Chronic hepatitis C virus infections in Brazilian patients: association with genotypes, clinical parameters and response to long term alpha interferon therapy

Abstract

The present study assessed the clinical significance of hepatitis C virus (HCV) genotypes and their influence on response to long term recombinant-interferon-alpha (r-IFN-alpha) therapy in Brazilian patients. One hundred and thirty samples from patients previously genotyped for the HCV and with histologically confirmed chronic hepatitis C (CH-C) were evaluated for clinical and epidemiological parameters (sex, age, time of HCV infection and transmission routes). No difference in disease activity, sex, age or mode and time of transmission were seen among patients infected with HCV types 1, 2 or 3. One hundred and thirteen of them were treated with 3 million units of r-IFN-alpha, 3 times a week for 12 months. Initial response (IR) was significantly better in patients with genotype 2 (100%) and 3 (46%) infections than in patients with genotype 1 (29%) (p < 0. 005). Among subtypes, difference in IR was observed between 1b and 2 (p < 0.005), and between 1b and 3a (p < 0.05). Sustained response (SR) was observed in 12% for (sub)type 1a, 13% for 1b, 19% for 3a, and 40% for type 2; significant differences were found between 1b and 2 (p < 0.001), and between 1b and 3a (p < 0.05). Moreover, presence of cirrhosis was significantly associated with non response and response with relapse (p < 0.05). In conclusion, non-1 HCV genotype and lack of histological diagnosis of cirrhosis were the only baseline features associated with sustained response to treatment. These data indicate that HCV genotyping may have prognostic relevance in the responsiveness to r-IFN-alpha therapy in Brazilian patients with chronic HCV infection, as seen in other reports worldwide.

Chronic hepatitis C virus in the state of Piauí, northeastern Brazil

“…The mean age of our patients was about 48 years, similar to what has been described in other studies in Brazil [11,13,17,24,28]. There was no difference between mean ages in patients with genotypes 1 and 3 (48.0 and 47.7 years old, respectively), similar to what was found by Bassit et al in São Paulo [24].…”

“…There was no difference between mean ages in patients with genotypes 1 and 3 (48.0 and 47.7 years old, respectively), similar to what was found by Bassit et al in São Paulo [24]. In a survey from Bahia, the average age of the patients infected with genotype 3 was inferior to age of patients with genotype 1 (38 and 55 years, respectively) [12].…”

“…Other issues indicate a predominance of genotype 1 in Southeastern Region of Brazil [11,15,17,18,24,25]. Its prevalence is around 70.0% in the states of Rio de Janeiro and São Paulo, and 84.1% in Minas Gerais [18].…”

Viral Hepatitis C in a leading Brazilian hospital: epidemiological factors and genotyping

“…The genotype of the other nine samples could not be determined due to insufficient material. These data were similar to those previously found in Brazil, where genotype 1 is predominant (1,4,26,31,36). These data are in contrast to the genotype distribution observed by Busek et al (8) in a study conducted among ten patients from a haemodialysis centre, where there was a higher prevalence of genotype 3 followed by genotypes 1 and 2.…”

Cost-effective analysis of different algorithms for the diagnosis of hepatitis C virus infection

“…In these individuals, antibodies against some antigenic fractions have already turned negative for the IB test, but they are sufficient to yield ELISA-positive results (19,21); 3) individuals infected with genotype 3 or other uncommon genotypes that could have low reactivity to antigen fractions from genotype 1a used in most commercially available kits for anti-HCV. In this case, IB may be indeterminate but ELISA could be positive due to the reaction with better-preserved antigens such as core (22). 4) Other factors related to the kit performance (23) or to patient immunoresponse variability (24) may be involved.…”