Clinical–liver, pancreas, and biliary tractHepatitis C Virus Genotypes and Viral Concentrations in Participants of a General Population Survey in the United States
Section snippets
Study Population
HCV RNA–positive persons were identified from among HCV antibody (anti-HCV)–positive participants in the Third National Health and Nutrition Examination Survey (NHANES III) conducted during 1988 to 1994.6 This survey used a stratified multistage sampling design to produce a representative sample of the civilian noninstitutionalized population in the 50 states. Information collected from each participant included demographic, socioeconomic, and limited risk factor histories. The design, sampling
Results
Of the 284 HCV RNA–positive samples, 275 had a positive amplicon generated from the NS5b region. When compared by pairwise analysis, the frequency distribution of the evolutionary distances of the NS5b region grouped into 3 nonoverlapping clusters, corresponding to genotypes (or clades), subtypes of genotypes, and individual variants within a subtype (data not shown). Genotype was determined for all 275 specimens; 1a was found in 142 specimens, 1b in 73, 2a in 8, 2b in 27, 3a in 17, 4 in 3, and
Discussion
Despite the changing patterns of HCV transmission during the past 20–30 years in the United States,15 most HCV infections are the same genotype, genotype 1, regardless of the population studied.16, 17, 18, 19, 20, 21 However, there appears to have been a temporal shift in the transmission of the subtypes of genotype 1, as indicated in this study by the predominance of genotype 1a compared with genotype 1b overall, and particularly among younger persons. Several studies from Western Europe where
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