The Nationwide Distribution and Trends of Hepatitis C Virus Genotypes in Mainland China.

Comprehensive data on HCV genotypes distribution is critical for treatment regimen selection, vaccine design and drug development. This study aimed to understand the dynamic distribution of HCV genotypes in Mainland China. 362 studies published from January 1993 to December 2017 involving 64,891 samples (5,133 injecting drug users, 2,748 volunteer blood donors, 1,509 former paid plasma donors, 160 sexually encounters, and 1,992 HIV/HCV coinfection patients) were eligible for the quantitative synthesis estimation. Pooled proportion of HCV genotypes (and 95%CIs) was estimated through the Freeman-Tukey double arcsine transformation by period, region, and risk group. A sharp decline of the subtype 1b was observed in all regions except in northwestern and central regions. The genotypes 3 and 6 showed an obvious increase in southern and southwestern regions and have already spread nationwide. After 2010, subtype 1b was the most dominant variant in all regions and risk groups, accounting for 54.0% (95%CI:51.9-56.1) of all national infections. Subtype 2a was the second most prevalent strain in all regions except in the south and southwest, with 15.4% (95%CI:13.1-17.8) national infections. The subtype 6a in southern region and 3b, 3a in southwestern region had a higher proportion of infections than that in other regions. In addition, the genotypes 3 and 6 are already prevalent in almost all risk groups. The distribution of HCV genotypes were sharply shifting in China in the past three decades.The subtype 1b posed a sharp decline, whereas genotypes 3 and 6 played an increasing role in the regional and populational HCV pandemic This article is protected by copyright. All rights reserved.