Ruta Simona, Sultana Camelia, Oprea Cristiana, Vagu Codruta, Ceausu Emanoil, Cernescu Costin
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
J Infect Dev Ctries. 2016 May 31;10(5):523-7. doi: 10.3855/jidc.7019.
Chronic hepatitis C cases diagnosed in Romania were mostly related to unsafe parenteral treatments and blood transfusions; HCV genotype 1b was prevalent. During the last decade, an increasing number of HCV infections was reported among people who inject drugs (PWID). The aim of the current study was to test if this epidemiological shift triggered a diversification of the circulating viral strains.
HCV genotypes were determined by reverse hybridization in 130 HCV-infected PWID (87.7% males; mean age 27.9 ± 6.7 years, injecting drugs for 8.1 ± 4.8 years).
HIV-HCV co-infection was diagnosed in 80.8% of the subjects and 26.9% were HIV-HCV-HBV triple infected. Active HCV viral replication was present in 104 PWID (80%), more frequently in those HIV-co-infected (91.4% vs. 52% in HCV mono-infected, and 77.148.5% in HIV-HCV-HBV triple-infected, p = 0.0001). Non-1b genotypes were prevalent (54.8%), with subtype 1a the most commonly detected (24%), followed by genotypes 3a (14.4%) and 4 (7.7%). Mixed infections with genotypes 1a and 1b were found in nine subjects (8.7%). There was no difference in the genotypes frequencies based on HIV or HBV co-infection status, length of drug usage, or associated risk factors (tattoos, piercing, detention).
The continuous surveillance of HCV genotypes in PWID from Romania will add valuable information to the overall European epidemiological picture, with important therapeutic implications.
罗马尼亚诊断出的慢性丙型肝炎病例大多与不安全的非肠道治疗和输血有关；丙型肝炎病毒1b基因型较为普遍。在过去十年中，注射毒品者（PWID）中报告的丙型肝炎病毒感染病例不断增加。本研究的目的是检验这种流行病学转变是否引发了流行病毒株的多样化。
通过反向杂交法对130名丙型肝炎病毒感染的注射毒品者（87.7%为男性；平均年龄27.9±6.7岁，注射毒品8.1±4.8年）进行丙型肝炎病毒基因型测定。
80.8%的受试者被诊断为艾滋病毒-丙型肝炎病毒合并感染，26.9%为艾滋病毒-丙型肝炎病毒-乙型肝炎病毒三重感染。104名注射毒品者（80%）存在活跃的丙型肝炎病毒复制，在合并感染艾滋病毒的患者中更为常见（分别为91.4%、丙型肝炎病毒单一感染患者中的52%以及艾滋病毒-丙型肝炎病毒-乙型肝炎病毒三重感染患者中的77.1%对48.5%，p = 0.0001）。非1b基因型较为普遍（54.8%），其中1a亚型最常被检测到（24%），其次是3a基因型（14.4%）和4基因型（7.7%）。9名受试者（8.7%）发现1a和1b基因型的混合感染。基于艾滋病毒或乙型肝炎病毒合并感染状态、吸毒时间或相关危险因素（纹身、穿孔、拘留），基因型频率没有差异。
对罗马尼亚注射毒品者的丙型肝炎病毒基因型进行持续监测，将为整个欧洲的流行病学情况增添有价值的信息，具有重要的治疗意义。
