Kaiser Permanente Division of Research, Oakland, California 94612, USA.
J Med Virol. 2012 Nov;84(11):1744-50. doi: 10.1002/jmv.23399.
Hepatitis C virus (HCV) genotypes influence response to therapy, and recently approved direct-acting antivirals are genotype-specific. Genotype distribution information can help to guide antiviral development and elucidate infection patterns. HCV genotype distributions were studied in a diverse cross-section of patients in the Northern California Kaiser Permanente health plan. Associations between genotype and race/ethnicity, age, and sex were assessed with multivariate logistic regression models. The 10,256 patients studied were median age 56 years, 62% male, 55% White non-Hispanic. Overall, 70% were genotype 1, 16% genotype 2, 12% genotype 3, 1% genotype 4, <1% genotype 5, and 1% genotype 6. Blacks (OR 4.5 [3.8-5.5]) and Asians (OR 1.2 [1.0-1.4]) were more likely to have genotype 1 than 2/3 versus non-Hispanic Whites. Women less likely had genotype 1 versus 2/3 than did men (OR 0.86 [0.78-0.94]). Versus non-Hispanic Whites, Asians (OR 0.38 [0.31-0.46]) and Blacks (OR 0.73 [0.63-0.84]) were less likely genotype1a than 1b; Hispanics (OR 1.3 [1.1-1.5]) and Native Americans (OR 1.9 [1.2-2.8]) more likely had genotype 1a than 1b. Patients age ≥65 years less likely had genotype 1a than 1b versus those age 45-64 (OR 0.34 [0.29-0.41]). The predominance of genotype 1 among all groups studied reinforces the need for new therapies targeting this genotype. Racial/ethnic variations in HCV genotype and subtype distribution must be considered in formulating new agents and novel strategies to successfully treat the diversity of hepatitis C patients.
丙型肝炎病毒 (HCV) 基因型影响治疗反应，最近批准的直接作用抗病毒药物是针对特定基因型的。基因型分布信息可以帮助指导抗病毒药物的开发，并阐明感染模式。本研究在加利福尼亚州北部 Kaiser Permanente 健康计划的不同患者群体中研究了 HCV 基因型分布。使用多变量逻辑回归模型评估了基因型与种族/民族、年龄和性别之间的关联。研究的 10256 名患者的中位年龄为 56 岁，62%为男性，55%为白种非西班牙裔。总体而言，70%为基因型 1，16%为基因型 2，12%为基因型 3，1%为基因型 4，<1%为基因型 5，1%为基因型 6。与非西班牙裔白人相比，黑人和亚洲人更有可能患有基因型 1（比值比[OR] 4.5 [3.8-5.5]）和基因型 1（OR 1.2 [1.0-1.4]）。与男性相比，女性患基因型 1 的可能性低于基因型 2/3（OR 0.86 [0.78-0.94]）。与非西班牙裔白人相比，亚洲人（OR 0.38 [0.31-0.46]）和黑人（OR 0.73 [0.63-0.84]）基因型 1a 的可能性低于基因型 1b；西班牙裔（OR 1.3 [1.1-1.5]）和美洲原住民（OR 1.9 [1.2-2.8]）更有可能患有基因型 1a 而不是 1b。与 45-64 岁的患者相比，年龄≥65 岁的患者基因型 1a 的可能性低于基因型 1b（OR 0.34 [0.29-0.41]）。在所有研究的人群中，基因型 1 的优势强调了需要针对这种基因型开发新的治疗方法。在制定新的药物和新的策略以成功治疗不同的丙型肝炎患者时，必须考虑 HCV 基因型和亚型分布的种族/民族差异。
