They are in effect different kinds of hepC - from different parts of the globe and thus being different have different characteristics and cause and effect and that is why some are harder to treat than others. In Egypt geno 4 is the most common for example.............here with us in the US it's geno 1 = same disease but different strains of the virus with different properties to go along with them.
That's the way I've always looked at it in English. I can't understand all the scientific mumbo jumbo though - but thats my take on it in easy to read Debbyspeak.
Hepatitis C Classification
Although discovering the root of someone’s liver disease as Hepatitis C is a task in and of itself, there is much more differentiation required to properly address this virus. As of late 2007, the number of known genotypes for Hepatitis C (the genetic make-up of the virus) grew from six to seven distinct viruses. In addition to being classified by genotype, there are over 50 known subtypes of Hepatitis C. As of the end of December 2007, the newly acknowledged genotype 7 has been associated with three separate subtypes.
Hepatitis C genotypes are most common in the following locations:
· Genotypes 1, 2 and 3 = North America and Western Europe
· Genotype 4 = Africa, Egypt and the Middle East, but is increasingly seen in some parts of Europe
· Genotype 5 = Africa and the Middle East
· Genotype 6 = Southeast Asia
· Genotype 7 = Central Africa
In order to prescribe a treatment plan with the highest chances of success, a person must have their particular Hepatitis C genotype and subtype identified. Additionally, knowing the exact strain of Hepatitis C virus is helpful in defining its epidemiology. Once the genotype is identified, it need not be tested again; genotypes do not change during the course of infection.
While the therapeutic responses between Hepatitis C subtypes are not disclosed here, some of the differences among genotypes include:
1. Those with genotypes 2 and 3 are almost three times more likely than patients with genotype 1 to respond to therapy with alpha interferon or the combination of alpha interferon and ribavirin.
2. A 24-week course of combination treatment is typically adequate for those with genotypes 2 and 3.*
3. A 48-week course of combination treatment is typically adequate for those with genotype 1.*
4. Data are mixed concerning genotype 4, though its response to combination treatment seems to be somewhere in between the response of genotypes 2 and 3, and genotype 1.
5. Recently published research on treating genotype 5 shows that its response to combination treatment is similar to those with genotype 1. However, previous results show that genotype 5 appears to be an easy to treat virus with response rates similar to those of genotypes 2 and 3 after a 48-week course of therapy.
6. Preliminary study results show that the response to treatment in those with genotype 6 lies at an intermediate level, between that seen with genotype 1 and genotypes 2 or 3.
7. Since it has just recently been discovered as having a distinct genetic make-up, the response to standard combination therapy is not yet established for genotype 7.
*Although some studies claim this duration of time to be ‘typically adequate,’ other trials have demonstrated that longer courses of treatment have lower relapse rates.
Our understanding of the various strains of the Hepatitis C virus is exponentially greater than the knowledge of viral hepatitis just a few decades ago. As more specificity about each type of viral infection is discerned, treatment approaches can be individually tailored. The one-size-fits-all method of prescribing medications is continually shown to be outdated, causing our medical practices to become more advanced. Accompanying this more advanced evolution of infectious hepatology, people fighting Hepatitis C stand their best chance ever of ridding themselves of their particular viral strain.
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