Aa
Genotype 3 Treatment
We now know that geno 3 should not be treated like geno 2. Someone (sorry, I cannot remember who) on this forum gave me this valuable information, according to latest studies of:
Columbia University, MD, special research for G3
NOT UND at W 4 48 weeks tx
High VL UND at W 4 36 weeks tx
Low VL UND at W 4 24 weeks tx
If anyone has more information and experience treating genotype 3, I would be very thankful to hear about it.
Marcia
Columbia University, MD, special research for G3
NOT UND at W 4 48 weeks tx
High VL UND at W 4 36 weeks tx
Low VL UND at W 4 24 weeks tx
If anyone has more information and experience treating genotype 3, I would be very thankful to hear about it.
Marcia
or even a large portion of the HCV community obtained the virus through IVDU.
I just don't believe that.
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Oh I do. The stats for IVDU are just too high.
I think more of it is from the medical treatments people have obtained
----------------------------------------
I also think that IVDU gets the blame for a lot of medical transmission.
Saves a lot of money and red faces, saying you got it from IVDU and not medical treatment.
CS
I just don't believe that.
----------------------------------------
Oh I do. The stats for IVDU are just too high.
I think more of it is from the medical treatments people have obtained
----------------------------------------
I also think that IVDU gets the blame for a lot of medical transmission.
Saves a lot of money and red faces, saying you got it from IVDU and not medical treatment.
CS
Steatosis is associated with G3a. Dont need any other risk factors for it.
Other 3 subtypes are also prone to it but not to the same extent.
Us 3s are lucky re the Fatty Liver It goes away with successful Tx.
It does slow down the viral kinetics somewhat though.
Thanks for clarification. 1a & 3a can be caught in a number of ways. IVDU just being one.
It was more about genotype distrubition changing and its being blamed on drug use.
CS
Other 3 subtypes are also prone to it but not to the same extent.
Us 3s are lucky re the Fatty Liver It goes away with successful Tx.
It does slow down the viral kinetics somewhat though.
Thanks for clarification. 1a & 3a can be caught in a number of ways. IVDU just being one.
It was more about genotype distrubition changing and its being blamed on drug use.
CS
The study came up as pdf file straight from your link. Very interesting!
It is a little contradictory to the suggestion of the Columbia University MD, suggesting to treat 36 weeks for High VL, if UND at week 4. it does suggest to prolong tx in certain cases, but unfortunately doesn't mention any time frames. Obviously they are still treading in muddy waters, concerning 'custom tx' for geno 3s. Considering dosing of meds, the studies done in Italy, could probably not really be applied to the US, as ppl are generally smaller in Italy. It could be applied to me, as I am about average Italian size.
Anyway, i will hopefully get a biopsy soon and then will be able to put down all the data and discuss how to attack this dragon.
Marcia
It is a little contradictory to the suggestion of the Columbia University MD, suggesting to treat 36 weeks for High VL, if UND at week 4. it does suggest to prolong tx in certain cases, but unfortunately doesn't mention any time frames. Obviously they are still treading in muddy waters, concerning 'custom tx' for geno 3s. Considering dosing of meds, the studies done in Italy, could probably not really be applied to the US, as ppl are generally smaller in Italy. It could be applied to me, as I am about average Italian size.
Anyway, i will hopefully get a biopsy soon and then will be able to put down all the data and discuss how to attack this dragon.
Marcia
Just wanted to comment on a few things.
Distribution of certain genotypes in IV drug users. This does not mean that you must have gotten it though IV drug use. So please, anyone who has never done IV drugs, don't get offended. It is just that these types at a certain times where introduced into that specific group of people and was easily spread though out that group. It makes perfect sense, as often utensils for using the drugs are shared. One does not even have to share the actual needle. Sharing spoons and cotton wool is already enough to get infected. So this is the spread seen locally.
Then one can look at the geographic situation.
Geno 3 and NASH. I read in a medical report, that fatty liver has been found in 71% of Hep c geno 3s. I cannot find it now, but had taken notes of, as it might be in my interest to get this matter checked. After what I researched on it, I found out that I am at low risk considering that my bmi is usually around 20.8 and has never been higher than 23.4. My normal blood pressure is low. And I don't have any other of the possible causes listed.
It's unclear exactly what causes nonalcoholic fatty liver disease. But many researchers believe that metabolic syndrome — a cluster of disorders that increase the risk of diabetes, heart disease and stroke — likely plays an important role in its development. Signs and symptoms of metabolic syndrome include:
* Obesity, particularly around the waist (abdominal obesity)
* High blood pressure (hypertension)
* One or more abnormal cholesterol levels — high levels of triglycerides, a type of blood fat, or low levels of high-density lipoprotein (HDL) cholesterol, the "good" cholesterol
* Resistance to insulin, a hormone that helps to regulate the amount of sugar in your blood
mar148.... Andiamo1 started a thread called 'Should forum members offer diagnosis?' on the Hepatitis Social/Living with Hepatitis Forum a couple of days ago . Check it out, there is some good discussion going on.
Marcia
Distribution of certain genotypes in IV drug users. This does not mean that you must have gotten it though IV drug use. So please, anyone who has never done IV drugs, don't get offended. It is just that these types at a certain times where introduced into that specific group of people and was easily spread though out that group. It makes perfect sense, as often utensils for using the drugs are shared. One does not even have to share the actual needle. Sharing spoons and cotton wool is already enough to get infected. So this is the spread seen locally.
Then one can look at the geographic situation.
Geno 3 and NASH. I read in a medical report, that fatty liver has been found in 71% of Hep c geno 3s. I cannot find it now, but had taken notes of, as it might be in my interest to get this matter checked. After what I researched on it, I found out that I am at low risk considering that my bmi is usually around 20.8 and has never been higher than 23.4. My normal blood pressure is low. And I don't have any other of the possible causes listed.
It's unclear exactly what causes nonalcoholic fatty liver disease. But many researchers believe that metabolic syndrome — a cluster of disorders that increase the risk of diabetes, heart disease and stroke — likely plays an important role in its development. Signs and symptoms of metabolic syndrome include:
* Obesity, particularly around the waist (abdominal obesity)
* High blood pressure (hypertension)
* One or more abnormal cholesterol levels — high levels of triglycerides, a type of blood fat, or low levels of high-density lipoprotein (HDL) cholesterol, the "good" cholesterol
* Resistance to insulin, a hormone that helps to regulate the amount of sugar in your blood
mar148.... Andiamo1 started a thread called 'Should forum members offer diagnosis?' on the Hepatitis Social/Living with Hepatitis Forum a couple of days ago . Check it out, there is some good discussion going on.
Marcia
Bug
the link below gives a really account of what is happening in Europe.
You will have to register with elsevier but it is free
http://download.journals.elsevierhealth.com/pdfs/journals/0168-8278/PIIS0168827807005739.pdf
It was already known that genotype distribution was associated with the mode of transmission, with subtypes 1a, 3a and 4 being mostly IDU-related and
genotypes 1b and 2 associated with blood transfusion and unsafe medical procedures
CS
the link below gives a really account of what is happening in Europe.
You will have to register with elsevier but it is free
http://download.journals.elsevierhealth.com/pdfs/journals/0168-8278/PIIS0168827807005739.pdf
It was already known that genotype distribution was associated with the mode of transmission, with subtypes 1a, 3a and 4 being mostly IDU-related and
genotypes 1b and 2 associated with blood transfusion and unsafe medical procedures
CS
Heres a study from Iran
http://www.comparative-hepatology.com/content/5/1/4#B28
Distribution of hepatitis C virus genotypes in patients infected by different sources and its correlation with clinical and virological parameters: a preliminary study
Genotypes 3a and 1a are more prevalent in IVDU in Europe and USA. In the present study, 18 (40%) and 17 (37.8%) patients with IVDA had genotype 1a and 3a respectively. It seems that there is a high similarity between the pattern of genotype in IVDU in Europe and United States when compared with Iran. However, it can not be due to migration of these people to these countries because the history of travel abroad was only seen in 6 cases (13.3%).
From http://www.wjgnet.com/1007-9327/14/1237.pdf
Hepatitis C virus genotypes distribution and transmission risk factors in Luxembourg from 1991 to 2006
Genotype 3 was significantly associated to IVDU
One pattern, characterized by high genetic diversity, involves geographically discrete areas where HCV has been endemic for a long time such as
West Africa with types 1 and 2,
Central Africa with type 4, and
Asia with types 3 and 6.
Another pattern involves areas with a few subtypes circulating in specific risk groups, e.g. subtype 3a in drug addicts.
The third pattern involves areas where a single subtype is present, such as in Egypt with subtype 4a and South Africa with subtype 5a.
Other molecular epidemiology studies have shown that HCV subtype 3a is significantly associated with transmission through injecting drug use in industrialized countries[22-24] and explain the prevalence of subtype 3a in many North and South American and European countries. HCV subtype 3a originates from Asia and has spread widely among injecting drug users[25,26].
Mechanisms of subtype 3a transmission remain poorly defined. Genotype 3 was not associated with a high level of HCV RNA as compared to the others genotypes in our cohort. Nevertheless, the relative homogeneity of NS5B sequences of injecting drug users from France, South America, Australia and California have indicated that HCV subtype 3a has been transmitted from a common origin through a unique worldwide epidemic among the drug user communities[27].
In this study, the authors reported region specific HCV 3a variants suggesting local transmission among intravenous drug users from the same geographical area. Therefore, the intrinsic characteristics of the transmission network of IVDU (unsafe injecting practices, drug preparation materials, needle or syringe exchange) together with the importance of the social context of drug injections may explain the efficiency of HCV genotype 3 transmission in Luxembourg.
Our study shows that the main risk factor for infection by genotype 3 is IVDU whereas the main risk factor for infection by genotype 1 is medical-related transmission.
The age of infected individuals may be a direct variable for the genotype distribution. Nevertheless, our data did not show that patients infected by genotype 1 were older than 40 years. This would mean other routes of infection by genotype 1 such as IVDU.
One from France
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1233931
The epidemiology of HCV infection in southeast France changed radically during the study period in relation to modifications in the etiology of infection. We observed the emergence of new epidemic subtypes (subtypes 1a and 3) linked to intravenous drug use and a decrease in the types linked to blood transfusion and nosocomial infection (epidemic subtype 1b and endemic type 2).
Replacing G1b and 2 with 1a and 3a is occurring worldwide. In the West anyway.
Its what is happening here in Aust.
All the Best
CS
http://www.comparative-hepatology.com/content/5/1/4#B28
Distribution of hepatitis C virus genotypes in patients infected by different sources and its correlation with clinical and virological parameters: a preliminary study
Genotypes 3a and 1a are more prevalent in IVDU in Europe and USA. In the present study, 18 (40%) and 17 (37.8%) patients with IVDA had genotype 1a and 3a respectively. It seems that there is a high similarity between the pattern of genotype in IVDU in Europe and United States when compared with Iran. However, it can not be due to migration of these people to these countries because the history of travel abroad was only seen in 6 cases (13.3%).
From http://www.wjgnet.com/1007-9327/14/1237.pdf
Hepatitis C virus genotypes distribution and transmission risk factors in Luxembourg from 1991 to 2006
Genotype 3 was significantly associated to IVDU
One pattern, characterized by high genetic diversity, involves geographically discrete areas where HCV has been endemic for a long time such as
West Africa with types 1 and 2,
Central Africa with type 4, and
Asia with types 3 and 6.
Another pattern involves areas with a few subtypes circulating in specific risk groups, e.g. subtype 3a in drug addicts.
The third pattern involves areas where a single subtype is present, such as in Egypt with subtype 4a and South Africa with subtype 5a.
Other molecular epidemiology studies have shown that HCV subtype 3a is significantly associated with transmission through injecting drug use in industrialized countries[22-24] and explain the prevalence of subtype 3a in many North and South American and European countries. HCV subtype 3a originates from Asia and has spread widely among injecting drug users[25,26].
Mechanisms of subtype 3a transmission remain poorly defined. Genotype 3 was not associated with a high level of HCV RNA as compared to the others genotypes in our cohort. Nevertheless, the relative homogeneity of NS5B sequences of injecting drug users from France, South America, Australia and California have indicated that HCV subtype 3a has been transmitted from a common origin through a unique worldwide epidemic among the drug user communities[27].
In this study, the authors reported region specific HCV 3a variants suggesting local transmission among intravenous drug users from the same geographical area. Therefore, the intrinsic characteristics of the transmission network of IVDU (unsafe injecting practices, drug preparation materials, needle or syringe exchange) together with the importance of the social context of drug injections may explain the efficiency of HCV genotype 3 transmission in Luxembourg.
Our study shows that the main risk factor for infection by genotype 3 is IVDU whereas the main risk factor for infection by genotype 1 is medical-related transmission.
The age of infected individuals may be a direct variable for the genotype distribution. Nevertheless, our data did not show that patients infected by genotype 1 were older than 40 years. This would mean other routes of infection by genotype 1 such as IVDU.
One from France
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1233931
The epidemiology of HCV infection in southeast France changed radically during the study period in relation to modifications in the etiology of infection. We observed the emergence of new epidemic subtypes (subtypes 1a and 3) linked to intravenous drug use and a decrease in the types linked to blood transfusion and nosocomial infection (epidemic subtype 1b and endemic type 2).
Replacing G1b and 2 with 1a and 3a is occurring worldwide. In the West anyway.
Its what is happening here in Aust.
All the Best
CS
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