Risk factors of hepatitis C virus transmission and genotype distribution in former blood donors from Chinese rural area

Abstract

BackgroundIllegal commercial plasma and blood donation activities in the late 1980s and early 1990s caused a large number of hepatitis C virus (HCV) infections in rural areas of China. In the present study, we aimed to elucidate the risk factors of HCV RNA positivity and HCV genotype distribution in former blood donors.MethodsA cross-sectional survey was carried out in a former blood donation village in rural Hebei Province, North China. All residents were invited for a questionnaire interview and testing for HCV antibodies as well as HCV nucleic acids. Questionnaires were administered to collect information about their personal status and commercial blood donation history. Nested PCR was used to amplify HCV nucleic acids in C/E1 region and NS5b region followed by genotyping and phylogenetic analysis. Univariate and multivariate logistic regression were used to analyze the distributions of HCV genotypes in different groups.ResultsA total of 512 blood samples were collected. Anti-HCV positive were 148 (28.5%) whereas RNA positive rate was 13.87%. Residents between 50 and 59 years old had the highest RNA positive rate (27/109, 24.77%) (P = 0.0051). Multivariate logistic regression model analysis revealed that plasma donation (OR = 8.666, 95% CI: 1.390-54.025) was the dominant risk factor of HCV infection. Furthermore, HCV subtypes 1b and 2a were found by genotyping and phylogenetic analysis. 36 samples (53.73%) were subtype 1b and 31 samples (46.27%) were subtype 2a.ConclusionsUnsafe practices during illegal plasma donation led to a high risk of HCV infection. The identification of genotypes 1b and 2a as major HCV genotypes circulating in this region may help to predict the future burden of HCV related diseases and facilitate better medical treatment towards HCV carriers. These results are useful for public healthcare as well as disease control and surveillance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1535-6) contains supplementary material, which is available to authorized users.

Genotype and genetic variation of HCV infections with low-risk factors in Putian coastal regions, China

“…The sequences of the 5′ UTR fragment were aligned with reference sequences from the GenBank database (https://www.ncbi.nlm.nih.gov/nucleotide) using ClustalX v1•8•31. A phylogenetic tree was constructed according to the neighbour-joining method using DIVEIN (PhyML 3•0) and MEGA 4 [15].…”

“…Additionally, HCV exhibits enormous genetic diversity and a high degree of genetic similarity, which can be used to determine the individual HCV isolates of various subtypes [13]. Genotyping is useful for investigating infection outbreaks and for improving the general understanding of the epidemiological and virological features of HCV infection [14,15] [3]. They also studied the global HCV epidemiology using available data published between 2000 and 2015 from 138 countries (approximately 90% of the global population), revealing that genotypes 1 (49•1%) and 3 (17•9%) were common worldwide, followed by genotypes 4 (16•8%) and 2 (11•1%), while genotypes 5 and 6 together represented <5% [16].…”

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

“…The “golden age” of uncontrolled HCV transmission took place before the 1990s in China. In the late 1980s and early 1990s, illegal blood collection and donation greatly promoted the spread of HCV genotypes 1 and 2 . In 1979, the Chinese government first opened its borders to trade and tourism after 40 years of relative isolation, which also created favorable conditions for drug smuggling and the consequent diffusion of genotypes 3 and 6.…”

“…In the late 1980s and early 1990s, illegal blood collection and donation greatly promoted the spread of HCV genotypes 1 and 2. 16 In 1979, the Chinese government first opened its borders to trade and tourism after 40 years of relative isolation, 17 which also created favorable conditions for drug smuggling and the consequent diffusion of genotypes 3 and 6. In 1998, mandatory HCV screening of blood and blood products was implemented in China, changing the predominant mode of HCV transmission from direct contact with human blood to intravenous and percutaneous drugs used gradually.…”

Molecular surveillance of HIV, HBV, and HCV amongst blood donors in five Chinese regions

“…The distribution of HCV genotypes is closely related to the modes of HCV acquisition (13). In the late 1980s and early 1990s in China, illegal blood collection and donation greatly promoted the spread of HCV genotype 1 and 2 (14). In 1998, mandatory HCV screening of blood and blood products was implemented in China, gradually changing the predominant mode of HCV transmission from direct contact with human blood to intravenous and percutaneous drugs used (15).…”