients with other genotypes were younger. The most frequent risk factor was identified as surgical intervention history. While young age, transplantation and intravenous drug use were identified as risk factors for development of infection with non-1b genotypes, household HCV contact was significant for genotype 1b.
Conclusion: In our study, the dominant genotype was identified as genotype 1b. Among the risk factors in our study, the most frequently identified are surgical interventions and dental treatment. The variation in traditional risk factors will cause an increase in non-1b genotypes. We think it is important to correctly analyze these variations in the global struggle with HCV.
Supporting Institution
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
References
- Hanafiah KM, Groeger J, Flaxman AD, et al. Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatol. 2013; 57(4): 1333-42. doi: https://doi.org/10.1002/hep.26141.
- Kulik L, El-Serag HB. Epidemiology and Management of Hepatocellular Carcinoma. Gastroenterology. 2019; 156(2): 477 - 91.
doi: https://doi.org/10.1053/j.gastro.2018.08.065.
- Doszhan A, Bektaeva R, Doskali M. Liver transplantation in the Republic of Kazakhstan and abroad (history, state of the problem at the moment). J Clin Med Kaz. 2015; 3(37): 6-8.
- Kaito M, Watanabe S, Tsukiyama-Kohara K, et al. Hepatitis C virus particle detected by immuno electron microscopic study. J Gen Virol. 1994; 75: 1755 - 60. doi:https://doi.org/ 10.1099/0022-1317-75-7-1755.
- Simmonds P, Bukh J, Combet C, et al. Consensus proposals for a unified system of nomenclature of hepatitis C virus genotypes. Hepatol. 2005; 42: 962- 73. doi: https://doi.org/ 10.1002/hep.20819.
- Kamal SM, Nasser IA. Hepatitis C virus genotype 4: what we know and what we don’t yet know. Hepatol. 2008; 47: 1371- 83. doi:https://doi.org/ 10.1002/hep.22127.
- Nguyen MH, Keeffe EB. Prevalence and treatment of hepatitis C virus genotypes 4, 5, and 6. Clin Gastroenterol Hepatol. 2005; 3 (Suppl. 2): 97 -101. doi: https://doi.org/10.1016/s1542-3565(05)00711-1.
- Tosun S, Balık İ, Tabak F, et al. Evaluation of risk factors associated with HBsAg and Anti-HCV seropositivity: results of a nationwide population-based epidemiological survey study in Turkey. Mediterr J Infect Microb Antimicrob. 2018; 7: 34. doi:10.4274/mjima.2018.34.
- Caliskan A, Kirisci O, Ozkaya E, et al. Distribution and predominance of genotype 3 in hepatitis C virus carriers in the province of Kahramanmaras, Turkey. Hepat Mon. 2015; 15 (4): e25142-9. doi: https://doi.org/ 10.5812/hepatmon.15(4)2015.25142.
- Shalmani HM, Ranjbar M, Alizadeh AHM. Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease. J Liver. 2013; 3: 147. doi: https://doi.org/ 10.4172/2167-0889.1000147.
- Andalibalshohada A, Rezaei SA, Abedi F. HCV prevalence and predominant genotype in iv drug users. Rev Clin Med. 2014; 1 (4): 200 - 6.
- Jiménez-Macías FM, Cabanillas-Casafranca M, Maraver-Zamora M, et al. Experience in real clinical practice with new direct acting antivirals in chronic hepatitis C. Med Clin. (Barc) 2017; 149(9): 375-82. doi: https://doi.org/ 10.1016/j.medcli.2017.03.007.
- Petruzziello A, Marigliano S, Loquercio G, et al. Global epidemiology of hepatitis C virus infection: an up-date of the distribution and circulation of hepatitis C virus genotypes. World J Gastroenterol. 2016; 22(34): 7824-7840. doi:10.3748/wjg.v22.i34.7824
- Duran AÇ, Çetinkaya ÖK, Sayıner AA, et al. Changes on Hepatitis C Virus Genotype Distribution in Western Turkey: Evaluation of Twelve Year Data. Turk J Gastroenterol. 2020; 31(2): 128 - 35. doi:https://doi.org/10.5152/tjg.2020.18798
- Suntur BM, Kaya H, Sahin Eker HB, et al. A cross-sectional study of real life data of HCV from Turkey south region. J Infect Dev Ctries. 2020; 14 (4): 380 -86. doi: https://doi.org/10.3855/jidc.11983.
- Wong MCS, Huang JLW, George J, et al. The changing epidemiology of liver diseases in the Asia–Pacific region. Nat Rev Gastroenterology & Hepatol. 2019; 16: 57-73. doi: https://doi.org/ 10.1038/s41575-018-0055-0.
- Boglione L, Mornese Pinna S, De Nicolò A, et al. Treatment with direct‐acting antiviral agents of hepatitis C virus infection in injecting drug users: A prospective study. J Viral Hepat. 2017; 24: 850-57. doi: https://doi.org/ 10.1111/jvh.12711.
- Kulah C, Altindis M, Akyar I, et al. The Prevalence of Mixed Genotype Infections in Turkish Patients with Hepatitis C: a Multicentered Assessment. Clin Lab. 2019; 65(4): 485-90.
doi: https://doi.org/10.7754/Clin.Lab.2018.180824.
- Reid M, Price JC, Tien PC. Hepatitis C Virus Infection in the Older Patient. Infect Dis Clin North Am. 2017; 31 (4): 827- 38. doi:https://doi.org/ 10.1016/j.idc.2017.07.014.
- Gün R, Özbayraktar S, Köroğlu M, et al. Serotrends/Change in Blood Donor Screening Test Results According to Years; Thirteen Year Evaluation, Sakarya. Journal of BSHR 2017; 1(3): 83-87.
- Maan MA, Hussain F, Muhammad J. Epidemiology of hepatitis C viral infection in Faisalabad, Pakistan: a retrospective study (2010-2012). African Health Sciences. 2014; 14(4): 810-15
- Yildirim B, Tahan V, Ozaras R, et al. Hepatitis C virus risk factors in the Turkish community. Dig Dis Sci. 2005; 50: 2352- 5. doi:https://doi.org/ 10.1007/s10620-005-3061-3.
- Karaca C, Cakaloglu Y, Demir K, et al. Risk factors for the transmission of hepatitis C virus infection in the Turkish population. Dig Dis Sci. 2006; 51: 365-9. doi:https://doi.org/ 10.1007/s10620-006-3139-6.
- Grebely J, Larney S, Peacock A, et al. Global, regional, and country-level estimates of hepatitis C infection among people who have recently injected drugs. Addiction. 2019; 114(1): 150 - 66. doi: https://doi.org/ 10.1111/add.14393
- Bayomy Helal HE, Yuonis A, Shaker RHM,et al. Prevalence of HCV Infection in Household Contacts of Chronic Liver Diseases Cases in Egypt. J Environ Public Health. 2018; 24; 1-9. doi: https://doi.org/ 10.1155/2018/2153537.
- Minola E , Baldo V, Baldovin T, et al. Intrafamilial Transmission of Hepatitis C Virus Infection. Eur J Epidemiol. 2006; 21(4): 293-7. doi:https://doi.org/ 10.1007/s10654-006-0016-8.
- Jadoul M , Berenguer MC, Doss W, et al. Executive Summary of the 2018 KDIGO Hepatitis C in CKD Guideline: Welcoming Advances in Evaluation and Management. Kidney Int 2018; 94(4): 663- 73.
- Jadoul M, Bieber BA, Martin P, et al. Prevalence, incidence, and risk factors for hepatitis C virus infection in hemodialysis patients. Kidney International 2019; 95(4): 939-47.
- Süleymanlar G, Ateş K, Seyahi N. Registry of the Nephrology, Dialysis and Transplantation in Turkey registry 2018. Ankara, Turkey: Published by the Turkish Society of Nephrology, 2019; p. 29-128.
Kronik Hepatit C Enfeksiyonlu Hastalarda Genotip Dağılımı ve Risk Faktörleri
Year 2021,
, 50 - 56, 30.04.2021
Arzu Altunçekiç Yıldırım
,
Celali Kurt
,
Ali Seydi Alpay
,
Ahmet Doğan
Abstract
Amaç: Hepatit C virusu (HCV) enfeksiyonu tüm dünyada yaygın, önemli bir halk sağlığı sorunudur. HCV genotipinin belirlenmesi epidemiyolojik olarak ve tedavi yaklaşımının belirlenmesinde önemlidir. Bu çalışmada, Türkiye’nin kuzeyinde yer alan merkezimizde takip ettiğimiz hastalarda genotip dağılımının ve ilişkili risk faktörlerinin değerlendirilmesi amaçlanmıştır.
Yöntem: Çalışmamızda 2016-2019 yılları arasında Enfeksiyon Hastalıkları Polikliniğinde Kronik hepatit C tanısı almış ve doğrudan etkili antiviral tedavi uygulanmış 175 hasta retrospektif olarak değerlendirildi. Genotip dağılımı belirlenerek hastaların bulaş ve farklı genotipler açısından risk faktörleri analiz edildi.
Bulgular: Genotip 1b hakim genotip olarak saptandı (%95). % 5 hastada 1b dışı genotipler (genotip 1a, 3 ve mixt) mevcuttu. Genotip 1b, 50 yaş üstü hastalarda sık iken diğer genotiplere sahip hastalar daha gençti. Risk faktörü olarak en sık cerrahi girişim öyküsü tespit edildi. Genç yaş, transplantasyon ve damar içi uyuşturucu kullanımı 1b dışı genotip ile enfeksiyon gelişimi için risk faktörü olarak saptanırken, ev içi HCV teması genotip 1b için anlamlı bulundu.
Sonuç: Çalışmamızda hakim genotip, genotip1 b olarak saptanmıştır. Risk faktörleri arasında en sık tespit edilenler cerrahi müdahaleler ve dental girişim öyküsüdür. Geleneksel risk faktörlerindeki değişim 1b dışı genotiplerin artmasına yol açabilir. HCV ile küresel mücadelede bu değişimin doğru analiz edilmesinin önemli olduğunu düşünüyoruz.
References
- Hanafiah KM, Groeger J, Flaxman AD, et al. Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatol. 2013; 57(4): 1333-42. doi: https://doi.org/10.1002/hep.26141.
- Kulik L, El-Serag HB. Epidemiology and Management of Hepatocellular Carcinoma. Gastroenterology. 2019; 156(2): 477 - 91.
doi: https://doi.org/10.1053/j.gastro.2018.08.065.
- Doszhan A, Bektaeva R, Doskali M. Liver transplantation in the Republic of Kazakhstan and abroad (history, state of the problem at the moment). J Clin Med Kaz. 2015; 3(37): 6-8.
- Kaito M, Watanabe S, Tsukiyama-Kohara K, et al. Hepatitis C virus particle detected by immuno electron microscopic study. J Gen Virol. 1994; 75: 1755 - 60. doi:https://doi.org/ 10.1099/0022-1317-75-7-1755.
- Simmonds P, Bukh J, Combet C, et al. Consensus proposals for a unified system of nomenclature of hepatitis C virus genotypes. Hepatol. 2005; 42: 962- 73. doi: https://doi.org/ 10.1002/hep.20819.
- Kamal SM, Nasser IA. Hepatitis C virus genotype 4: what we know and what we don’t yet know. Hepatol. 2008; 47: 1371- 83. doi:https://doi.org/ 10.1002/hep.22127.
- Nguyen MH, Keeffe EB. Prevalence and treatment of hepatitis C virus genotypes 4, 5, and 6. Clin Gastroenterol Hepatol. 2005; 3 (Suppl. 2): 97 -101. doi: https://doi.org/10.1016/s1542-3565(05)00711-1.
- Tosun S, Balık İ, Tabak F, et al. Evaluation of risk factors associated with HBsAg and Anti-HCV seropositivity: results of a nationwide population-based epidemiological survey study in Turkey. Mediterr J Infect Microb Antimicrob. 2018; 7: 34. doi:10.4274/mjima.2018.34.
- Caliskan A, Kirisci O, Ozkaya E, et al. Distribution and predominance of genotype 3 in hepatitis C virus carriers in the province of Kahramanmaras, Turkey. Hepat Mon. 2015; 15 (4): e25142-9. doi: https://doi.org/ 10.5812/hepatmon.15(4)2015.25142.
- Shalmani HM, Ranjbar M, Alizadeh AHM. Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease. J Liver. 2013; 3: 147. doi: https://doi.org/ 10.4172/2167-0889.1000147.
- Andalibalshohada A, Rezaei SA, Abedi F. HCV prevalence and predominant genotype in iv drug users. Rev Clin Med. 2014; 1 (4): 200 - 6.
- Jiménez-Macías FM, Cabanillas-Casafranca M, Maraver-Zamora M, et al. Experience in real clinical practice with new direct acting antivirals in chronic hepatitis C. Med Clin. (Barc) 2017; 149(9): 375-82. doi: https://doi.org/ 10.1016/j.medcli.2017.03.007.
- Petruzziello A, Marigliano S, Loquercio G, et al. Global epidemiology of hepatitis C virus infection: an up-date of the distribution and circulation of hepatitis C virus genotypes. World J Gastroenterol. 2016; 22(34): 7824-7840. doi:10.3748/wjg.v22.i34.7824
- Duran AÇ, Çetinkaya ÖK, Sayıner AA, et al. Changes on Hepatitis C Virus Genotype Distribution in Western Turkey: Evaluation of Twelve Year Data. Turk J Gastroenterol. 2020; 31(2): 128 - 35. doi:https://doi.org/10.5152/tjg.2020.18798
- Suntur BM, Kaya H, Sahin Eker HB, et al. A cross-sectional study of real life data of HCV from Turkey south region. J Infect Dev Ctries. 2020; 14 (4): 380 -86. doi: https://doi.org/10.3855/jidc.11983.
- Wong MCS, Huang JLW, George J, et al. The changing epidemiology of liver diseases in the Asia–Pacific region. Nat Rev Gastroenterology & Hepatol. 2019; 16: 57-73. doi: https://doi.org/ 10.1038/s41575-018-0055-0.
- Boglione L, Mornese Pinna S, De Nicolò A, et al. Treatment with direct‐acting antiviral agents of hepatitis C virus infection in injecting drug users: A prospective study. J Viral Hepat. 2017; 24: 850-57. doi: https://doi.org/ 10.1111/jvh.12711.
- Kulah C, Altindis M, Akyar I, et al. The Prevalence of Mixed Genotype Infections in Turkish Patients with Hepatitis C: a Multicentered Assessment. Clin Lab. 2019; 65(4): 485-90.
doi: https://doi.org/10.7754/Clin.Lab.2018.180824.
- Reid M, Price JC, Tien PC. Hepatitis C Virus Infection in the Older Patient. Infect Dis Clin North Am. 2017; 31 (4): 827- 38. doi:https://doi.org/ 10.1016/j.idc.2017.07.014.
- Gün R, Özbayraktar S, Köroğlu M, et al. Serotrends/Change in Blood Donor Screening Test Results According to Years; Thirteen Year Evaluation, Sakarya. Journal of BSHR 2017; 1(3): 83-87.
- Maan MA, Hussain F, Muhammad J. Epidemiology of hepatitis C viral infection in Faisalabad, Pakistan: a retrospective study (2010-2012). African Health Sciences. 2014; 14(4): 810-15
- Yildirim B, Tahan V, Ozaras R, et al. Hepatitis C virus risk factors in the Turkish community. Dig Dis Sci. 2005; 50: 2352- 5. doi:https://doi.org/ 10.1007/s10620-005-3061-3.
- Karaca C, Cakaloglu Y, Demir K, et al. Risk factors for the transmission of hepatitis C virus infection in the Turkish population. Dig Dis Sci. 2006; 51: 365-9. doi:https://doi.org/ 10.1007/s10620-006-3139-6.
- Grebely J, Larney S, Peacock A, et al. Global, regional, and country-level estimates of hepatitis C infection among people who have recently injected drugs. Addiction. 2019; 114(1): 150 - 66. doi: https://doi.org/ 10.1111/add.14393
- Bayomy Helal HE, Yuonis A, Shaker RHM,et al. Prevalence of HCV Infection in Household Contacts of Chronic Liver Diseases Cases in Egypt. J Environ Public Health. 2018; 24; 1-9. doi: https://doi.org/ 10.1155/2018/2153537.
- Minola E , Baldo V, Baldovin T, et al. Intrafamilial Transmission of Hepatitis C Virus Infection. Eur J Epidemiol. 2006; 21(4): 293-7. doi:https://doi.org/ 10.1007/s10654-006-0016-8.
- Jadoul M , Berenguer MC, Doss W, et al. Executive Summary of the 2018 KDIGO Hepatitis C in CKD Guideline: Welcoming Advances in Evaluation and Management. Kidney Int 2018; 94(4): 663- 73.
- Jadoul M, Bieber BA, Martin P, et al. Prevalence, incidence, and risk factors for hepatitis C virus infection in hemodialysis patients. Kidney International 2019; 95(4): 939-47.
- Süleymanlar G, Ateş K, Seyahi N. Registry of the Nephrology, Dialysis and Transplantation in Turkey registry 2018. Ankara, Turkey: Published by the Turkish Society of Nephrology, 2019; p. 29-128.