Distribution of hepatitis C virus genotypes in a diverse US integrated health care population

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Abstract
Hepatitis C virus (HCV) genotypes influence response to therapy, and recently approved direct‐acting antivirals are genotype‐specific. Genotype distribution information can help to guide antiviral development and elucidate infection patterns. HCV genotype distributions were studied in a diverse cross‐section of patients in the Northern California Kaiser Permanente health plan. Associations between genotype and race/ethnicity, age, and sex were assessed with multivariate logistic regression models. The 10,256 patients studied were median age 56 years, 62% male, 55% White non‐Hispanic. Overall, 70% were genotype 1, 16% genotype 2, 12% genotype 3, 1% genotype 4, <1% genotype 5, and 1% genotype 6. Blacks (OR 4.5 [3.8–5.5]) and Asians (OR 1.2 [1.0–1.4]) were more likely to have genotype 1 than 2/3 versus non‐Hispanic Whites. Women less likely had genotype 1 versus 2/3 than did men (OR 0.86 [0.78–0.94]). Versus non‐Hispanic Whites, Asians (OR 0.38 [0.31–0.46]) and Blacks (OR 0.73 [0.63–0.84]) were less likely genotype1a than 1b; Hispanics (OR 1.3 [1.1–1.5]) and Native Americans (OR 1.9 [1.2–2.8]) more likely had genotype 1a than 1b. Patients age ≥65 years less likely had genotype 1a than 1b versus those age 45–64 (OR 0.34 [0.29–0.41]). The predominance of genotype 1 among all groups studied reinforces the need for new therapies targeting this genotype. Racial/ethnic variations in HCV genotype and subtype distribution must be considered in formulating new agents and novel strategies to successfully treat the diversity of hepatitis C patients. J. Med. Virol. 84:1744–1750, 2012.

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