Temporal dynamics of hepatitis C genotypes in a five-year hospital-based surveillance in Northern Italy

Abstract

Hepatitis C virus (HCV) genotypes have became important epidemiological markers in the management of HCV-infected subjects and infection treatment. The dynamics of HCV genotypes are changing in Europe. During a five-year (2009-2013) hospital-based surveillance in the area of Parma, Northern Italy, serum/plasma samples from 1,265 HCV RNA-positive subjects were genotyped. Subtypes 1b, 3a, and 1a were predominant (32.6 %, 19.1 %, and 17.8 %, respectively), with a correlation between viral load and gender. Subtypes 1a and 3a were more frequent in adults and males with a significant difference with the over-50 age group and females (P > 0.0001). Subtype 1b, as well as 2a/2c and G2 not-subtypeable (15.7 % and 7.2 %, respectively), were more common in females and in the over-50 age group compared to males (P < 0.0001, P < 0.0001, and P < 0.05, respectively) and the under-50 age group (P < 0.0001). While subtype 1b showed a nearly constant trend, subtype 1a peaked in 2012, when a consistent decrease in G2 was observed. The increasing detection of G4, mainly in adults, and subtypes 1a and 3a suggests their epidemiological relevance in the population. The detection of more than one HCV genotype in the same sample (0.2 %) and different genotypes in distant samples (5.1 %) from the same subject reinforces the opinion that re-infection and super-infection with different genotypes are not negligible events, especially in HIV-infected subjects. The dynamics of HCV genotypes could have significant implications for infection control.

Nine-year distribution pattern of hepatitis C virus (HCV) genotypes in Southern Italy

“…On the other hand, genotypes 1a and 3a, considerably less common in our area (2.6 and 3.2%, respectively), compared to data from other regions of Italy [41] exhibit a drastic decrease during the nine studied years (-5.3% and -3.6%, respectively), even though these data could be modified by the “not further classified” genotype 1* whose classification is still unclear. Regarding genotype 4, recently documented in some Mediterranean countries, such as Albania, Spain and Greece [46–48] and probably related to migratory flows from Middle Eastern countries and Northern Africa, its presence do not seems to be relevant in our area, at least until 2014, showing a stable prevalence in the three periods studied.…”

“…Our data seems to suggest some interesting changes in the epidemiology of HCV genotypes in Southern Italy over the nine years. Genotype 1b is historically the most prevalent, both in Southern Italy and throughout the whole Italy [18,40–41] and still remains so (54.4%), followed by genotype 2a/2c (28.7%) that however shows a marked increase from 2006–2008 to 2012–2014 (+7.0%). It is likely that the migration fluxes from Balkan area to Italy may have caused an increase prevalence of genotype 2 in the Southern Italy [17].…”

Younger trend of cirrhosis incidence in genotype 3 HCV infected patients in Eastern China

“…The geographical distribution and genetic diversity of HCV is constantly evolving. Studies from Italy reveal a temporal dynamic trend of HCV GTs . In China, the diversity of HCV GTs has undergone great changes, especially in certain areas and among specific populations .…”

“…Studies from Italy reveal a temporal dynamic trend of HCV GTs. [10][11][12][13] In China, the diversity of HCV GTs has undergone great changes, especially in certain areas and among specific populations. [14][15][16][17][18][19] Therefore, it is necessary to maintain continuous surveillance of HCV GTs for both prevention and management of HCV.…”