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Hepatitis C genotype: types and treatment regimens

Hepatitis C genotype: types and treatment regimens

Hepatitis C is a dangerous viral disease that causes a number of serious complications - liver cancer, cirrhosis, steatosis, etc.

The scheme of therapy and the features of how the disease proceeds depends on the genotype of the pathogen virus. To establish the genotype, special laboratory tests are carried out.

Virus genotyping

Currently, experts identify from 6 to 11 genotypes of the pathogen. The description of each genotype does not fall within the framework of a clear classification, which explains the variability in the number of genotypes. In addition, there are no boundaries that define the differences between two genomes, so individual genotypes are considered subtypes.

If the difference in RNA genotypes reaches 30%, then the difference between RNA subtypes is only 15%. Despite the fact that scientists have several hundred subtypes of the virus, only a few of the subtypes are of diagnostic value when drawing up a therapy regimen. The most significant genotypes are from 1 to 6, while the rest remain poorly studied and characteristic of limited territories.

The type of hepatitis C has a lot to do with the prognosis for each patient. It depends on the genotype whether the disease will turn into a chronic form, whether treatment will be effective, and whether there will be a risk of complications.

Can Hepatitis C Be Cured?

More recently, hepatitis C was considered an incurable disease. The situation could be changed by the emergence of new American drugs based on sophosbuvir and daclatasvir. The high cost of original drugs made them inaccessible to most patients, so Indian pharmaceutical companies were given the right to manufacture analog drugs.

Feedback from doctors and patients confirms that the effectiveness of Indian generics is not inferior to the effectiveness of drugs from the United States. Medicines from India not only help fight hepatitis C of different genotypes, but also have an affordable price.

There are three main treatment regimens for patients with hepatitis C:

Define your treatment regimen using the table:

Virus genotype

Interferon therapy

Cirrhosis of the liver

Sofosbuvir Daklatasvir

Sofosbuvir Ledipasvir

Sofosbuvir Velpatasvir

Grazoprevir Elbasvir

Glecaprevir Pibrentasvir

Sofosbuvir Velpatasvir Voxilaprevir

Genotype 1

No

Yes

24 weeks

24 weeks

24 weeks

-

12 weeks

12 weeks

No

12 weeks

12 weeks

12 weeks

12 weeks

8 weeks

8 weeks

Yes

 

24 weeks

24 weeks

24 weeks

-

-

-

Genotype 2

No

Yes

24 weeks

Not effective

24 weeks

Not effective

12 weeks

12 weeks

No

12 weeks

12 weeks

8 weeks

8 weeks

Yes

 

24 weeks

24 weeks

-

-

Genotype 3

No

Yes

24 weeks

Not effective

24 weeks

-

12 weeks

8 weeks

No

12 weeks

12 weeks

12 weeks (in conjunction with sofosbuvir)

8 weeks

8 weeks

Yes

 

24 weeks

24 weeks

-

-

-

Genotype 4

No

Yes

24 weeks

24 weeks

24 weeks

-

12 weeks

12 weeks

No

12 weeks

12 weeks

12 weeks

12 weeks

8 weeks

8 weeks

Yes

 

24 weeks

24 weeks

24 weeks

-

-

-

Genotype 5-6

No

Yes

24 weeks

24 weeks

24 weeks

Not effective

12 weeks

12 weeks

No

12 weeks

12 weeks

12 weeks

8 weeks

8 weeks

Yes

 

24 weeks

24 weeks

24 weeks

-

-

 

Mixed genotypes of the virus

In some cases, the original pathogen recombines with a different genotype of infection, which complicates the course of the disease and reduces the effectiveness of therapy.

Examples of combinations of pathogens are the following combinations:

  • 1a + 2b;
  • 1b + 2k;
  • 1a + 1c;
  • 1b + 3a (3b);
  • 1a + 1b etc.

Having found two pathogens in the patient's body, doctors prescribe drugs that affect each genotype. If the aggressiveness of the genotypes is different, then the concentration in the blood of one of the viruses during therapy will decrease faster. The duration of therapy depends on which type of virus is the most dangerous.

What genotype of hepatitis C is considered the most dangerous

When determining the severity of a virus, the following factors are taken into account:

  1. The rate of development of the disease.
  2. The tendency to recombine with other types of virus.
  3. The likelihood of complications.
  4. The likelihood of a cure.
  5. Duration of therapy.

Experts believe that genotype 1b is the most dangerous, it is the most common type of virus that does not respond to treatment with interferons. In addition, genotype 1b often recombines with pathogens of the second subtype. These pathogens often lead to the development of complications and a severe course of the pathological process, but they are better than others amenable to therapy. Type 3 virus is dangerous for the development of hepatosis, although the chances of recovery with this type of infection remain high.

How long do people with hepatitis C live?

The prognosis is individual for each patient. The patient's life expectancy depends on the timeliness and accuracy of the diagnosis, treatment regimen and its effectiveness.

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