Titre : | Molecular epidemiology of hepatitis C infection in U.S. veteran liver transplant recipients: evidence for decreasing relative prevalence of genotype 1B |
Titre traduit : | (Epidémiologie moléculaire de l'infection par hépatite C chez des vétérans américains bénéficiaires d'une transplantation de foie : baisse relative de la prévalence du génotype 1B) |
Auteurs : | H. R. ROSEN ; S. CHOU ; SASAKI A. W. ; GRETCH D. P. |
Type de document : | Périodique |
Année de publication : | 1999 |
Format : | 3015-3019 / fig. ; tabl. |
Note générale : |
American Journal of Gastroenterology (The), 1999, 94, (10), 3015-3019 |
Langues: | Français |
Discipline : | MAL (Maladies infectieuses / Infectious diseases) |
Mots-clés : |
Thésaurus mots-clés GREFFE ; FOIE ; HEPATITE ; ENQUETE ; EPIDEMIOLOGIE ; CONDUITE A RISQUE ; GENETIQUEThésaurus géographique ETATS-UNIS |
Résumé : |
ENGLISH : OBJECTIVE: The U.S. Veteran population represents a unique patient group to study different HCV genotypes because of geographically diverse exposures. The aim of this study was to characterize the distribution of HCV genotypes in U.S. veterans undergoing liver transplantation (OLT), trace genotypes to modes of acquisition (risk behavior and location), and evaluate the relative prevalence of HCV genotypes according to the time of acquisition. METHODS: Between 10/88 and 12/95, 110 primary OLTs were performed in U.S. Veterans at our center. Forty-nine (45%) patients had detectable HCV-RNA by PCR at the time of OLT. Determination of HCV genotypes was performed by restriction fragment length polymorphism of the 5' noncoding region and classified according to Simmonds et al. RESULTS: Twenty-three of 49 (47%) veterans had 1a, 17 (35%) 1b, two (4%) 2a, three (6%) 2b, two (4%) 3a, two (4%) mixed (1a/2a, 1b/2a). This distribution of HCV genotypes was comparable to the genotypic distribution of a contemporary cohort of nonveteran OLT recipients at the University of Washington. There was a statistically significant association between illicit injection drug use (IDU) and 1a, with 63% of 1a patients having IDU whereas only 14% of 1b patients admitted to IDU (p = 0.03). All patients in whom the mode of acquisition was unknown had genotype 1b (p = 0.04). Intranasal cocaine use was strongly correlated with IDU (p = 0.002). Patients who had tattoos but no history of blood transfusion (BT) or recreational drug use had genotype 1 (2 had 1a, 2 had 1b; p = NS). Twenty-two (45%) patients had serological evidence of prior hepatitis B (HBV) infection. Patients who had genotype 2a, 2b, 3a, or mixed were much more likely to have had HBV (seven of nine, 78%) than patients with genotype 1a or 1b (15 of 40, 37.5%) (p = 0.03). There was no significant correlation between BT, dates, or military branch of service, high risk behavior in Southeast Asia, level of education, ethnicity, and particular genotype(s). Whereas the proportion of 1b accounting for HCV infection in patients with a first exposure before 1968 was 50%, all patients with a first exposure post-1975 were non-1b (p = 0.04), suggesting a change in the epidemiology of HCV in our cohort. CONCLUSIONS: In U.S. Veterans undergoing OLT: 1) 45% had PCR-confirmed HCV infection, 2) 1a was the predominant genotype and was associated with IDU, and 3) a significant decrease in the prevalence of genotype 1b from the pre-Vietnam era to post-1975 suggests a changing epidemiology of HCV genotypes. (Review' s abstract) |
Note de contenu : | fig. ; tabl. |
Domaine : | Drogues illicites / Illicit drugs |
Refs biblio. : | 29 |
Affiliation : |
Division of Gastroenterology/Hepatology, Oregon Health Sciences Univ., Portland Veterans Affairs Medical Center, 3710 SW US Veterans Hospital Rd, PO Box 1034, P3-GI Portland OR 97207 Etats-Unis. United States. |
Numéro Toxibase : | 1300788 |
Centre Emetteur : | 13 OFDT |
Cote : | A01498 |
Exemplaires
Disponibilité |
---|
aucun exemplaire |
Accueil