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Hepatitis C virus genotypes in Serbia and Montenegro: The prevalence and clinical significance
作者姓名:Svirtlih N  Delic D  Simonovic J  Jevtovic D  Dokic L  Gvozdenovic E  Boricic I  Terzic D  Pavic S  Neskovic G  Zerjav S  Urban V
作者单位:Institute for Infectious Diseases Clinical Centre of Serbia Belgrade Serbia,Institute for Infectious Diseases Clinical Centre of Serbia Belgrade Serbia,Institute for Infectious Diseases Clinical Centre of Serbia Belgrade Serbia,Institute for Infectious Diseases Clinical Centre of Serbia Belgrade Serbia,Institute for Infectious Diseases Clinical Centre of Serbia Belgrade Serbia,Institute for Infectious Diseases Clinical Centre of Serbia Belgrade Serbia,Institute for Pathology Medical Faculty University of Belgrade Serbia,Clinical Centre of Podgorica Montenegro,General Hospital Uzice Serbia,Institute for Nuclear Sciences Vinca Serbia,Institute for Infectious Diseases Clinical Centre of Serbia Belgrade Serbia,Medical Faculty University of Belgrade Serbia
摘    要:AIM: To investigate the prevalence of hepatitis C virus (HCV) genotypes in Serbia and Montenegro and their influence on some clinical characteristics in patients with chronic HCV infection. METHODS: A total of 164 patients was investigated. Complete history, route of infection, assessment of alcohol consumption, an abdominal ultrasound, standard biochemical tests and liver biopsy were done. Gene sequencing of 5' NTR type-specific PCR or commercial kits was performed for HCV genotyping and subtyping. The SPSS for Windows (version 10.0) was used for univariate regression analysis with further multivariate analysis.
RESULTS: The genotypes 1, 2, 3, 4, 1b3a and 1b4 were present in 57.9%, 3.7%, 23.2%, 6.7%, 6.7% and 1.8% of the patients, respectively. The genotype 1 (mainly the subtype 1b) was found to be independent of age in subjects older than 40 years, high viral load, more severe necro-inflammatory activity, advanced stage of fibrosis, and absence of intravenous drug abuse. The genotype 3a was associated with intravenous drug abuse and the age below 40. Multivariate analysis demonstrated age over 40 and intravenous drug abuse as the positive predictive factors for the genotypes lb and 3a, respectively.
CONCLUSION: In Serbia and Montenegro, the genotypes 1b and 3a predominate in patients with chronic HCV infection. The subtype lb is characteristic of older patients, while the genotype 3a is common in drug abusers. Association of the subtype lb with advanced liver disease, higher viral load and histological activity suggests earlier infection with this genotype and eventually its increased pathogenicity.

关 键 词:丙型肝炎  病毒  基因型  治疗方法  致病性
收稿时间:2006 Sep 22

Hepatitis C virus genotypes in Serbia and Montenegro: the prevalence and clinical significance
Svirtlih N,Delic D,Simonovic J,Jevtovic D,Dokic L,Gvozdenovic E,Boricic I,Terzic D,Pavic S,Neskovic G,Zerjav S,Urban V.Hepatitis C virus genotypes in Serbia and Montenegro: the prevalence and clinical significance[J].World Journal of Gastroenterology,2007,13(3):355-360.
Authors:Svirtlih Neda  Delic Dragan  Simonovic Jasmina  Jevtovic Djordje  Dokic Ljubisa  Gvozdenovic Eleonora  Boricic Ivan  Terzic Dragic  Pavic Sladjana  Neskovic Gorana  Zerjav Sonja  Urban Vladimir
Institution:1. Institute for Infectious Diseases, Clinical Centre of Serbia, Belgrade, Serbia
2. Institute for Pathology Medical Faculty University of Belgrade, Serbia
3. Clinical Centre of Podgorica, Montenegro
4. General Hospital, Uzice, Serbia
5. Institute for Nuclear Sciences, Vinca, Serbia
6. Medical Faculty University of Belgrade, Serbia
Abstract:AIM To investigate the prevalence of hepatitis C virus(HCV) genotypes in Serbia and Montenegro and their influence on some clinical characteristics in patients with chronic HCV infection.METHODS A total of 164 patients was investigated.Complete history, route of infection, assessment of alcohol consumption, an abdominal ultrasound, standard biochemical tests and liver biopsy were done. Gene sequencing of 5' NTR type-specific PCR or commercial kits was performed for HCV genotyping and subtyping. The SPSS for Windows (version 10.0) was used for univariate regression analysis with further multivariate analysis.RESULTS The genotypes 1, 2, 3, 4, 1b3a and 1b4 were present in 57.9%, 3.7%, 23.2%, 6.7%, 6.7% and 1.8%of the patients, respectively. The genotype 1 (mainly the subtype 1b) was found to be independent of age in subjects older than 40 years, high viral load, more severe necro-inflammatory activity, advanced stage of fibrosis,and absence of intravenous drug abuse. The genotype 3a was associated with intravenous drug abuse and the age below 40. Multivariate analysis demonstrated age over 40 and intravenous drug abuse as the positive predictive factors for the genotypes 1b and 3a, respectively.CONCLUSION Tn Serbia and Montenegro, the genotypes 1b and 3a predominate in patients with chronic HCV infection. The subtype 1b is characteristic of older patients, while the genotype 3a is common in drug abusers. Association of the subtype 1b with advanced liver disease, higher viral load and histological activity suggests earlier infection with this genotype and eventually its increased pathogenicity.
Keywords:Hepatitis C virus  Genotypes  Prevalence  Serbia  Montenegro
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