Serological, epidemiological and molecular aspects of hepatitis C virus infection in a population from Londrina, PR, Brazil, 2001-2002

Abstract

SUMMARYSerological, epidemiological and molecular aspects of hepatitis C virus (HCV) infection were evaluated in 183 subjects from Londrina, Paraná, Brazil, and adjacent areas. Serum samples which tested anti-HCV positive by microparticle enzyme immunoassay (MEIA) obtained from eight patients with chronic hepatitis C, 48 blood donors, and 127 patients infected with the human immunodeficiency virus (HIV) were submitted to another enzyme immunoassay (ELISA) and to the polymerase chain reaction (PCR). About 78.7% of samples were also reactive by ELISA, with the greater proportion (70.8%) of discordant results verified among blood donors. A similar finding was observed for HCV-RNA detection by PCR, with 111/165 (67.3%) positive samples, with higher rates among HIV-positive subjects and patients with chronic hepatitis than among blood donors. Sixty-one PCRpositive samples were submitted to HCV genotyping, with 77.1, 21.3 and 1.6% of the samples identified as types 1, 3 and 2, respectively. Finally, analysis of some risk factors associated with HCV infection showed that intravenous drug use was the most common risk factor among HIV/HCV co-infected patients, while blood transfusion was the most important risk factor in the group without HIV infection. The present study contributed to the knowledge regarding risk factors associated with HCV infection and the distribution of HCV genotypes in the population evaluated. KEYWORDS:Hepatitis C virus; Anti-HCV; Genotypes; Epidemiology. INTRODUCTIONAbout 170 million people all over the world are infected with hepatitis C virus (HCV), although many ignore such fact 30 . In most cases, the infection develops as an asymptomatic clinical picture but with severe consequences, since about 80% of the infected subjects develop chronic hepatitis, cirrhosis or hepatocellular carcinoma 16,28 .Co-infection of HCV-infected subjects with the human immunodeficiency virus (HIV) has important implications for the prognosis and management of both diseases. These subjects show elevated alanine aminotransferase levels and are at a higher risk of developing fibrosis, cirrhosis, liver failure or hepatocellular carcinoma than subjects infected only with HCV 6 ; in addition, they show a higher risk of developing hepatic toxicity related to the use of highly active antiretroviral therapy than patients infected only with HIV 5,26 .The use of the polymerase chain reaction (PCR) for the detection of HCV-RNA allows the identification of the presence of active HCV infection. However, RNA levels may show fluctuations with nondetectable periods even in patients not submitted to interferon therapy 7 .Patient counseling regarding the risk-benefit of treatment also requires analysis of a liver biopsy and the determination of the HCV genotype. Differences in the response to treatment depending on the HCV genotype have been observed, with type 1 being more resistant than types 2 and 3 19 . Genotyping based on the amplification of the 5' untranslated region (5'-UTR) has the advantage that it can be performed on PCR ...

Trends and projections of hepatitis C virus epidemiology in Latin America

“…There were multiple references reporting the genotype distribution in different populations (39,41,48,(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70). Among these studies, there were some consistent findings: G1 was the most frequent genotype in all regions, followed by G3.…”

High proportion of hepatitis C virus genotypes 1 and 3 in a large cohort of patients from Southern Brazil

“…In Brazil, several studies have been conducted to determine the distribution of HCV genotypes among different groups of individuals. Most of these studies have shown a predominance of genotype 1 (Krug et al 1996, Oliveira et al 1999, Paraná et al 2000, Busek & Oliveira 2002, Codes et al 2003, Vogler et al 2004, Martins et al 2006, Silva et al 2006. The aim of the present study was to determine with precision the frequency of each HCV genotype in the South of Brazil, by studying a large cohort of patients from Rio Grande do Sul (RS) and Santa Catarina (SC), the southernmost states of the country.…”

Hepatitis C virus infection among HIV‐1 infected individuals from northern Mexico

“…In this study we found that the prevalence of HCV among HIV‐infected patients was 12.1%, which is significantly higher than comparable levels for the general population (0.7%) 20 in Mexico. However, it was lower then the prevalence reported in other American countries such as the USA (35%), Argentina (58.5%) and Brazil (52%) 14,15,21,22 …”

“…However, it was lower then the prevalence reported in other American countries such as the USA (35%), Argentina (58.5%) and Brazil (52%). 14,15,21,22 In the studied group the most frequent genotype was 1a (41%), followed by genotype 1b (29.4%), 2a/c (17.6%), 2b (5.9%) and 3 (5.9%). The genotype pattern observed followed reports from other regions of Mexico, North America and South American countries where genotype 1 (including subtype 1a and 1b) is highly prevalent, followed by genotypes 2 and 3, and other genotypes are less frequent.…”