New Epidemiologic Data Regarding Hepatitis C Virus Infection in Romania
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Mircea Manuc1, Carmen M. Preda1, Corneliu P. Popescu2, Cristian Baicuș3, Theodor Voiosu3, Corina S. Pop4, Liana Gheorghe1, Ioan Sporea5, Anca Trifan6, Marcel Tanțău7, Alina Tanțău8, Emanoil Ceaușu2, Doina Proca1, Ileana Constantinescu1, Simona M. Ruta2, Larisa E. Fulger1, Mircea Diculescu1, Alexandru Oproiu9
1) Gastroenterology and Hepatology Dept., Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest;
2) Virology Dept., Victor Babes Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest;
3) Internal Medicine Dept., Colentina Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest;
4) Gastroenterology Dept., Emergency Universitary Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest;
5) Gastroenterology and Hepatology Dept., Timisoara Emergency Hospital, University of Medicine and Pharmacy, Timișoara;
6) Gastroenterology and Hepatology Dept., Gastroenterology and Hepatology Institute, Gr. T. Popa University of Medicine and Pharmacy, Iași;
7) Regional Institute of Gastroenterology and Hepatology, and Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca;
8) 4th Medical Clinic, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca;
9) Dept. Gastroenter, Agrippa Ionescu Hospital, Bucharest, Romania
Background & Aims: Literature data suggest that HCV genotype-1b is present in 93-99% of the Romanian patients infected with hepatitis C virus (HCV). We present the genotyping tests recently performed on patients with HCV and advanced fibrosis eligible for the Direct-Acting Antiviral (DAA) therapy, as well as the prevalence of these cases across Romania.
Methods: The genotyping method was performed on 7,421 HCV patients with advanced fibrosis. The detection method was automatic real time PCR platform M2000 (Abbott). Every subject was introduced into a database including age, sex, county and address.
Results: Genotype 1b was almost exclusively present: 7,392/7,421 (99.6%). Genotype 1b patients were 19.6% from Bucharest, 49% were males, with a median age of 60 years. Genotype non-1b was encountered in 29/7,421 subjects (0.4%), 62% were males, 69% from Bucharest and the median age was 52 years. Most of the subjects (75%) were in the 6th and 7th age decade. The prevalence of these cases varied significantly across Romanian counties: the highest was in Bucharest (61.3/105), Bihor (47/105), Iasi (46/105) and Constanța (43/105), and the lowest in Ilfov (2.8/105), Harghita (3.7/105), Covasna (5.4/105) and Maramureș (8.8/105) (p<0.001).
Conclusions: Genotype 1b is encountered in 99.6% of patients with chronic hepatitis C and advanced fibrosis from Romania. The presence of genotypes non-1b is more common in Bucharest, in males and at a younger age. There are significant differences regarding the distribution of these cases across Romania: the highest rates are in Bucharest, Bihor, Iasi and Constanta.
Key words: liver cirrhosis – hepatitis C virus (HCV) – epidemiology – direct-acting antiviral agents – DAA.
Abbreviations: BMI: body mass index; DAA: direct-acting antiviral agent; GT: genotype; HBV: hepatitis B virus; HCC: hepatocellular carcinoma; HCV: hepatitis C virus; IDU: intravenous drug users; MELD: model for end stage liver disease; NASH: non-alcoholic steatohepatitis; SVR; sustained virologic response.