Abstract
It has been estimated that there are more than 60 million Hepatitis C virus (HCV) carriers in the World Health Organisation's Western Pacific region (WHO-WPR), where liver cancer is among the top three causes of cancer death. WHO and the US Centres for Disease Control and Prevention report the prevalence of HCV in the South Pacific islands (countries within the WHO-WPR) to be high (5–10% and >2% respectively). However, since HCV is not tested for in many of these countries, there is sparse data available to support this assertion. We screened ∼2000 apparently healthy individuals from Papua New Guinea, Fiji and Kiribati and found a sero-prevalence of 2.0%, 0.1% and 0%, respectively. All sero-positive samples tested negative for HCV RNA. Curious as to why all the sero-positive individuals were negative for HCV-RNA, we also screened them for the HCV protective IL28B SNP markers rs12979860 and rs8099917. All antibody-positive participants bar one had HCV protective haplotypes. Our results suggest that HCV is present in these Pacific island countries, albeit at a prevalence lower than previous estimates. As none of our participants had undergone antiviral treatment, and therefore must have cleared infection naturally, we hypothesise that genotypes 1 and/or 4 are circulating in South Pacific Island people and that these peoples are genetically predisposed to be more likely to spontaneous resolve HCV infection than to become chronic carriers.
Highlights
Isolated in 1989, the hepatitis C virus (HCV) has since been found to be a globally diverse, positive sense, RNA virus, belonging to the Flaviviridae family, and is classified into at least genotypes and numerous subtypes [1,2,3,4]
Our results suggest that Hepatitis C virus (HCV) is present in these Pacific island countries, albeit at a prevalence lower than previous estimates
As none of our participants had undergone antiviral treatment, and must have cleared infection naturally, we hypothesise that genotypes 1 and/or 4 are circulating in South Pacific Island people and that these peoples are genetically predisposed to be more likely to spontaneous resolve HCV infection than to become chronic carriers
Summary
Isolated in 1989, the hepatitis C virus (HCV) has since been found to be a globally diverse, positive sense, RNA virus, belonging to the Flaviviridae family, and is classified into at least genotypes and numerous subtypes [1,2,3,4]. Subtype, displays different patterns of endemic and epidemic epidemiology. Subtype strains such as 1a, 1b, 2a, 2b, 3a, and 4a, are linked with 20th century outbreaks caused by the use of unscreened blood products, illicit drug injecting, or nonsterile medical injections [5,6,7,8,9,10]. Genotype 6, for example, exhibits a very high degree of genetic diversity, and evolutionary molecular (an adult female) and zero I-Kiribati samples tested reactive for both the Ortho HCV3 assay and the anti-HCV Monolisa assay. In PNG there were considerable provincial differences in HCV sero-reactivity. Samples were collected at sites representing 5 of the 19 provincial regions in PNG: Central Province
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