Retrospective comparative study on hepatitis C virus (HCV) genotypic patterns: Drug-related versus non-drug-related HCV

Background: Hepatitis C virus (HCV) remains a global health challenge, with genotype distribution influencing disease progression and treatment outcomes. In India, genotype 3a predominates and is linked to accelerated fibrosis and hepatocellular carcinoma. Intravenous drug use (IVDU) is a major driver of transmission, though transfusion, occupational exposure, and comorbidities remain relevant. Aims and Objectives: This retrospective study compared demographic, genotypic, and clinical features of drug-induced versus non-drug-induced HCV infections. Materials and Methods: Medical records of 120 confirmed HCV patients (2018–2023) were reviewed. Group A included drug-induced HCV (n=60), and Group B non-drug-induced HCV (n=60). Demographics, risk factors, comorbidities, fibrosis/cirrhosis status, and treatment outcomes were analyzed using Welch’s t-test and Chi-square/Fisher’s exact tests. Results: Group A patients were younger (34.2 vs. 49.7 years; P<0.0001), predominantly male (82% vs. 61%; P=0.0151), and less comorbid. Genotype 3a predominated in both groups (56.7% vs. 66.7%; P=0.2599). IVDU was exclusive to Group A (100% vs. 3.3%; P<0.0001), while transfusion-related HCV was more common in Group B (20% vs. 3.3%; P=0.0045). Non-drug-related patients had higher rates of diabetes (30% vs. 6.7%; P=0.0010), hypertension (33.3% vs. 3.3%; P<0.0001), advanced fibrosis (56.7% vs. 25%; P=0.0004), and cirrhosis (33.3% vs. 10%; P=0.0019). Sustained virological response was high in both groups (77.8% vs. 91.7%; P=0.3752). Conclusion: Drug-induced HCV affects younger individuals, with fibrosis evident in a subset, underscoring the need for harm reduction and early linkage to care. Non-drug-related patients, older and comorbidity-burdened, present with advanced disease, highlighting the importance of integrated hepatology and metabolic management. Tailored strategies remain essential for HCV elimination.