Analysis of the Hepatitis C Virus (HCV) genotype spread in a particular area has a crucial impact on public health. In this study, we update information on the distribution of HCV genotypes, by evaluating a hospital-based cohort of 2,153 chronic hepatitis C patients, collected prospectively among subjects attending University Hospital of Catanzaro, within an area of Southern Italy. We assessed the rates (%) of HCV genotypes during two consecutive periods, from 2001 to 2005 and from 2006 to 2011, according to age and gender. Considering overall observation time, subtype 1b was predominant followed by subtypes 2a/2c, genotype 3 and 4. Statistical evaluation of the age of HCV patients stratified by genotypes, revealed a slight but significant increase in the median age of 1b, 2a/2c and 3 HCV genotype-infected subjects, during the 2006–2011 period, whilst genotype 4 patients exhibited a decrease in the median age during the same period studied. Moreover genotype 4 increased between 2002 and 2003 as well as between 2010 and 2011. Due to the peculiar diagnostic/clinical/therapeutic features of HCV-4, our findings warrant a deeper investigation to better control infections caused by such genotype. 1. Introduction Hepatitis C virus (HCV) is a major cause of acute and chronic liver disease worldwide. In as many as 85% of cases, acute HCV infection progresses to a chronic hepatitis. Infection by HCV constitutes an important health problem, and its spread reflects the socioeconomic standards and good sanitary regulations [1]. The distribution of HCV depends on a complex interaction between the social risks of the host and the molecular characteristics of the virus. HCV is characterized by a high degree of genetic heterogeneity; indeed, it is classified into three hierarchical layers based on a decreasing extent of different nucleotide variation: genotypes, subtypes, and quasispecies. HCV genotype distribution reflects the epidemiology of hepatitis C, and as such is related to particular routes of transmission. Subtype 1b is observed worldwide, whereas genotypes 1a and 3a are distributed in European and North American countries, genotype 2 in the Mediterranean region, Far East, and Western Africa. Genotype 4 is endemic in Middle East and Central Africa, genotype 5 in South Africa, genotype 6 in South East Asia [2], and genotype 7 was found in patients from the Democratic Republic of Congo [3]. In Europe, the most common subtype is 1b followed by subtype 2a/2c and genotype 3. Among European countries, the highest prevalence of HCV infection has been found in Italy.
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