Influence of different hepatitis C virus genotypes on the course of asymptomatic hepatitis C virus infection

Background & Aims: The association of liver disease with hepatitis C virus (HCV) genotypes mainly refers to patients with serious liver damage; little information is available on symptomless carriers, The aim of this study was to investigate the correlation of genotypes with clinical course, risk factors for infection, and antibody to HCV reactivity in asymptomatic subjects. Methods: One hundred nine viremic blood donors with at least 1 year of follow-up were studied; 41 underwent liver biopsy. Genotypes were determined by line-probe assay, Results: Genotype 1 was found in 47 (43.1%), genotype 2 in 48 (44%), genotype 3 in 8 (7.3%), genotype 4 in 2 (1.8%), and coinfections in 4 (3.7%). The relative risk (RR) for a raised pattern of alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyltranspeptidase was 2.1 (confidence interval [Cl], 1.4-3.2), 1.7 (Cl, 1.2-2.4), and 2.8 (Cl, 1.6-4.9) in subjects with genotype 1 vs. 0.4 (Cl, 0.2-0.7), 0.4 (Cl, 0.3-0.7), and 0.4 (Cl, 0.2-0.8) in subjects with genotype 2. Chronic hepatitis was found in 68%; the RR of chronic hepatitis was similar for genotypes 1 and 2 (RR, 1.1 [Cl, 0.8-1.7] vs. RR, 1.0 [Cl, 0.7-1.6]). Reactivity to NS4-derived antigens was infrequent in type 2-infected subjects. Conclusions: Genotype 2 was as frequent as genotype 1 but associated with less liver function impairment. The high prevalence of chronic hepatitis should be considered in counseling viremic asymptomatic donors.