Hepatitis C virus (HCV) genotypes in Spanish patients with HCV infection: relationship between HCV genotype 1b, cirrhosis and hepatocellular carcinoma

Background/Aims: The influence of the infecting virus genotype on the progression of the underlying liver disease in patients with chronic hepatitis C virus (HCV) infection remains controversial, The aim of this study was to investigate the prevalence of HCV genotypes in Spanish patients with chronic HCV infection and to elucidate the relationship between the infecting genotype and the severity of the disease. Methods: A cross-sectional, retrospective analysis of frequency distribution of HCV genotypes was carried out in 414 Spanish patients with chronic HCV infection, including 243 patients with asymptomatic or minimally symptomatic chronic hepatitis, 112 patients with cirrhosis and hepatocellular carcinoma and 59 patients with decompensated cirrhosis, HCV genotype was determined by restriction fragment length polymorphisms of the 5' non-coding region. Results: Infection with HCV genotype Ib was found in 72% of patients with chronic hepatitis and in more than 90% of patients,vith cirrhosis, with or without hepatocellular carcinoma, Older age, infection with genotype Ib and absence of overt parenteral exposure as a possible source of infection mere associated with cirrhosis and hepatocellular carcinoma by univariate analysis and this association was confirmed by regression analysis. Conclusions: HCV genotype Ib is associated with advanced liver disease in our geographical area, However, this mag be related to a cohort-effect caused by over-representation of genotype Ib in older patients with more advanced disease, because, in our country, this HCV genotype appeared earlier in time and is therefore associated with more prolonged periods of infection.