Abstract
Hepatitis C Virus (HCV) genotype and viral load are two significant predictive variables knowledge of which might persuade treatment decisions. The objective of the present study was to identify the distribution of different HCV genotypes circulating in the study area and to estimate viral load in chronically HCV infected patients. Out of total 305 HCV positive patients, 177 (58%) were males and 128 (42%) were females. Frequency breakup of the HCV positive patients was 169, 69, 38 and 29 from Abbottabad, Mansehra, Haripur and Battagram districts respectively. Out of the total 305 tested serum samples, 255 (83.06%) were successfully genotyped whereas 50 (16.4%) samples were found with unclassified genotypes. Among typable genotypes, 1a accounted for 21 (6.8%) 1b for 14 (4.6%), 2a for 4 (1.31%) 3a for 166 (54.42%) and genotype 3b for (8.19%). Twenty five (8.19%) patients were infected with mixed HCV genotypes. Viral load distribution was classified into three categories based on its viral load levels such as low (< 60, 0000 IU/mL), intermediate (60,0000-80,0000 IU/mL) and high (> 80,0000 IU/mL). The baseline HCV RNA Viral load in HCV genotype 3 infected patients was 50 (26.17%), 46 (24.08%) and 95 (49.73%) for low, intermediate and high categories respectively. For genotypes other than 3, these values for low, intermediate and high viral load categories were 50 (43.85), 35 (30.70) and 29 (25.43) respectively. Pre-treatment viral load in patients with untypable genotype was 19 (38.00%), 5 (20.00%) and 11 (44.00%) for low, intermediate and high viral load categories. Viral load distribution was also categorized sex wise; for males it was 58 (32.76%), 26 (14.68%) and 93 (52.54%) whereas for females it was 40 (31.25%), 34 (26.56%) and 54 (42.18%) for low, intermediate and high viral load respectively. In conclusion HCV genotype 3a is the most prevalent genotype circulating in Hazara Division like other parts of pakistan. Pre-treatment viral load is significantly high (p 0.014) in patients infected with HCV genotype 3 as compared to other genotypes.
Highlights
Hepatitis C virus (HCV) is a principal cause of chronic liver diseases including liver fibrosis, liver cirrhosis and hepatocellular carcinoma [1,2]
In this study we have studied the distribution of HCV genotypes and associated these genotypes with gender
Identified HCV genotypes in our study showed no regional difference and was distributed with same fashion predominant genotype was 3a followed by 3b as has been reported by Ali et al, [27] from various regions of Pakistan where the authors concluded that there is no regional difference in HCV genotype distribution
Summary
Hepatitis C virus (HCV) is a principal cause of chronic liver diseases including liver fibrosis, liver cirrhosis and hepatocellular carcinoma [1,2]. 170-200 million individuals infected globally including 10-17 million persons in Pakistan [1,3,4,5]. HCV is an enveloped virus having positive single stranded RNA as its genome that was firstly discovered in 1989 belonging to a virus family Flaviviridae [3,6,7]. HCV genome is approximately 9.6 kb in length with single open reading frame and encodes a polypeptide of 3000 amino acids [8,9]. Total six major HCV genotypes and multiple subtypes have been identified from around the world [10]. Identification of HCV genotype/subtype is extremely important clinically before prescribing therapy
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