Prevalence and distribution of hepatitis C virus genotypes in spain during the 2000‐2015 period (the GEHEP 005 study)

Aim We report the largest study on the prevalence and distribution of HCV genotypes in Spain (2000-2015), and we relate them with clinical, epidemiological and virological factors. Methods Patients from 29 hospitals in 10 autonomous communities (Andalusia, Aragon, Castilla-Leon, Catalonia, Galicia, Canary Islands, Madrid-Community, Valencian-Community, Murcia Region and Basque Country) have been studied. Annual distribution of HCV genotypes and subtypes, as well as gender, age, transmission route, HIV and/or HBV-coinfection, and treatment details were recorded. Results We recruited 48595 chronically infected HCV patients; median age 51 years (IQR, 44-58), 67.9% male, 19.1% HIV-coinfected, 23.5% HBV-coinfected. Parenteral transmission route was the most frequent (58.7%). Genotype distribution was: 66.9% GT1 (24.9% subtype1a and 37.9% subtype1b), 2.8% GT2, 17.3% GT3, 11.4% GT4, and 0.1% GT5 and 0.02% GT6. LiPA was the most widely HCV genotyping test used (52.4%). HCV subtype 1a and genotypes 3 and 4 were closely associated with male gender, parenteral route of infection, and HIV and HBV coinfection; in contrast, subtype 1b and genotype 2 were associated with female gender, non-parenteral route and mono-infection. Age was related to genotype distribution, and different patterns of distribution and biodiversity index were observed between different geographical areas. Finally, we describe how treatment and changes in transmission routes may have affected HCV genotype prevalence and distribution patterns. Conclusions We present the most recent data on molecular epidemiology of hepatitis C virus in Spain. This study confirms that genotype distributions vary with age, sex, HIV and HBV-coinfection and within geographical areas and epidemiological groups. This article is protected by copyright. All rights reserved.