HEPATITIS C & GENOTYPES

Hepatitis C & Genotypes

Table of Contents

Chapter - I3

Introduction3

Collection of Serum Samples6

Hepatitis C Virus Genotyping6

Genotype distribution and epidemiological aspects10

Abbreviations18

References19

Chapter - I

Introduction

Hepatitis C virus (HCV) exhibits marked sequence heterogeneity. The six major genotypes, labeled, and numerous subtypes have been described, 1 with different geographical distribution. Genotypes 1b and 2 are widely distributed in southern Europe; 1a in the U.S. and Northern Europe, 3 in the Indian subcontinent and among drug abusers in Europe and type 4 in Africa and the Middle East. Several studies in adults in particular, assess the proposed role of genotype in the progression of liver disease and response to interferon (IFN) therapy. Infection with genotype 1, b was associated with greater risk of progression to cirrhosis and hepatocellular carcinoma, but these data are controversial. It was suggested that the severity of liver disease, possibly reflecting the longer-term infection, rather than the more aggressive form hepatitis.15 On the other hand, a correlation was found between hepatic steatosis and infection with the virus genotype 3, which could be responsible for liver damage by direct effects on hepatic lipid homeostasis. There is, instead, general agreement on the role of genotype as predictors of response to IFN, alone or in combination with ribavirin, high response rates reported in patients infected with genotypes 2 and 3.

Little is known about the genotypes of HCV in children, mainly because children are less often infected than adults. In Italy, the estimated prevalence of anti-HCV in the pediatric population was 0.3% in the early 1990's, thus, most pediatric studies were limited by small sample size. Nevertheless, childhood infections, HCV can be an interesting model to assess the role of the genotype because of the specific routes of infection, minor relevance of environmental cofactors of liver damage and clinical symptoms of liver disease is usually asymptomatic and mild liver injury, but with variable expression biochemical parameters. In this multicenter retrospective study, we describe the epidemiological and clinical features associated with different genotypes of HCV in a large series of HCV-infected children without major systemic diseases, consistently observed in 15 Italian centers between 1990 and 2002.

Research Design

This multicenter retrospective study was designed to investigate the HCV genotypes and related epidemiological and clinical features in a series of anti-HCV and HCV RNA-positive children in succession observed in 15 children and infectious diseases department between 1990 and 2002. These organizations participated in the "Italian Observatory for Hepatitis C in Children", created in 1998 Hepatologic of the Italian Society of pediatric gastroenterology and hepatology to condemn children infected with HCV.

Each of the specialized centers meet the following requirements: the transfer of stable throughout the study; usual study of HCV RNA in anti-HCV-positive children; HCV genotypes studied, at least two-thirds of viraemic patients, as well as the availability of baseline and follow-up clinical data on the basis of medical records of patients. None of the selected centers, managed hepatological population and only 2 studies were conducted of mother and child HCV transmission of one or two years during the last ...