Ramos Belén, Núñez Marina, Toro Carlos, Sheldon Julie, García-Samaniego Javier, Ríos Pilar, Soriano Vincent
Department of Infectious Diseases, Hospital Carlos III, Calle Sinesio Delgado 10, 28029 Madrid, Spain.
J Infect. 2007 Feb;54(2):173-9. doi: 10.1016/j.jinf.2006.02.006. Epub 2006 Mar 29.
Changes in the prevalence of distinct hepatitis C virus (HCV) genotypes and subtypes over time have not been explored in detail.
A retrospective analysis was carried out in all specimens from subjects with chronic hepatitis C sent for testing to a reference laboratory in Spain since 1998-2004.
A total of 1226 distinct subjects were analyzed. The most frequent HCV genotype was 1 (64.1%), followed by 3 (20.9%) and 4 (11.7%). The most frequent HCV subtype was 1b (32.4%). A total of 797 patients (65%) were HIV-positive. Although genotype 1 was the most frequent, it represented 74.6% of HIV-negative and 58.5% of HIV-positive patients (p<0.01). While HCV subtype 1a was the most frequent among HIV-positive subjects (32.1%), 1b was the most common in HIV-negative patients (53.8%). There was a significant increase in the prevalence of genotype 4 and conversely a decline in genotype 3 among HIV-positive patients over time.
Genotype 1 is the most frequent HCV variant circulating in Spain. Genotypes 3 and 4 are significantly more prevalent in HIV/HCV-coinfected than in HCV-monoinfected patients. However, HCV-3 has declined and HCV-4 is increasing in the former group. These findings are relevant given their different susceptibility to interferon-based therapies.
不同丙型肝炎病毒（HCV）基因型和亚型的流行率随时间的变化尚未得到详细研究。
对1998年至2004年期间送往西班牙一家参考实验室进行检测的慢性丙型肝炎患者的所有标本进行回顾性分析。
共分析了1226名不同的受试者。最常见的HCV基因型是1型（64.1%），其次是3型（20.9%）和4型（11.7%）。最常见的HCV亚型是1b型（32.4%）。共有797名患者（65%）为HIV阳性。虽然1型是最常见的基因型，但在HIV阴性患者中占74.6%，在HIV阳性患者中占58.5%（p<0.01）。虽然HCV 1a亚型在HIV阳性受试者中最常见（32.1%），但1b型在HIV阴性患者中最常见（53.8%）。随着时间的推移，HIV阳性患者中4型基因型的流行率显著增加，相反，3型基因型的流行率下降。
1型是西班牙流行的最常见HCV变异株。3型和4型基因型在HIV/HCV合并感染患者中的流行率明显高于HCV单一感染患者。然而，在前一组中，HCV-3型有所下降，HCV-4型正在增加。鉴于它们对基于干扰素的治疗的不同敏感性，这些发现具有重要意义。
