This uncommissioned review article was subject to full peer-review.
Review article: the epidemiology and therapy of chronic hepatitis C genotypes 4, 5 and 6
Article first published online: 19 NOV 2013
© 2013 John Wiley & Sons Ltd
Alimentary Pharmacology & Therapeutics
Volume 39, Issue 2, pages 137–147, January 2014
How to Cite
Wantuck, J. M., Ahmed, A. and Nguyen, M. H. (2014), Review article: the epidemiology and therapy of chronic hepatitis C genotypes 4, 5 and 6. Alimentary Pharmacology & Therapeutics, 39: 137–147. doi: 10.1111/apt.12551
- Issue published online: 16 DEC 2013
- Article first published online: 19 NOV 2013
- Manuscript Accepted: 27 OCT 2013
- Manuscript Revised: 21 OCT 2013
- Manuscript Revised: 23 JUN 2013
- Manuscript Received: 27 MAY 2013
The global burden of hepatitis C (HCV) infection is mostly found in Africa, the Middle East and Asia, where HCV genotypes 4, 5 and 6 are common. The literature on these genotypes is sparse and this synopsis will review characteristics of patients infected with these genotypes.
To review characteristics of patients infected with HCV genotypes 4, 5 and 6.
PubMed search for ‘hepatitis C’ AND ‘genotype 4’, ‘hepatitis C’ AND ‘genotype 5’, and ‘hepatitis C’ AND ‘genotype 6’ was conducted and relevant articles were reviewed.
Intravenous drug use is generally responsible for HCV genotype 4 infection in developed countries, but unsafe medical practices cause most cases of HCV genotypes 4, 5 and 6 in endemic countries. The sustained virological response (SVR) rate for patients with HCV genotype 4 who receive pegylated interferon and ribavirin for 48 weeks ranges from 40% to 70% in various small studies. The SVR rate is in the 60–70% range for HCV genotype 5 and 70–80% range for HCV genotype 6 following 48 weeks with pegylated interferon and ribavirin. Preliminary data suggest that a shorter course of 24 weeks of pegylated interferon and ribavirin may be acceptable for HCV genotype 6, with an SVR rate of approximately 70%.
The current standard-of-care therapy for HCV genotypes 4, 5 and 6 is pegylated interferon and ribavirin for 48 weeks. A shorter course with 24 weeks of therapy may be considered for patients with genotype 6. Newer and much more effective therapies may be forthcoming in the next few years.