Martinot-Peignoux M, Roudot-Thoraval F, Mendel I, Coste J, Izopet J, Duverlie G, Payan C, Pawlotsky J M, Defer C, Bogard M, Gerolami V, Halfon P, Buisson Y, Fouqueray B, Loiseau P, Lamoril J, Lefrere J J, Marcellin P
Unité de Recherche INSERM U481 and Centre de Recherche Claude Bernard sur les Hépatites Virales, Hôpital Beaujon, Clichy.
J Viral Hepat. 1999 Nov;6(6):435-43. doi: 10.1046/j.1365-2893.1999.00187.x.
The aim of this study was to investigate the following in a large population of French patients with chronic hepatitis C: the geographical distribution of hepatitis C virus (HCV) genotypes; the relationship between HCV genotypes and epidemiological characteristics; severity of the disease; and response to interferon (IFN) therapy. Data from 14 tertiary referral centres, corresponding to 1872 patients with chronic hepatitis C, were prospectively collected from 1989 to 1997. HCV genotyping was performed using the line probe assay (LiPA). HCV genotypes 1b, 3, 1a, 2, 4 and a mixed infection were found in 41%, 22%, 16%, 11%, 4% and 4% of our population, respectively. HCV genotype distribution was homogeneous, except for genotype 2 that was found more frequently in the southwest than in the other regions (21% vs 9.2%) (P=0.001). HCV distribution was associated with gender, age, and source and duration of infection. In multivariate analysis, these correlations were related to the source of infection, which was the only independent factor significantly associated with genotype (P=0.001). Genotype 1b was significantly more common in patients with cirrhosis, but in multivariate analysis cirrhosis was independently related to older age at exposure and longer duration of infection (P=0.001). A sustained response to IFN therapy was observed in 11% of patients infected with genotypes 1a or 1b vs 32% of those infected with genotypes 2 or 3 (P=0.001). This study shows that HCV genotype is mainly related to the source infection, but not to the intrinsic pathogenicity of HCV, and is a strong predictor of sustained response to therapy.
丙型肝炎病毒（HCV）基因型的地理分布；HCV基因型与流行病学特征之间的关系；疾病的严重程度；以及对干扰素（IFN）治疗的反应。1989年至1997年期间，前瞻性收集了来自14个三级转诊中心、共1872例慢性丙型肝炎患者的数据。采用线性探针分析法（LiPA）进行HCV基因分型。在我们的研究人群中，HCV基因型1b、3、1a、2、4和混合感染分别占41%、22%、16%、11%、4%和4%。HCV基因型分布是均匀的，但基因型2在西南部比其他地区更常见（21%对9.2%）（P = 0.001）。HCV分布与性别、年龄、感染源和感染持续时间有关。在多变量分析中，这些相关性与感染源有关，感染源是与基因型显著相关的唯一独立因素（P = 0.001）。基因型1b在肝硬化患者中明显更常见，但在多变量分析中，肝硬化独立与暴露时年龄较大和感染持续时间较长有关（P = 0.001）。11%感染基因型1a或1b的患者对IFN治疗有持续反应，而感染基因型2或3的患者中这一比例为32%（P = 0.001）。本研究表明，HCV基因型主要与感染源有关，而与HCV的内在致病性无关，并且是治疗持续反应的有力预测指标。
