Aguilera A, Navarro D, Rodríguez-Frias F, Viciana I, Martínez-Sapiña A M, Rodríguez M J, Martró E, Lozano M C, Coletta E, Cardeñoso L, Suárez A, Trigo M, Rodríguez-Granjer J, Montiel N, de la Iglesia A, Alados J C, Vegas C, Bernal S, Fernández-Cuenca F, Pena M J, Reina G, García-Bujalance S, Echevarria M J, Benítez L, Pérez-Castro S, Ocete D, García-Arata I, Guerrero C, Rodríguez-Iglesias M, Casas P, García F
Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain.
Hospital Universitari Vall d'Hebron, Barcelona, Spain.
J Viral Hepat. 2017 Sep;24(9):725-732. doi: 10.1111/jvh.12700. Epub 2017 Apr 10.
We report the largest study on the prevalence and distribution of HCV genotypes in Spain (2000-2015), and we relate them with clinical, epidemiological and virological factors. Patients from 29 hospitals in 10 autonomous communities (Andalusia, Aragon, Castilla-Leon, Catalonia, Galicia, Canary Islands, Madrid Community, Valencian Community, Murcia Region and Basque Country) have been studied. Annual distribution of HCV genotypes and subtypes, as well as gender, age, transmission route, HIV and/or HBV coinfection, and treatment details were recorded. We included 48595 chronically HCV-infected patients with the following characteristics: median age 51 years (IQR, 44-58), 67.9% male, 19.1% HIV-coinfected, 23.5% HBV-coinfected. Parenteral transmission route was the most frequent (58.7%). Genotype distribution was 66.9% GT1 (24.9% subtype 1a and 37.9% subtype 1b), 2.8% GT2, 17.3% GT3, 11.4% GT4 and 0.1% GT5 and 0.02% GT6. LiPA was the most widely HCV genotyping test used (52.4%). HCV subtype 1a and genotypes 3 and 4 were closely associated with male gender, parenteral route of infection and HIV and HBV coinfection; in contrast, subtype 1b and genotype 2 were associated with female gender, nonparenteral route and mono-infection. Age was related to genotype distribution, and different patterns of distribution and biodiversity index were observed between different geographical areas. Finally, we describe how treatment and changes in transmission routes may have affected HCV genotype prevalence and distribution patterns. We present the most recent data on molecular epidemiology of hepatitis C virus in Spain. This study confirms that genotype distributions vary with age, sex, HIV and HBV coinfection and within geographical areas and epidemiological groups.
我们报告了西班牙规模最大的关于丙型肝炎病毒（HCV）基因型流行率和分布情况的研究（2000 - 2015年），并将其与临床、流行病学和病毒学因素相关联。对来自10个自治区（安达卢西亚、阿拉贡、卡斯蒂利亚 - 莱昂、加泰罗尼亚、加利西亚、加那利群岛、马德里自治区、巴伦西亚自治区、穆尔西亚地区和巴斯克地区）29家医院的患者进行了研究。记录了HCV基因型和亚型的年度分布情况，以及性别、年龄、传播途径、HIV和/或HBV合并感染情况和治疗细节。我们纳入了48595例慢性HCV感染患者，其具有以下特征：年龄中位数为51岁（四分位间距，44 - 58岁），男性占67.9%，HIV合并感染占19.1%，HBV合并感染占23.5%。经肠外途径传播最为常见（58.7%）。基因型分布为：66.9%为基因1型（GT1，24.9%为1a亚型，37.9%为1b亚型），2.8%为基因2型（GT2），17.3%为基因3型（GT3），11.4%为基因4型（GT4），0.1%为基因5型（GT5），0.02%为基因6型（GT6）。线性探针分析（LiPA）是使用最广泛的HCV基因分型检测方法（52.4%）。HCV 1a亚型以及基因3型和4型与男性、经肠外感染途径以及HIV和HBV合并感染密切相关；相反，1b亚型和基因2型与女性、非肠外途径以及单一感染相关。年龄与基因型分布有关，不同地理区域观察到不同的分布模式和生物多样性指数。最后，我们描述了治疗和传播途径的变化可能如何影响HCV基因型的流行率和分布模式。我们展示了西班牙丙型肝炎病毒分子流行病学的最新数据。这项研究证实，基因型分布因年龄、性别、HIV和HBV合并感染情况以及地理区域和流行病学群体的不同而有所差异。
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