Assessment of HCV-RNA Testing Results and Genotype Distribution Among Anti-HCV-Positive Patients in Aksu Prefecture, Xinjiang, China: A Retrospective Hospital-Based Study

Abstract

Background: Hepatitis C virus (HCV) is a major cause of chronic liver disease worldwide. However, local data on HCV RNA positivity and genotype distribution among anti-HCV-positive patients in Aksu Prefecture remain limited. Objectives: To describe HCV-RNA positivity and genotype distribution among anti-HCV-positive patients tested at a regional hospital in Aksu Prefecture and to evaluate demographic and geographic associations with HCV-RNA positivity. Methods: This retrospective hospital-based study included 4,735 independent anti-HCV-positive patients with valid HCV-RNA results at the Third People’s Hospital of Aksu Prefecture in 2024. Proportions were reported with Wilson 95% confidence intervals (CIs). A multivariable logistic regression model including sex, age group, and region was fitted to the individual-level analytical subset from eight regions (n = 3,842). Results: HCV RNA was detected in 1,361 of 4,735 anti-HCV-positive patients (28.74%; 95% CI, 27.47% - 30.05%). In the eight-region individual-level subset, 1,283 of 3,842 patients were HCV RNA-positive (33.39%; 95% CI, 31.92% - 34.90%). Male sex was associated with higher adjusted odds of HCV RNA positivity than female sex (adjusted odds ratio [aOR], 2.22; 95% CI, 1.91 - 2.57). Patients aged 31 - 40 years also had higher adjusted odds of HCV RNA positivity than those aged ≥ 61 years (aOR, 1.75; 95% CI, 1.41 - 2.16). Genotype 1b was the most frequent (41.59%), followed by 3a (26.60%), 2a (19.54%), and 3b (11.32%). Conclusions: HCV-RNA positivity and genotype distribution varied across demographic and geographic strata within this hospital-tested, anti-HCV-positive cohort. These estimates do not represent population-level prevalence in Aksu Prefecture.