Hepatitis C virus type 1b (II) infection in France and Italy. Collaborative Study Group

Ann Intern Med. 1995 Feb 1;122(3):161-8. doi: 10.7326/0003-4819-122-3-199502010-00001.


Objective: To analyze the distribution of hepatitis C virus (HCV) genotypes among patients positive for antibody to HCV (anti-HCV) according to age, severity of liver disease, and duration of infection; to investigate the influence of HCV genotypes on response to interferon-alpha therapy; and to study HCV viremia levels in relation to genotypes and severity of liver disease.

Design: Cross-sectional study.

Setting: 3 university hospitals and 2 research units.

Patients: 3 groups of French and Italian patients with chronic HCV infection and detectable serum HCV RNA: Group 1 included 35 patients with hepatocellular carcinoma; group 2, 71 patients with cirrhosis who did not have hepatocellular carcinoma; and group 3, 114 patients with chronic active hepatitis. 106 of the patients with chronic hepatitis or cirrhosis were treated with interferon-alpha (3 MU subcutaneously 3 times/wk for > or = 6 months).

Measurements: Genotyping by polymerase chain reaction with capsid-specific primers; serum HCV RNA by branched DNA (bDNA) signal amplification.

Results: Hepatitis C virus genotype 1b (II) was the most prevalent genotype (61.8%). In a univariate analysis, it was associated with older age (< 40 years, 47.4%; > or = 60 years, 80.4%; P = 0.001), longer duration of disease (< or = 10 years, 40.4%; > or = 20 years, 86.7%; P = 0.005), and cirrhosis with or without hepatocellular carcinoma (78.4% compared with 53.8% for chronic hepatitis; P < 0.001). Viremia levels did not differ between patients infected with HCV type 1b (II) and those infected with other HCV genotypes. Patients with HCV type 1b (II) responded to interferon-alpha therapy significantly less than did patients with other HCV genotypes (P = 0.01). In a multivariate analysis, age and cirrhosis were independently associated with HCV genotype 1b (II). Genotype and HCV viremia level were independent predictors of response to interferon-alpha therapy.

Conclusions: The prevalence of HCV genotypes in French and Italian patients has been changing; the prevalence of HCV type 1b (II) infection has progressively decreased, although it still accounts for most HCV-related cirrhosis and hepatocellular carcinoma. High HCV viremia levels and HCV genotype type 1b (II) are independent predictors for poor response to interferon-alpha therapy and should be considered in the management of patients with HCV infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Carcinoma, Hepatocellular / virology
  • Cross-Sectional Studies
  • Female
  • France / epidemiology
  • Genotype
  • Hepacivirus / genetics*
  • Hepacivirus / isolation & purification
  • Hepatitis C / drug therapy
  • Hepatitis C / epidemiology*
  • Hepatitis C / virology
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use
  • Italy / epidemiology
  • Liver Cirrhosis / virology
  • Liver Neoplasms / virology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • RNA, Viral / blood
  • Recombinant Proteins
  • Retrospective Studies
  • Time Factors
  • Viremia / drug therapy
  • Viremia / epidemiology
  • Viremia / virology


  • Interferon alpha-2
  • Interferon-alpha
  • RNA, Viral
  • Recombinant Proteins