Hepatitis C Virus in mainland China with an emphasis on genotype and subtype distribution

Abstract

Due to the low fidelity of the RNA-dependent RNA polymerase, Hepatitis C virus (HCV) mutates quite frequently. There are seven genetically divergent genotypes (GTs) distributed in the world, each of which contains several closely related subtypes. The peer-reviewed literatures reporting the prevalence rate of HCV GTs in Chinese hospitalized patients were identified by systematic searching of three electronic databases, and the prevalence rates were pooled through 137 qualified studies. The significant difference between HCV GT and HCV viral load and severity of hepatitis were analyzed under Chi-squared or Fisher’s exact test. Data from epidemiological studies on hospitalized patients demonstrated that HCV GTs 1–6 have been found in China, of which 1b (62.78%(95% CI: 59.54–66.02%)) and 2a (17.39% (95% CI: 15.67–19.11%)) are the two predominant subtypes. HCV GTs and subtypes exhibits significant regional divergence. In North, Northwest, Northeast, East (except Jiangxi province) and Central China (except Hunan province), HCV-1b, 2a remain the two predominant subtypes; South China shows the most abundant genetic diversity that 14 subtypes were found, and HCV-3 in the Southwest China remains higher prevalent subtype than the other regions. In addition, co-infection in Liaoning province of Northeast China is the most diverse with 10 co-infection types, and Tibet has the highest rate of co-infection. The associations between HCV GTs and patients group, severity of illness and antiviral treatment efficacy were also discussed in this review.

A cross‐sectional serum investigation of a clustering hepatitis C virus infection in Southwest China

“…Envelope sequence analysis showed that HCV 1b and 3b subtypes were the dominant epidemic genotypes in this crowd. Both genotypes were also the major HCV genotypes prevailing in southwestern China …”

“…Both genotypes were also the major HCV genotypes prevailing in southwestern China. 6 It has been confirmed that the clustering HCV infection was caused by needle sharing in a rural clinic in the 1990s. This The HCV antibody positive rate in tested adult female sera was as high as 41.2%, of which 72.7% were also HCV RNA positive.…”

The nationwide distribution and trends of hepatitis C virus genotypes in mainland China

“…We have observed that the frequency of HCV subtypes in the southern and southwestern regions has undergone an important change in the last three decades, and the prevalence of genotypes 3 and 6 in these regions was much higher than in other regions after 2010, which could be a result of the unique geographical location, changing routes of HCV transmission and increasing population mobility. [28][29][30] Some southwestern provinces, especially Yunnan and Guangxi, are adjacent to the "Golden Triangle," an area overlapping the mountains of three countries (Myanmar, Laos, and Thailand) and regarded as one of Asia's two main opium-producing areas. These provinces have become critical transferring stations for drug trafficking from the "Golden Triangle" to China since the 1980s.…”

<p>A Single- and Multiple-Dose Study to Evaluate the Pharmacokinetics of Fixed-Dose Grazoprevir/Elbasvir in Healthy Chinese Participants</p>

“…2,3 Epidemiologic studies have indicated that HCV genotype 1 is the most common genotype in Chinese patients, although there is a wide diversity across the country. 4,5 The mainstay of treatment in China is pegylated interferon and ribavirin (PEG-IFN/RBV), but both sofosbuvir and the combinations of daclatasvir/asunaprevir, ombitasvir, paritaprevir/ritonavir/dasabuvir, and sofosbuvir/velpatasvir have also received approvals. [6][7][8][9][10][11][12] Another direct-acting antiviral agent (DAA) is the fixeddose combination of elbasvir (EBR) and grazoprevir (GZR), approved in the United States, Europe, and Canada for the treatment of HCV genotype 1 and 4 infection, in Japan for the treatment of HCV genotype 1 infection, and in Canada for use in combination with sofosbuvir for the treatment of HCV genotype 3 infection.…”