795 
Relationship between HIV and Hepatitis C Viral Genotypes and Routes of Transmission among Blood Donors in Northern Thailand
L Thaikruea*1, K E Nelson2, S Thongsawat1, N Maneekarn1, D Netski3, and D L Thomas3
1Chiang Mai Univ. Faculty of Med., Thailand; 2Bloomberg Sch. of Publ. Hlth., Johns Hopkins Univ., Baltimore, MD, USA; and 3Johns Hopkins Univ. Sch. of Med., Baltimore, MD, USA
Background: The
substantial HIV epidemic in Thailand
is more severe in the northern region than elsewhere. HCV is a common
co-infection with HIV. However, partly because of lack of HCV information, there
is no effective program in Thailand
to prevent HCV infection. Objectives
of this study were to determine HCV genotype distribution and investigate the
relationship between HIV and HCV genotypes and routes of transmission
among blood donors in
northern Thailand.
Methods:
Donors were eligible for the study if they were at least 18 years of
age, resided in the north, and had donated blood during January 2001 to June
2002. The participants had face-to-face interviews, physical examination,
counseling, and blood drawn for HCV supplement tests. By using HCV direct
sequencing using ABI 3100
automated sequencer, HCV infected cases with positive PCR
were typed. Phylogenic analysis was conducted
Results: Of 254 eligible cases, 175 were confirmed, of
whom 157 were positive for PCR;
genotype could be identified in 156 persons. A neighbor-joining
phylogenic tree showed clustering of sequences within subtypes with high
bootstrap values which were distinct from other genotypes. The genotypes distribution was
comprised of type 3 (36.5%), 6 (34.7%), and 1 (28.8%). Participants
infected with type 3 had significantly higher ALT
levels than other types (p <0.001).
They also had higher prevalence of HIV than other types (p = 0.001). The possible routes of transmission were injection drug
use (IDU) (34.6%), surgery (21.2%), blood transfusion (19.9%), and other
parenteral route (24.4%). Type 1 and 6 were more common among cases who had
blood transfusion before 1992, whereas type 3 was prevalent in those transfused
after 1992. Based on 54 IDU donors of known genotype, duration of the last
injecting drugs was statistically associated with genotype prevalence (p = 0.045). IDU donors who reported last
injecting drugs within the past 5 years, 5 to 9 years, and at least 10 years
had the highest prevalence of type 3, type 1, and type 6, respectively.
Conclusions: The common routes of
transmission were IDU, blood transfusion, and surgery. HIV was more prevalent
in donors infected with genotype 3. Genotype 3 was more prevalent in IDU donors
and donors who had blood transfusion recently. Thus, the relationship between
these virus and IDU and blood transfusion routes should be further evaluated
for effective intervention program.
Keywords: Hepatitis C Virus; Human Immunodeficiency Virus; blood donor
