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Major HCV genotypes G1, G2, and G3 account for 98.02% of infections in FSU regionsAnalysis Reveals Hepatitis C Genotype Patterns in Former Soviet Union

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Key Takeaway
Note that major HCV genotypes G1, G2, and G3 comprise 98.02% of cases in the FSU, but RAS data remain limited.

This scoping review with a genotype meta-analysis evaluates the distribution of major HCV genotypes and the prevalence of resistance-associated substitutions (RAS) among patients in the Former Soviet Union (FSU). The analysis identifies a pooled prevalence of 98.02% (95% CI: 96.71-98.94%) for major genotypes G1, G2, and G3. Specific regional data indicate G1 prevalence of 59% overall, with higher concentrations in the Mixed Region (73.5%) and lower concentrations in the South Caucasus (30.6%).

Genotype G3 was identified at a prevalence of 27% overall, with 34.5% in Eastern Europe. Additionally, G2 was reported at 16.8% in the Southern Caucasus. The study also assessed clinically significant RAS, specifically NS5A-A30K and Y93H, which were reported in 4 small studies involving a total of 329 patients.

The authors note that baseline RAS data are severely limited. These findings highlight the necessity for robust virological surveillance systems in the FSU region to better characterize the viral landscape. Clinical application of these findings is currently limited by the lack of comprehensive data on resistance markers.

How this fits prior evidence

This study addresses a gap in regional virological data for the Former Soviet Union. While previous coverage notes that direct-acting antivirals achieve an 89% SVR rate in patients with hepatocellular carcinoma, this meta-analysis provides specific regional genotype distribution (98.02% for G1, G2, and G3) and identifies the limited availability of data regarding resistance-associated substitutions (RAS) in these specific populations.

This review looked at the distribution of Hepatitis C (HCV) across countries in the Former Soviet Union. The study focused on identifying the most common types of the virus, known as genotypes, and looking for specific mutations that could make the virus harder to treat.

Researchers found that major genotypes like G1, G2, and G3 make up over 98% of the cases in the region. Specifically, G1 was found in 59% of cases, while G3 was found in 27%. These numbers varied by location, such as G1 being more common in the Mixed Region, while G3 was more common in Eastern Europe.

While the study identified some mutations that might affect treatment, the data on these specific resistance markers was very limited. Because the current data on resistance is sparse, the findings are mostly used to highlight the need for better monitoring systems. Patients should talk to their doctors about how these regional trends affect their specific treatment plan.

What this means for you:
The study identifies common Hepatitis C types in the region but notes that data on drug resistance is limited.

Common questions

What types of Hepatitis C were found in the region?

The study found that major genotypes G1, G2, and G3 make up 98.02% of the cases. Specifically, genotype G1 was found in 59% of cases and genotype G3 was found in 27% of cases across the studied areas.

Were any drug-resistant mutations found?

The study looked for clinically significant resistance-associated substitutions, specifically NS5A-A30K and Y93H. These were reported in 4 small studies involving 329 patients, but the overall data on these mutations is currently very limited.

How do the findings change based on location?

The distribution varies by area. For example, G1 was found in 73.5% of cases in the Mixed Region and 30.6% in the South Caucasus. G2 was found in 16.8% of cases in the Southern Caucasus, while G3 was found in 34.5% of cases in Eastern Europe.

Study Details

Study typeMeta analysis
Sample sizen = 329
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
BACKGROUND: Despite high hepatitis C virus (HCV) prevalence in the Former Soviet Union (FSU), data on genotype distribution and resistance-associated substitutions (RAS) remain fragmented. This study aims to map the breadth of molecular epidemiological evidence on HCV genotypes and resistance in FSU. METHOD: We performed a scoping review with a genotype meta-analysis of 24 cross-sectional studies published in PubMed, Web of Science, and Google Scholar from 1990 to 2025. The systematic review was registered with PROSPERO (CRD420251140060). RESULTS: The pooled prevalence of the major HCV genotypes (G1, G2, and G3) was 98.02% (95% CI: 96.71-98.94%), with G1 having the highest prevalence (59%), followed by G3 (27%). G1 was highest in the Mixed Region (73.5%) and lowest in the South Caucasus (30.6%), G2 was highest in the Southern Caucasus (16.8%), and G3 was highest in Eastern Europe (34.5%). Crucially, baseline RAS data were severely limited, with only four small studies (n = 329) from Russia and Georgia reporting clinically significant RAS (NS5A-A30K, Y93H). CONCLUSION: This study confirms G1 and G3 as the predominant circulating HCV genotypes in the FSU and highlights the near absence of data on RAS. Achieving HCV elimination in this region depends on both strengthening the care cascade and implementing robust virological surveillance systems.
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