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Hepatitis C virus (HCV) shows considerable variation in its genomic structure, allowing classification into six main genotypes. Epidemiological studies have shown marked differences in genotype distribution by geographical region, and between patient groups. Improved understanding of the rate of nucleotide sequence mutation in HCV has allowed the approximate time of divergence of major genotypes to be estimated, and the origin and spread of the present epidemic of hepatitis C to be better defined. Improved methods of genotype definition over the last few years have enabled the importance of genotype in the progression of HCV-related disease and response to anti-viral therapy to be studied. Present data strongly indicates that HCV genotype is an important determinant of response to treatment, but the effect of genotype on disease progression has been harder to clarify. This is largely due to the absence of model systems of HCV infection, the epidemiological differences in patient groups infected with the different genotypes, and the lack of good prospective longitudinal clinical data. As a result of advances in methodology, and recent results of large clinical trials of combination therapy, a knowledge of HCV genotype is now central to the clinician in the management of patients with chronic hepatitis C.

Original publication

DOI

10.1053/bega.1999.0072

Type

Journal article

Journal

Bailliere's best practice & research. Clinical gastroenterology

Publication Date

04/2000

Volume

14

Pages

229 - 240

Addresses

Centre for Hepatology, Department of Medicine, Royal Free and University College Medical School, London, UK.

Keywords

Humans, Hepacivirus, Hepatitis C, Interferon Type I, Recombinant Proteins, RNA, Viral, Ribavirin, Antiviral Agents, Incidence, Genotype, Global Health