A recent article (Hepatology 2014; 59: 2403-12) notes a changing perception for Hepatitis C (HCV) genotype 3. Previously, HCV genotype 3 was considered easy-to-treat with pegylated interferon and ribavirin. Along with genotype 2, treatment for genotype 3 was given for half the duration as treatment for genotype 1; in addition, the response was much better than genotype 1 (~70-80% compared with ~50%).
With new treatments, the situation has changed. In the U.S., genotype 1 accounts for about 70% of all infections and worldwide about 60% of all HCV infections. In contrast, genotype 3 accounts for 10-15% of the world HCV reservoir.
Specific problems (alluded to by the authors) with genotype 3:
- Increased steatosis
- Increased liver fibrosis progression
- Increased risk of hepatocellular carcinoma (HCC)
- Increased risk of end-stage liver disease
- Reduced sustained virological response (SVR) after direct-acting antiviral therapies
While the newest therapies have dramatically increased SVR rates for genotype 1 and improved treatment for genotype 2, this is not the case with genotype 3 thus far. Instead of being a good genotype, genotype 3 is now a villain.
Another article provides additional data on HCV genotype 3 (Hepatology 2014; 60: 98-105). In this study of U.S. Veterans with HCV (n=110,484), there were 8,337 with genotype 3. In this group, despite being younger, they had a higher risk of cirrhosis (HR 1.40) and hepatocellular carcinoma (HCC) (HR 1.66) in comparison to HCV genotype 1.
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- HCV Website -No “Cat on The Roof” | gutsandgrowth -discusses new HCVguidelines website
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- Wiping out Hepatitis C | gutsandgrowth