Prevalence, Risk Factors and Clinical Characteristics in Patients with Genotype 6 Chronic Hepatitis C: A Single Institute Experience

Seung Kak Shin; Soo Yong Park; Young Kul Jung; Eui Joo Kim; Heon Nam Lee; Jong Joon Lee; Oh Sang Kwon; Duck Joo Choi; Yun Soo Kim; Ju Hyun Kim

doi:10.4166/kjg.2015.65.2.105

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Shin, Park, Jung, Kim, Lee, Lee, Kwon, Choi, Kim, and Kim: Prevalence, Risk Factors and Clinical Characteristics in Patients with Genotype 6 Chronic Hepatitis C: A Single Institute Experience

Original Article

Korean J Gastroenterol 2015;65(2):105-111.

Published online: 4 October 2015

DOI: https://doi.org/10.4166/kjg.2015.65.2.105

Prevalence, Risk Factors and Clinical Characteristics in Patients with Genotype 6 Chronic Hepatitis C: A Single Institute Experience

Seung Kak Shin, Soo Yong Park, Young Kul Jung¹, Eui Joo Kim, Heon Nam Lee, Jong Joon Lee, Oh Sang Kwon, Duck Joo Choi, Yun Soo Kim, Ju Hyun Kim

Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea

¹Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea

Correspondence to: Ju Hyun Kim, Department of Internal Medicine, Gachon University Gil Medical Center, 21, Namdone-daero 774 beon-gil, Namdong-gu, Incheon 405-760, Korea. Tel: +82-32-460-3778, Fax: +82-32-460-3408, E-mail: jhkim@gilhospital.com

Received 20 September 201421 November 2014 Accepted 24 November 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Hepatitis C genotypes 1 and 2 are widely distributed globally. In contrast, genotype 6 is found mainly in Southeast Asia, while genotype 6 is rare in Korea. This study aims to investigate the prevalence, risk factors and clinical characteristics of patients with genotype 6 chronic hepatitis C.

Methods

We retrospectively identified 133 HCV-infected patients who underwent HCV genotype analysis between January 2012 and December 2012, and analyzed the prevalence, risk factors and clinical characteristics of patients diagnosed with genotype 6 chronic hepatitis C.

Results

Among 133 patients, 53 patients (39.8%) were infected with genotype 1, 62 patients (46.6%) with genotype 2, 2 patients (1.5%) with genotype 3, 14 patients (10.5%) with genotype 6, and 2 patients (1.5%) with mixed genotypes (genotype 1 and 6). The risk factors associated with genotype 6 were acupuncture (n=4, 28.6%), intravenous drug use (n=3, 21.4%), tattoo (n=2, 14.3%), and transfusion (n=2, 14.3%). Of the 14 patients with genotype 6, 6 patients were treated with pegylated interferon and ribavirin. Five patients had reached the end of treatment. All patients reaching end of treatment for genotype 6 showed early virological response and sustained virological response.

Conclusions

The prevalence of genotype 6 is 10.5% and mixed infections of genotype 1 and 6 are 1.5% in patients with chronic hepatitis C. A major potential risk factor is intravenous drug use and the treatment response rate to pegylated interferon plus ribavirin is high in patients with genotype 6 chronic hepatitis C. Large scale multicenter studies are needed.

Keywords: Genotype 6, Hepatitis C, Prevalence, Risk factors, Treatment response

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Fig. 1.

Distribution of HCV genotypes.

Fig. 2.

Exposure to potential risk factors in patients with genotype 6 chronic hepatitis C.

Table 1.

Clinical Characteristics of Patients according to Genotype

Characteristic	Genoype 1 (n=53)	Genotype 2 (n=62)	Genotype 6 (n=14)	p-value
Sociodemographics
Age (yr)	52 (25–86)	50 (32–85)	42 (34–61)	0.109
Male	28 (52.8)	30 (48.4)	9 (64.3)	0.551
Diagnosis
Acute hepatitis	2 (3.8)	0	0	0.373
Chronic hepatitis	34 (64.2)	42 (67.7)	11 (78.6)	0.617
Liver cirrhosis	16 (30.2)	16 (25.8)	2 (14.3)	0.507
Hepatocellular carcinoma	6 (11.3)	6 (9.7)	1 (7.1)	0.999
Biochemistry
AST (IU/L)	58 (17–738)	69 (13–1,019)	88 (20–547)	0.143
ALT (IU/L)	60 (9–983)	45 (8–1,231)	104 (25–497)	0.046
Total bilirubin (mg/dL)	0.9 (0.4-6.3)	0.8 (0.2-17.3)	0.9 (0.6-2.9)	0.105
Albumin (g/dL)	4.2 (2.3-4.9)	4.2 (2.7-4.9)	4.3 (2.6-4.6)	0.875
Platelets ×1,000/μ L	195 (38–342)	188 (60–389)	145 (64–398)	0.572
INR	1.03 (0.90-2.12)	1.04 (0.86-1.52)	1.05 (0.95-2.60)	0.942
HCV RNA (IU/mL)	485,744 (494–7,393,532)	402,356 (163–8,497,182)	969,339 (31,423-6,258,764)	0.492

Values are presented as median (range) or n (%).

Table 2.

Treatment Results of Patients with Genotype 6 Chronic Hepatitis C

Patient	Age (yr)	Sex	Diagnosis	Regimen	Treatment duration (wk)	RVR	EVR	SVR
1	44	Male	LC	PegIFN α-2a+ribavirin	48	NC	Y	Y
2	49	Female	CH	PegIFN α-2a+ribavirin	48	N	Y	Y
3	40	Female	CH	PegIFN α-2b+ribavirin	48	N	Y	Y
4	34	Female	CH	PegIFN α-2a+ribavirin	48	N	Y	Y
5	38	Male	LC	PegIFN α-2a+ribavirin	48	Y	Y	Y
6	45	Male	CH	PegIFN α-2a+ribavirin	4	NC	NC	NC

RVR, rapid virological response; EVR, early virological response; SVR, sustained virological response; LC, liver cirrhosis; CH, chronic hepatitis; PegIFN, peginterferon; N, no; Y, yes; NC, not checked.

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