changing epidemiology of chronic hepatitis c: a university hospital experience

Background: hepatitis c virus (hcv) infection remains a significant public health problem worldwide, with varying epidemiological trends over time necessitating continual surveillance and intervention strategies. objectives: this retrospective study aimed to examine trends in demographics, transmission routes, and disease characteristics among 635 patients diagnosed with hcv infection between 2003 and 2023. methods: data on demographics, hcv rna levels, liver enzymes, genotype distribution, and transmission routes were retrospectively analyzed. the study period was divided into four segments for detailed analysis. results: there was a gradual increase in the diagnosed cases over the study period, particularly noticeable after 2012. the mean age at diagnosis remained stable from 2003 - 2007 to 2008 - 2012 but decreased significantly in the following years (p = 0.001). male predominance was observed throughout the study, with a notable increase in the male/female ratio over time (p < 0.001). intravenous drug use (ivdu) emerged as the predominant transmission route, reaching 68.3% in 2018 - 2022 (p < 0.001). the prevalence of incarceration history among patients increased significantly, reaching 24.6% in 2018 - 2022 (p < 0.001). disease characteristics varied between periods; median hcv rna levels were highest in 2018 - 2022, and median alanine aminotransferase (alt) levels differed significantly between periods (p = 0.001). the genotype distribution showed a shift over time, with genotype 1 predominating initially and genotypes 3, 4, and 5 becoming more prevalent in later years (p < 0.001). conclusions: this study highlights the dynamic changes in hepatitis c epidemiology over two decades in southern turkey, highlighting the increasing burden in younger populations, the increasing prevalence of ivdu as a transmission route, and the changing genotype distribution.