Distribution Of Hepatitis C Virus Genotypes In China: A Meta-analysis

Background Hepatitis C virus(HCV)infection remains a global public health problem,there were differences in the distribution of HCV in regions,populations and transmission routes.The aim of this study was to investigate the distribution of hepatitis C virus(HCV)genotypes among people in different regions,ethnic groups and transmission risk factors in China.Methods Search the Wanfang database and the NCBI database for articles about the distribution of HCV genotypes in China from January 1992 to May 2017,the articles were screened according to the inclusion and exclusion criteria,and the data was classified by different regions,ethnic groups,and transmission risk factors.The data was analyzed by meta-analysis to observe the distribution of genotypes.Results In China,the HCV genotype 1 was the most prevalent,the HCV genotypes were mainly genotype 1(52.7%-79.7%)and genotype 2(13.9-44.9%)in the northern region,and the average proportion of genotype 2(29.6%)was significantly higher than that in other regions(P<0.001);the HCV genotypes were mainly genotype 1(51.7%-79%)in the southeast region,and the genotype 6 was widely distributed in Hong Kong(31.3%),Guangdong(23.1%),Fujian(21.8%)and Macau(20.6%);the HCV genotypes were mainly genotype 1(19.7%-73.4%)and genotype 3(13.4%-58.5%)in the southwest region,and the average proportion of genotype 3 was28.7%,which was significantly higher than that in northern region(1.9%,P<0.001)and southeastern region(7.2%,P<0.001);the main genotypes distributed in the western region were genotype 1(53.6%-66.8%),genotype 2(15.8%-32.1%)and genotype 3(12.8%-15.8%);the proportion of genotype 2 in Korean nationality was(22.4%,P<0.001),in Uyghur(13.1%,P<0.001)and in Kazakh(18.5%,P<0.05),and the proportion of genotype 3 in Uyghur was 16.6%,significantly higher than 9.4% of the Han nationality 42.2%,significantly higher than that in Han(P<0.001);the proportion of genotype 3 in persons with intravenous drug use was 31.1%,significantly higher than with blood transmission infected(4.5%,P<0.001)or sexual transmission infected(24.1%,P<0.05),and the proportion of genotype 6 infection in intravenous drug users was 26.7%,significantly higher than by blood transmission infection(4.1%,P<0.001)or by sexual transmission infection(15.1%,P<0.001);the proportion of type 3 and type 6 in individuals with HCV/HIV mixed infection were higher than that in with HCV infection alone(all P<0.001).Conclusion HCV genotype 1 was widely prevalent in China,the HCV genotypes were mainly genotype 1 and genotype 2 in the northern region,while the western,southwestern and southeastern regions have rich genetic diversity.Genotype 3 was mainly prevalent in the western and southwestern regions,and genotype 6 was mainly prevalent in southwestern and southeastern regions.The genotypes of HCV in different ethnic groups are consistent with those in ethnic settlements.The HCV genotypes were mainly genotype 1 and genotype 2 in Korean nationality,the HCV genotypes were mainly genotype 3 and genotype 6 in Zhuang and Hani nationalities,The HCV genotypes were mainly genotype 1 and genotype 3 in Uygur nationality.The proportion of genotype 3 and 6 in intravenous drug users was higher than that in other risk groups.Compared with the HCV-infected group,the proportion of genotype 3 and 6 were higher in HCV/HIV co-infected persons.