The distribution of hepatitis C virus infection in Shanghai, China: a time-spatial study
Open Access
- 18 September 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Infectious Diseases
- Vol. 21 (1), 1-11
- https://doi.org/10.1186/s12879-021-06577-8
Abstract
Shanghai, as a pilot city of China to achieve the goal of eliminating hepatitis C, its strategy of allocating medical resources is a pressing problem to be solved. This study aims to infer the time-spatial clustering patterns of HCV-infected cases, and grasp the dynamic genotype distribution of HCV, thereby inform elimination strategies of HCV with efficacy and efficiency. Reported HCV cases including their demographic information in Shanghai city from 2005 to 2018 were released from the National Infectious Disease Reporting Information System, population data at community scale, geographical layers of hospitals, communities and districts were gathered from former research. Blood samples of HCV-infected individuals were collected during 2014–2018 from 24 sentinel hospitals, HCV-antibody test, qualitative nucleic acid test and NS5B/5’UTR gene amplification were performed accordingly to determine the genotypes of the specimen. Furthermore, global and local spatial self-correlation analysis of both acute and chronic HCV infections were conducted at community scale year by year, then time-spatial clusters of acute and chronic HCV infections and HCV genotype distribution of specimen collected from sentinel hospitals by districts were mapped by using Arcmap10.1. A total of 2631 acute HCV cases and 15,063 chronic HCV cases were reported in Shanghai from 2005 to 2018, with a peak in 2010 and 2017, respectively. The mean age of chronic HCV patients was 49.70 ± 14.55 years, 3.34 ± 0.32 years older than the acute (t = 10.55, P-value < 0.01). The spatial distribution of acute HCV infection formed one primary cluster (Relative Risk = 2.71), and the chronic formed one primary cluster and three secondary clusters with Relative Risk ranged from 1.94 to 14.42, meanwhile, an overlap of 34 communities between acute and chronic HCV clusters were found with time period spans varied from 6 to 12 years. Genotype 1 (N = 257, 49.71%) was the most prevalent HCV genotype in Shanghai, genotype 3 infections have increased in recent years. Baoshan district presented cluster of acute HCV and the highest proportion of genotype 2, Pudong new area was the cluster of chronic HCV and occupied the highest proportion of genotype 3. Despite the low prevalence of HCV infection, it is still needed to push forward the elimination process in Shanghai, as there is a certain amount of HCV infected people waiting to be treated. The time-spatial clustering patterns and the dynamic of HCV genotype distribution together indicated a changing constitution of different transmission routes of HCV infection, thus, a focused strategy may be needed for high-risk population related to genotype 3 infection like drug users, in addition to an enforcement of the existing measures of preventing the iatrogenic and hematogenic transmission of HCV.Funding Information
- National Natural Science Foundation of China (81872679)
- Shanghai Municipal Health Bureau (201840117)
This publication has 25 references indexed in Scilit:
- The Current Hepatitis C Virus Prevalence in China May Have Resulted Mainly from an Officially Encouraged Plasma Campaign in the 1990s: a Coalescence Inference with Genetic SequencesJournal of Virology, 2013
- Expanded classification of hepatitis C virus into 7 genotypes and 67 subtypes: Updated criteria and genotype assignment web resourceJournal of Hepatology, 2013
- Update on epidemiology of hepatitis B and C in ChinaJournal of Gastroenterology and Hepatology, 2013
- Direct-Acting Antivirals for the Treatment of Chronic Hepatitis C: Open Issues and Future PerspectivesThe Scientific World Journal, 2013
- Epidemiology of Viral Hepatitis and Hepatocellular CarcinomaGastroenterology, 2012
- HCV Subtype Characterization among Injection Drug Users: Implication for a Crucial Role of Zhenjiang in HCV Transmission in ChinaPLOS ONE, 2011
- New trends of HCV infection in China revealed by genetic analysis of viral sequences determined from first-time volunteer blood donorsJournal of Viral Hepatitis, 2010
- The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwideJournal of Hepatology, 2006
- Hepatitis C virus genotype distribution in China: Predominance of closely related subtype 1b isolates and existence of new genotype 6 variantsJournal of Medical Virology, 2005
- Dominant role of hepatitis B virus and cofactor role of aflatoxin in hepatocarcinogenesis in Qidong, ChinaJournal of Hepatology, 2002