Hepatitis C still poses a threat to public safety, and there are few reports of hepatitis C virus (HCV) in Heilongjiang Province. Therefore, we aimed to study the epidemiology and resistance-associated substitutions (RASs) of HCV in Heilongjiang and explore the efficacy of treatment. 7019 specimens from Heilongjiang Province were subjected to the genotype identification. The Autoregressive Integrated Moving Average (ARIMA) model was utilized to predict HCV infection trends from 2024 to 2030. The Sanger sequencing was performed on samples of genotype(GT) 1b and 2a to investigate RASs. Phylogenetic analysis was conducted to assess the similarity of local HCV sequences with those from other countries. In addition, we tracked the effect of patients treated with DAAs and the relationship between efficacy and RASs. The predominant HCV subtypes in Heilongjiang were 1b (47.51 %) and 2a (43.85 %). From 2012 to 2023, the proportions of GT2a, GT3a, GT3b, and GT6a gradually increased. And the prevalence of GT2a will exceed that of GT1b over the next seven years. The proportion of RASs in GT1b and GT2a NS5A region was 73.47 % and 15.22 %, respectively. And the proportion of RASs in GT1b NS5B region was 100 %. Local HCV sequences exhibited phylogenetic relationships with sequences from other countries. The GT1b R30Q and GT2a C92S were correlated with drug efficacy. K107R and P206S, which have not been reported in the literature, were also related to drug efficacy. The epidemiology of HCV genotypes in Heilongjiang is becoming increasingly diverse. HCV GT1b has a large variety and a high proportion of RASs, and patients infected with this genotype of HCV need to be sequenced before treatment.
Keywords: Direct-acting antivirals; Hepatitis C virus; Resistance-associated substitutions.
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