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Global genotype distribution of hepatitis C viral infection among people who inject drugs.
Bielen R1,2, Robaeys G1,2,3, Azar DA2,3, Razavi H4, Nevens F3 1Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; 2Department of Gastro-Enterology and Hepatology, ZOL Genk, Belgium;
3Department of Gastro-Enterology and Hepatology, KULeuven, Belgium; 4Center for disease analysis, Louisville, USA
BACKGROUND AND OBJECTIVES
RESULTS
Hepatitis C viral infection (HCV) after injection drug use is very prevalent. The kind of genotype determines the response to treatment. Since People who inject drugs (PWID) are today the major risk group for HCV and to our knowledge no global systematic reviews on the worldwide genotype distribution of HCV genotypes in PWIDs have been published up to now, we conducted a systematic review on the global distribution of genotypes in PWIDs.
MATERIALS & METHODS
A systematic review was performed by using the keywords: Genotype, Hepatitis C, Injection drug user / Intravenous drug user / Substance user/ PWID, Name of countries in Pubmed, Embase and PsychInfo. The results were compared with the review of Gower et al. in 2014, concerning the distribution of HCV genotypes in the general HCV population. Data were graded according to the principles defined by Nelson et al in 2011*.
*Nelson PK, Mathers BM, Cowie B, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet 2011; 378(9791):
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403 articles
207 excluded based on title or abstract
196 full text recourses
64 articles excluded based on full text
- 24 No results of genotyping/no genotyping.
- 25 No results of genotyping among PWID only.
- 10 No specification between genotype subgroups.
- 2 Samples with age/gender restriction
- 3 Reports of regions, no data for countries only.
132 reports on genotyping of HCV among PWID*.
84 sources were graded lower or were within range but older, or with lower study population than sources used to generate estimates.
48 sources used to generate an estimation of the prevalence of the specific genotypes of HCV among PWID in 48 countries across 10 world regions.
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CONCLUSIONS
ACKNOWLEDGEMENTS
The most important genotype causing HCV infection in PWID globally is genotype 1, as is the case in the general population, but also genotype 3 is highly prevalent in PWID. Genotype 4 is most prevalent in Africa, spreading into Europe, whereas genotype 2 and 6 are more located in Asia. The most important difference comparing to the general population are generally lower prevalence of genotype 1b, and higher prevalence of genotype 3 in PWID. As the genotype nowadays still determines the treatment, and as there is a different genotype distribution than in the general population, it is important to identify the genotype also in PWID.
This study is part of the Limburg Clinical Research Program (LCRP) UHasselt-ZOL-Jessa, supported by the foundation Limburg Sterk Merk, province of Limburg, Flemish government, Hasselt University, Ziekenhuis Oost-Limburg and Jessa Hospital.
Contact Information
Rob Bielen, PhD student Gastro-Enterology/Hepatology
/32,15,60