Current status and emerging challenges in the treatment of hepatitis C virus genotypes 4 to 6

Table 1 Indicative reports of hepatitis C virus genotype 4 to 6 prevalence in different continental areas

	Genotype 4		Genotype 5		Genotype 6
	Country	Prevalence	Country	Prevalence	Country	Prevalence
Africa	Egypt[10]	91%	South Africa[22,23]	40%
	Gabon[12]	71%
	Cameroon[7]	76%
	Nigeria[8]	60%
Middle East	Saudi Arabia[11]	60%	Syria[25]	10%
	Lebanon[9]	30%	Saudi Arabia[11]	1%
	Syria[5]	30%
	Iraq[6]	35.40%
Asia	China[33]	0-1.7%			Hong Kong[33-35]	10%-30%
					Vietnam[30]	14%
					South Korea[31]	1.40%
					China[32,35]	0-50%
Europe	France[15]	4%-10%	France[15,26]	3%-14.2%
	Spain[17,20]	1.4%-14%	Belgium[28]	1%-5%
	Italy[16,19]	1.4%-3.1%	Spain[27]	0-10.3%
	Greece[18]	13.2%-15.2%	Italy[24]	0-0.1%
			Greece[18,29]	0.4%-1.9%
America	United States[13,14]	0-2%

Table 2 Predictors of response to antiviral treatment in patients with hepatitis C virus genotype 4 infection

Predictor	Ref.
Age	[57]
Liver histopathology (advanced fibrosis/severe steatosis)	[40,52,54,60]
Baseline viral load1	[42,43]
Ethnicity	[52,54]
Diabetes/Insulin resistance	[49,54,57]
IL28B polymorphisms	[58,63]
Plasma levels of IP-102	[59]
HCV 4 subtypes	[52]
Co-infections (HIV, Schistosomiasis)	[38,61]

¹Most studies used a cut-off value of 400.000 IU/mL;

²Interferon-c inducible protein 10. HCV: Hepatitis C virus; HIV: Human immunodeficiency virus; IP-10: Inducible protein 10.

Table 3 Studies reporting rates of sustained virological response to 48-wk interferon-based combination therapy in patients with hepatitis C genotype 5

Author/Country/Year	No. patients	Regimen	SVR
Legrand-Abravanel/France/2004[75]	12	Standard/Pegylated IFN plus RBV	63.60%
Delwaide/Belgium/2006[74]	6	Standard/Pegylated IFN plus RBV	83%
Bonny/France/2006[78]	87	Standard/Pegylated IFN plus RBV	60%
1Antaki/Syria/2008[77]	26	Standard/Pegylated IFN plus RBV	54%
D’Heygere/Belgium/2011[79]	38	Standard/Pegylated IFN plus RBV	55.30%
Karatapanis/Greece/2012[29]	10	Pegylated IFN plus RBV	60%
Antaki/Syria/2012[76]	49	Standard/Pegylated IFN plus RBV	49%
Mauss/Germany/2012	24	Pegylated IFN plus RBV	58%
Papastergiou/Greece/2014[81]	27	Pegylated IFN plus RBV	63%

¹Thirteen out of 26 patients received 24 wk of treatment due to personal, financial or medical reasons. IFN: Interferon; RBV: Ribavirin; SVR: Sustained virological response.