Hepatitis C virus: epidemiology and genotypes in the north east of England.

Watson, John; Brind, AM; Chapman, CE; Bates, CL; Gould, F.K.; Johnson, SJ; Burt, Alastair D.; Ferguson, Joy; Simmonds, Peter; Bassendine, MF

doi:10.1136/gut.38.2.269

Cited by 65 publications

(45 citation statements)

References 33 publications

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“…We confirm that 1b is the most prevalent genotype among European donors [12]and patients [13], followed by 3a. We also found that IVDU and a history of blood transfusion are the main routes of HCV transmission, as observed in French studies [14, 15]and in other European countries [16, 17]. Genotype 1b seems to correlate with blood transfusion, and 1a and 3a strongly with IVDU [13, 18].…”

Section: Discussionsupporting

confidence: 49%

Hepatitis C Virus: Routes of Infection and Genotypes in a Cohort of Anti-HCV-Positive French Blood Donors

Elghouzzi¹,

Bouchardeau²,

Pillonel³

et al. 2000

Vox Sanguinis

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Background: We evaluated and analysed risk factors of HCV-infected blood donors according to HCV genotypes in order to improve the transfusion policy and safety of blood supply. Materials and Methods: HCV-RNA was analysed in sera from 518 anti-HCV-positive blood donors, who were invited to medical consultation and interview as to risk factors by means of an extensive questionnaire. HCV genotyping was done on all samples positive for HCV-RNA. Results: Of the 518 sera, 399 (77%) were HCV-RNA positive, and 394 of 399 HCV genotypes were identified. Major genotypes were 1b (34.3%), 3a (24%), 1a (19.5%) and 2 (11.4%). Of the donors, 289 (55.8%) were interviewed regarding their risk behaviour: 27% were former intravenous drug users (IVDUs), 26% had been transfused, 8% had a history of invasive diagnostic procedures, and 13% a history of surgery. Among the 224 interviewed donors, genotypes 1a and 3a were mainly associated with IVDU (51 and 45% respectively) and genotype 1b, with transfusion and nosocomial infections (40 and 25%, respectively). Conclusion: In this population of anti-HCV-positive blood donors, nosocomial infection may be a route of HCV spread, but the main risk factor remains IVDU, particularly in young men. The transfusion policy will improve if predonation interviews of such young men are done with a specific and sensitive questionnaire.

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Section: Discussionsupporting

confidence: 49%

Hepatitis C Virus: Routes of Infection and Genotypes in a Cohort of Anti-HCV-Positive French Blood Donors

Elghouzzi¹,

Bouchardeau²,

Pillonel³

et al. 2000

Vox Sanguinis

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“…1. The excess of clusters of genotype 1 is in accordance with the prevalence of HCV genotypes in the United Kingdom (21,25,44). The only exception was recipient 2 of cluster 3, whose genotype differed from the implicated donor and the other recipient in the cluster.…”

Section: Discussionmentioning

confidence: 52%

Evolutionary Rate and Genetic Drift of Hepatitis C Virus Are Not Correlated with the Host Immune Response: Studies of Infected Donor-Recipient Clusters

Allain¹,

Dong²,

Vandamme

et al. 2000

J Virol

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Six donor-recipient clusters of hepatitis C virus (HCV)-infected individuals were studied. For five clusters the period of infection of the donor could be estimated, and for all six clusters the time of infection of the recipients from the donor via blood transfusion was also precisely known. Detailed phylogenetic analyses were carried out to investigate the genomic evolution of the viral quasispecies within infected individuals in each cluster. The molecular clock analysis showed that HCV quasispecies within a patient are evolving at the same rate and that donors that have been infected for longer time tend to have a lower evolutionary rate. Phylogenetic analysis based on the split decomposition method revealed different evolutionary patterns in different donor-recipient clusters. Reactivity of antibody against the first hypervariable region (HVR1) of HCV in donor and recipient sera was evaluated and correlated to the calculated evolutionary rate. Results indicate that anti-HVR1 reactivity was related more to the overall level of humoral immune response of the host than to the HVR1 sequence itself, suggesting that the particular sequence of the HVR1 peptides is not the determinant of reactivity. Moreover, no correlation was found between the evolutionary rate or the heterogeneity of the viral quasispecies in the patients and the strength of the immune response to HVR1 epitopes. Rather, the results seem to imply that genetic drift is less dependent on immune pressure than on the rate of evolution and that the genetic drift of HCV is independent of the host immune pressure.Hepatitis C virus (HCV) causes persistent infection in a majority of infected individuals. Among the possible mechanisms explaining persistence are the relatively poor immunogenicity of the virus, particularly of the envelope glycoproteins; the low level of viremia outside the preseroconversion period; and the considerable variability of the viral genome, leading to substantial changes in the viral epitopes over time in the same individual (22,36). One of the main contributors to these genomic changes is the hypervariable region 1 (HVR1) located at the N terminus of the major envelope glycoprotein E2. Mutations in HVR1, which is critical for virus interaction with target cells (34, 48), produce escape mutants, a likely contributing factor to viral persistence (24,38,46).The host of HCV, primate or human, seems in most cases unable to generate an effective immune response, whether humoral, as levels of antibody to the E2 protein or HVR1 are typically low or undetectable, or cellular, as no evidence of a specific T-cell response to E2 epitopes has been provided (3,16,17,37). This feature was supported by data collected in vivo indicating that neither natural defenses nor passive immunotherapy was able to prevent reinfection of a chronically infected patient or animal with the same or related viruses (7,30).Some studies of HCV evolution over time, in the same infected individual or in different individuals infected with the same viral quasispecies...

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“…A study previously carried out in the North East of England in a predominantly Caucasian population revealed a mean age in cirrhotics of 60.7±12.5 years. 17 This may be due to an increased rate of infection in early childhood in Middle Eastern populations, whereas the English population studied may have been more likely to acquire the disease in adult life.…”

Section: Discussionmentioning

confidence: 94%

Hepatitis C Virus Genotypes in a Cohort of Middle Eastern Patients

Watson

Al-Mardini

Awadh³

et al. 1999

Ann Saudi Med

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Design and Methods: Serum from 81 Middle Eastern HCV ELISA-2-positive patients was analyzed for the presence of HCV RNA by PCR. RNA-positive patients were genotyped by selective hybridization of amplicons to HCV genotype-specific oligonucleotides (InnoLipa2, Innogenetics, Belgium). Where possible, data was also obtained on racial origin, liver histology, serum ALT, prothrombin time, albumin, and risk factors for infection. Results: Sixty-five of 81 patients were HCV RNA-positive. A higher proportion of Middle Eastern patients were genotype 4 compared to equivalent studies from Western Europe, USA and Japan. However, the most common genotype was la. No significant difference in genotype was found between patients with chronic hepatitis and patients with cirrhosis. Conclusions: Eight of 65 (12%) patients were genotype 4, but the most common genotype was la, a "Western" genotype (24/65, 37%). The mean age of cirrhotics was low compared to Western studies. This may be due to infection in early childhood or race-related host factors. Twelve of 65 patients (18%) were not classifiable for genotype using InnoLipa2. This may be due to multiple infecting genotypes in these patients, or unusual, non 1-3 HCV genotypes which cannot be classified by InnoLipa2.

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Hepatitis C virus: epidemiology and genotypes in the north east of England.

Cited by 65 publications

References 33 publications

Hepatitis C Virus: Routes of Infection and Genotypes in a Cohort of Anti-HCV-Positive French Blood Donors

Hepatitis C Virus: Routes of Infection and Genotypes in a Cohort of Anti-HCV-Positive French Blood Donors

Evolutionary Rate and Genetic Drift of Hepatitis C Virus Are Not Correlated with the Host Immune Response: Studies of Infected Donor-Recipient Clusters

Hepatitis C Virus Genotypes in a Cohort of Middle Eastern Patients

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