Aim: To investigate the HCV genotype distribution in Romania in the first national study, to establish the correlations with epidemiological, biochemical, virological and histological features and to compare our results with those from neighboring countries.
Patients and methods: Two distinct groups of patients and two methods were used: 153 patients in the frame of ACHIEVE study with genotyping and subtypes determination (Versant HCV genotype 2.0 assay) and 461 patients in the frame of an Epidemiological National Multicenter Study having only genotype determination with a commercial kit (Roche Molecular System). Epidemiological, biochemical, virological and histological features were investigated only in the ENMS group.
Results: Genotype 1b was found in 93.46% (ACHIEVE study) and genotype 1 (without subtype identification) in 99.13% of patients (ENMS study). Percutaneous routes of transmission were found in 85.9% of cases. The prevalence of HCV infection increased with age. A high viral load (> or = 600,000 IU/ml) was found in 67.9% of patients, especially those older than 40 years. Significant fibrosis > or = F2 was present in patients older than 40 years (70.9%). There were no correlations between HCV-RNA levels and histological features or between ALT levels and METAVIR activity or fibrosis scores. A similar homogeneity of HCV genotype distribution has been reported for Moldavia (96%) and Hungary (94.5%).
Conclusions: Type 1 HCV genotype was found almost exclusively in Romanian patients with chronic hepatitis C by two different methods of investigation. The pattern showed by this distribution in Romania and some neighboring countries suggests an epidemic profile of HCV infection.