Predominant Hepatitis C Virus Genotype Research Articles

Hepatitis C Virus Seroprevalence and Genotypic Distribution Among Hemodialysis Patients at a Teaching and Training Hospital in Western Rajasthan, India.

Background Hepatitis C virus (HCV) infection is a chronic hepatotropic blood-borne infection. The transmission of HCV in patients undergoing hemodialysis (HD) is more common in comparison to the general population due to factors such as frequent blood transfusions, prolonged vascular access, and the potential for nosocomial infections. Western Rajasthan in India is home to numerous teaching and training hospitals that cater to a large number of HD patients. Understanding the seroprevalence and genotypic distribution of HCV in this specific patient population is crucial for assessing the extent of infection within this vulnerable group for targeted surveillance and developing effectively tailored treatment protocolsin healthcare settings. Hence, this study was conducted with an aim to determine seroprevalence, seroconversion, and genotypes of HCV in HD patients at a tertiary care hospital. Methods This was a cross-sectional observational study. The duration of the study was from July 2019 to March 2022. In this study, the patients undergoing maintenance HD due to chronic kidney disease (CKD) were recruited. The data collected include patients' demographics, etiology of CKD, underlying other co-morbidities, duration of dialysis, and biochemical and blood count parameters. The patients recruited at the start of the study were screened for anti-HCV antibodies by HCV enzyme-linked immune sorbent assay (ELISA). The anti-HCV antibody-negative patients were followed up for the detection of anti-HCV antibodies. At the end of the follow-up period, all anti-HCV antibody negative samples in the pool of five and all anti-HCV antibody positive samples were subjected to a real-time polymerase chain reaction (RT-PCR) of 5' untranslated region (5'UTR) and core region, followed by line probe assay (LiPA). Results In this study, after applying inclusion and exclusion criteria, a total of 109 patients were recruited, out of which 64 (58.7%) were males and 45 (41.3%) were females. The age range of participants was 11-88 years with a mean and standard deviation of 46.75 and 16.35 years, respectively. A total of 39 patients (20 on screening, 19 on follow-up) were detected anti- HCV antibody positive. By RT-PCR, 24 patients tested HCV RNA positive (10 on screening, 14 on follow-up). Among 24 HCV RNA-positive samples, LiPA showed, HCV genotype 1a (n=21), genotype 3b (n=1), and two samples were detected to be inconclusive. Conclusion The increasing duration of dialysis is significantly associated with acquiring HCV infection. The majority of the cases of CKD in this geographical region are due to hypertensive nephropathy. There can be discordance between antibody and viral RNA positivity in HCV infection. The predominant HCV genotype identifiedin the dialysis ward of tertiary care hospital was genotype 1a.

Incidence of Hepatocellular Carcinoma in Hepatitis C Patients Treated with Direct-Acting Antivirals and Its Relation to Hepatic Fibrosis Stage

Abstract Introduction Significant advances in understanding of the molecular virology, life cycle, and pathogenesis of Hepatitis C Virus (HCV) led to the Direct-Acting Anti-viral (DAA) era of HCV therapy in 2011 (Hezode et al.,2015). It can be expected that rates of HCV-associated hepatocellular carcinoma (HCC) will decrease significantly after the widespread adoption of DAAs, However Hepatitis C patients with cirrhosis who were treated with direct-acting antivirals had increased likelihood of developing HCC (Tayyab et al., 2020) (Kozbial et al., 2016). HCC was also associated with greater liver stiffness according to transient elastography and lower platelet counts (Conti et al., 2016). The aim of this study is to investigate incidence of HCC in Egyptian HCV patients in whom other predominant HCV genotypes are prevalent and different treatment protocols followed. Methods This was a retrospective study including 400 chronic HCV patients who were following up their medical condition at Kobri El-Koba Military Hospital hepatology outpatient clinic from January 2018 to September 2019. Patients were divided into two main equal groups regarding either received HCV direct acting antivirals or not. Incidence of HCC after 18 months of follow up were compared between two groups. Its relation to hepatic fibrosis stage was calculated in both groups. Results DAA receiving group had significantly lower incidence of HCC than non DAA receiving group (control group). Eleven patients in DAA receiving group developed HCC (5.5%) compared to twenty-two patients in control group (11%) with P- value 0.04. Although there was no significant difference between two groups regarding pre-treatment prevalence of ascites, splenomegaly, or esophageal varices, DAA receiving group had statistically significant advanced hepatic fibrosis when compared to control group. Before starting treatment, DAA Receiving group shows (4.5% F0, 14% F1, 7% F2, 11.5% F3 and 63% F4) versus (20.5% F0, 14% F1, 18.5% F2, 6.5% F3 and 40.5% F4) in control group with highly significant P value 0.00. Conclusion Incidence of HCC decreased significantly after DAA in chronic HCV patients. Decreased incidence occurred despite advanced hepatic fibrosis in this group of patients.

Circulating miRNA-192 and miR-29a as Disease Progression Biomarkers in Hepatitis C Patients with a Prevalence of HCV Genotype 3.

MicroRNAs miR-29a and miR-192 are involved in inflammatory and fibrotic processes of chronic liver disease, and circulating miR-29a is suggested to diagnose fibrosis progression due to hepatitis C virus (HCV) infection. This study aimed to evaluate the expression profile of circulating miR-192 and 29a in a patient cohort with a high frequency of HCV genotype-3. A total of 222 HCV blood samples were collected and serum were separated. Patients were classified into mild, moderate, and severe liver injury based on their Child-Turcotte-Pugh CTP score. RNA was isolated from the serum and used for quantitative real-time PCR. The HCV genotype-3 (62%) was the predominant HCV genotype. In HCV patients, the serum miR-192 and miR-29a levels were significantly upregulated in comparison to healthy controls (p = 0.0017 and p = 0.0001, respectively). The progression rate of miR-192 and 29a in the patient group with mild was highly upregulated compared to patients with moderate and severe hepatitis infection. The ROC curve of miR-192 and miR-29a of moderate liver disease had a significant diagnostic performance compared to the other HCV-infected groups. The increase in miR-29a and miR-192 serum levels was even slightly higher in patients with HCV genotype-3 than in non-genotype-3 patients. In conclusion, serum miR-192 and miR-29a levels significantly increased during the progression of chronic HCV infection. The marked upregulation in patients with HCV genotype-3 suggests them as potential biomarkers for hepatic disease, independently of the HCV genotype.

Hepatitis C virus genotype diversity in Ningxia Hui autonomous region, Northwestern China

Hepatitis C virus (HCV) genotypes vary greatly in different regions. The aim of this study is to investigate the distribution of HCV genotypes in HCV infected patients, in Ningxia Hui Autonomous Region. Nucleic acid extraction and amplification were performed with test kits on 153 HCV infected patients serum samples. The HCV viral load was measured using reverse transcriptase PCR (RT-PCR) and HCV genotypes were determined. Among the 153 HCV-infected patients, 56 had genotype (GT)1b (36.60%), 45 had GT2a (29.40%), 23 had GT3a (15.00%), 14 had GT3b (9.20%),13 had GT6a (8.50%), 1 had GT1g (0.70%), 1 had GT6xa (0.70%). In GT1b, 21.40% were female and 78.60% were male; in GT2a, 42.20% were female and 57.80% were male;Males were most prevalent in genotypes 1b(39.30%), while female were most prevalent in genotype 2a(46.30%). Rare GT1g and GT6xa were also detected in males. The 41-50 year age group had the highest HCV prevalence of 32.00%. HCV GT1b is the predominant HCV genotype in Ningxia Hui Autonomous Region.

Changing epidemiology and viral interplay of hepatitis B, C and D among injecting drug user-dominant prisoners in Taiwan

The spreading of viral hepatitis among injecting drug users (IDU) is an emerging public health concern. This study explored the prevalence and the risks of hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV) among IDU-dominant prisoners in Taiwan. HBV surface antigen (HBsAg), antibodies to HCV (anti-HCV) and HDV (anti-HDV), viral load and HCV genotypes were measured in 1137(67.0%) of 1697 prisoners. 89.2% of participants were IDUs and none had HIV infection. The prevalence of HBsAg, anti-HCV, dual HBsAg/anti-HCV, HBsAg/anti-HDV, and triple HBsAg/anti-HCV/anti-HDV was 13.6%, 34.8%, 4.9%, 3.4%, and 2.8%, respectively. HBV viremia rate was significantly lower in HBV/HCV-coinfected than HBV mono-infected subjects (66.1% versus 89.9%, adjusted odds ratio/95% confidence intervals [aOR/CI] = 0.27/0.10–0.73). 47.5% anti-HCV-seropositive subjects (n = 396) were non-viremic, including 23.2% subjects were antivirals-induced. The predominant HCV genotypes were genotype 6(40.9%), 1a(24.0%) and 3(11.1%). HBsAg seropositivity was negatively correlated with HCV viremia among the treatment naïve HCV subjects (44.7% versus 72.4%, aOR/CI = 0.27/0.13–0.58). Anti-HCV seropositivity significantly increased the risk of anti-HDV-seropositivity among HBsAg carriers (57.1% versus 7.1%, aOR/CI = 15.73/6.04–40.96). In conclusion, IUDs remain as reservoirs for multiple hepatitis viruses infection among HIV-uninfected prisoners in Taiwan. HCV infection increased the risk of HDV infection but suppressed HBV replication in HBsAg carriers. An effective strategy is mandatory to control the epidemic in this high-risk group.

High rate of hepatitis C virus and human immunodeficiency virus false-positive results in serologic screening in sub-Saharan Africa: adverse impact on the blood supply.

False positivity in blood screening may cause unnecessary deferral of healthy donors and exacerbate blood shortages. An international multicenter study was conducted to estimate the frequency of HCV and HIV false seropositivity in seven African countries (Burundi, Cameroon, Democratic Republic of Congo, Madagascar, Mali, Mauritania, and Niger). Blood donations were tested for hepatitis C virus (HCV) and human immunodeficiency virus (HIV) with rapid detection tests (RDTs), third-generation enzyme immunoassays (EIAs), or fourth-generation EIAs. HCV (456/16,613 [2.74%]) and HIV (249/16,675 [1.49%]) reactive samples were then confirmed with antigen/antibody assays, immunoblots, and nucleic acid testing. Partial viral sequences were analyzed when possible. The HCV reactivity rate with RDTs was significantly lower than with EIAs (0.55% vs. 3.52%; p < 0.0001). The HIV reactivity rate with RDTs was lower than with third-generation EIAs (1.02% vs. 2.38%; p < 0.0001) but similar to a fourth-generation assay (1.09%). Only 16.0% (57/357) and 21.5% (38/177) of HCV and HIV initial reactive samples, respectively, were repeatedly reactive. HCV and HIV infections were confirmed in 13.2% and 13.7%, respectively, of repeated reactive donations. The predominant HCV genotype 2 and 4 strains in West and Central Africa showed high genetic variability. HIV-1 subtype CRF02_AG was most prevalent. High rates (>80%) of unconfirmed anti-HCV and anti-HIV reactivity observed in several sub-Saharan countries highlights the need for better testing and confirmatory strategies for donors screening in Africa. Without confirmatory testing, HCV and HIV prevalence in African blood donors has probably been overestimated.

The Predominance of Genotype 3 in Hepatitis C Virus in the Province of Kahramanmaras, Turkey/Genotype Distribution of Syrian Refugee Patients with Hepatitis C in Kahramanmaras Province

Background: The genotype determination is of importance in the clinical management of hepatitis C virus (HCV) infection. Objectives: The aim of this study was to evaluate the distribution of genotypes in HCV patients in the Kahramanmaras region, Turkey, and determine if the genotype rates of Syrian refugee patients with hepatitis C are different from the population they migrated to. Methods: Blood samples sent to the microbiology laboratory between September 2014 and February 2018 were examined with genotyping using a real-time PCR reagent kit. Results: The results of 274 patients who were HCV genotype-assigned were obtained from the hospital electronic information system. Of 230 Turkish HCV patients, 121 (52.8%) were identified as genotype 3, 100 (43.3%) as genotype 1, five (2.2%) as genotype 2, and four (1.7%) as genotype 4. Of the 44 Syrian refugee patients, 24 (54.5%) were identified as genotype 1, 18 (40.9%) as genotype 4, one (2.3%) as genotype 2, and one (2.3%) as genotype 3. Conclusions: Predominant genotype 3 with the prevalence of 52.8% was seen to be more frequent in the current study region than in other regions of Turkey, demonstrating the highest rate of genotype 3 infection in Turkey to date. In Syria, the predominant HCV genotype is genotype 4 with a 57% prevalence, followed by genotype 1 with 29%. In the Syrian refugees, however, the current study showed genotype 1 was more frequent than genotype 4 (54.5 % vs. 40.9%). This suggests that HCV genotypes may be affected by situations such as war and migration.

Phylogenetic analysis of hepatitis C virus among HIV/ HCV co-infected patients in Nigeria.

Hepatitis C virus (HCV) infection has been associated with liver disease including liver cirrhosis and hepatocellular carcinoma (HCC) in chronically-infected persons. However, in HIV/HCV co-infected patients, increased rate of progression to cirrhosis and HCC has been reported. Limited information exists regarding genetic variants of HCV circulating among co-infected patients, which could be important in the design of broadly protective vaccine and management of the disease. Here, we determined the genotypes of HCV isolates circulating among HIV/HCV co-infected patients in Ibadan, southwestern Nigeria. One hundred and twenty-five HIV/HCV IgM positive samples obtained from HIV laboratory, University of Ibadan were used for this study. HCV NS5B gene was amplified using polymerase chain reaction (PCR). The amplified NS5B gene was sequenced using gene specific primers. Twenty isolates were amplified, out of which 13 were successfully sequenced. Phylogenetic analysis of the 13 sequenced isolates showed three HCV subtypes 1a, 3a and 5a belonging to genotypes 1, 3 and 5 respectively. Ten isolates (77%) belong to subtype 5a, followed by 2 isolates (15%) subtype 1a and 1 isolate (8%) was subtype 3a. The predominant HCV genotype was 5, followed by genotype 1 (subtype 1a). The findings, as well as the observed mutations in NS5B gene, indicate the need for screening and monitoring of HIV/HCV co-infected patients. Further study to determine the phylogeny of isolates circulating in other parts of Nigeria will be carried out.

All-oral direct-acting antiviral therapy against hepatitis C virus (HCV) in human immunodeficiency virus/HCV-coinfected subjects in real-world practice: Madrid coinfection registry findings.

We evaluated treatment outcomes in a prospective registry of human immunodeficiency virus/hepatitis C virus (HCV)–coinfected patients treated with interferon‐free direct‐acting antiviral agent–based therapy in hospitals from the region of Madrid between November 2014 and August 2016. We assessed sustained viral response at 12 weeks after completion of treatment and used multivariable logistic regression to identify predictors of treatment failure. We evaluated 2,369 patients, of whom 59.5% did not have cirrhosis, 33.9% had compensated cirrhosis, and 6.6% had decompensated cirrhosis. The predominant HCV genotypes were 1a (40.9%), 4 (22.4%), 1b (15.1%), and 3 (15.0%). Treatment regimens included sofosbuvir (SOF)/ledipasvir (61.9%), SOF plus daclatasvir (14.6%), dasabuvir plus ombitasvir/paritaprevir/ritonavir (13.2%), and other regimens (10.3%). Ribavirin was used in 30.6% of patients. Less than 1% of patients discontinued therapy owing to adverse events. The frequency of sustained viral response by intention‐to‐treat analysis was 92.0% (95% confidence interval, 90.9%‐93.1%) overall, 93.8% (92.4%‐95.0%) for no cirrhosis, 91.0% (88.8%‐92.9%) for compensated cirrhosis, and 80.8% (73.7%‐86.6%) for decompensated cirrhosis. The factors associated with treatment failure were male sex (adjusted odds ratio, 1.75; 95% confidence interval, 1.14‐2.69), Centers for Diseases Control and Prevention category C (adjusted odds ratio, 1.65; 95% confidence interval, 1.12‐2.41), a baseline cluster of differentiation 4–positive (CD4+) T‐cell count <200/mm3 (adjusted odds ratio, 2.30; 95% confidence interval, 1.35‐3.92), an HCV RNA load ≥800,000 IU/mL (adjusted odds ratio, 1.63; 95% confidence interval, 1.14‐2.36), compensated cirrhosis (adjusted odds ratio, 1.35; 95% confidence interval, 0.96‐1.89), decompensated cirrhosis (adjusted odds ratio, 2.92; 95% confidence interval, 1.76‐4.87), and the use of SOF plus simeprevir, SOF plus ribavirin, and simeprevir plus daclatasvir. Conclusion: In this large real‐world study, direct‐acting antiviral agent–based therapy was safe and highly effective in coinfected patients; predictors of failure included gender, human immunodeficiency virus–related immunosuppression, HCV RNA load, severity of liver disease, and the use of suboptimal direct‐acting antiviral agent–based regimens. (Hepatology 2018;68:32‐47).

HBV and HCV Seroprevalence and the Predominant HCV Genotypes in a Hospital Setting in Cameroon

Infectious diseases are a substantial threat to global health. Hepatitis viral infections are life threatening infections, responsible for most liver cirrhosis and cancers. In order to determine the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections; as well as the HCV genotypes of the collected isolates, a study was conducted at a hospital setting in Cameroon. Enzyme immunoassays were used for HBV and HCV screening tests; HCV genotypes and subtypes were determined using standard molecular biology and genomic techniques that involved RT-PCR, gene cloning, DNA sequencing, and bioinformatics tools. The results showed that 14.15% of the study populations were screened HBV positive; whereas 24.82% were diagnosed HCV positive. The seroprevalence was higher in men: 12.75% and 16.1% respectively for HBV and HCV infections. The majority of HBV infected were younger, whereas HCV infected people were older. HCV genotypes 1 and 4 were identified. These findings are useful for policy making in Cameroon. Furthermore, the HCV clones generated in the present study might constitute useful and representative molecular tools for vaccine and drug development.

Genotype distribution of hepatitis C virus in 952 cases from 2014 to 2016 in Hunan Province, China.

IntroductionFew large-scale investigations on genotype (GT) distribution of hepatitis C virus (HCV) in Hunan Province, China, are reported.Material and methodsWe recruited all of the 952 patients in the census register of Hunan Province who were first diagnosed with HCV infection in the Second Xiangya Hospital, Central South University in 2014–2016. HCV genotypes were surveyed. The genotype distribution pattern was compared with those of the neighboring regions in China.ResultsAmong the 952 patients, genotype 1 (GT1) (69.9%) was the most common HCV genotype, followed by GT6 (19.0%), GT3 (8.4%), and GT2 (2.6%). GT4 and GT5 were not found. One case had mixed infection of GT3 and GT6. Predominance of GT1 HCV was more evident in the patients aged ≥ 40 years than in those aged < 40 years (79.5% vs. 47.9%, χ2 = 95.993, p < 0.001). HCV genotype distribution had gender difference (χ2 = 44.695, p < 0.001), with GT3 and GT6 more prevalent in males than in females (36.2% vs. 18.2%, χ2 = 39.088, p < 0.001) while GT1 more prevalent in females than in males (80.1% vs. 60.3%, χ2 = 44.276, p < 0.001). Though Hunan Province is located in central China, its HCV genotype priority was similar with the change trend in south and southwest China, while distinguished from those of other regions, in particular from the neighboring central province, Hubei Province.ConclusionsHCV GT1 was the most predominant HCV genotype in Hunan Province, and GT6 and GT3 accounted for a significant percentage, especially in young patients. The HCV distribution pattern was more similar to those of the regions in south China.

Sofosbuvir and Ribavirin for 24 Weeks Is An Effective Treatment Option for Recurrent Hepatitis C Infection After Living Donor Liver Transplantation

Recurrent hepatitis C virus (HCV) has been a serious problem after liver transplantation (LT). We report our experience of 24-week therapy with sofosbuvir (SOF) and ribavirin (RBV) in post-LT recurrent HCV in living donor liver transplantation (LDLT) setting in South Asia. Data from all patients treated for post-transplantation HCV recurrence in a single center were analyzed. Treatment regimen was 24 weeks of SOF 400mg daily and RBV (starting at 800mg daily, increased as tolerated). Sustained virological response (SVR) was assessed 12 weeks and 24 weeks after completion of treatment. 63 patients (median age 52 [range 30-69] years; 80% males) were treated. Most (76.2%) were treatment experienced and predominant HCV genotype was 3 (77.7%) followed by 1 (20.6%). Median transient elastography (Fibroscan) score was 7 (range 3-11) kPa and none of the patients had cirrhosis. SVR12 was achieved in 60 of 63 patients (95.2%) while SVR24 was noted in 59 (93.7%). SVR12 rates were as good in genotype-3 as in genotype-1. Older age, longer period after transplantation, higher Fibroscan value and higher need for erythropoietin were likely to be associated with relapse. Adverse effects were noted in 34 patients and weakness and fatigue were the commonest side effects. Significant drop in hemoglobin (<8g/dL) was seen in 6 patients. SOF+RBV combination therapy for 24 weeks was safe and effective in treatment of for post-LT recurrent HCV in a single LT center and remains relevant due to its low cost and lack of drug interactions.

Detection and analysis of hepatitis C virus in HIV-infected patients in the Guangxi province of China.

The aim of the present study was to investigate the prevalence rate of hepatitis C virus (HCV) infection in human immunodeficiency virus (HIV)-positive individuals and to study the infection status of HCV RNA in HIV-infected individuals who did not have anti-HCV antibodies in the Guangxi province of China, in order to provide basis for screening and clinical treatment of hepatitis C in future. Data were collected from patients recruited via a questionnaire. Between August 2008 and January 2009, 300 HIV-infected individuals were randomly selected from various HIV monitoring points in Liuzhou and Qinzhou (Guangxi, China). In addition, 41 patients with only hepatitis C were recruited from a hospital clinic (First Affiliated Hospital of Guangxi Medical University, Nanning, China). HCV antibodies in patient serum samples were detected by ELISA. HCV RNA expression was detected using nested polymerase chain reaction (PCR), HCV RNA levels in the serum were evaluated using quantitative fluorescence PCR, and HCV genotypes were confirmed using restriction fragment length polymorphism. The infection rate of HCV in the HIV-infected people was 48.67%. The anti-HCV positive rate differed between routes of disease transmission: Anti-HCV positive rate was 63.7% among drug users, 34.96% among sex-transmitted persons and 1.37% among other persons. In the anti-HCV-negative group, the HCV RNA-positive rate was 26.62%. In the anti-HCV-positive group, HCV RNA positive rate was 78.08%. HCV RNA level of HIV/HCV coinfected patients was higher than those infected with HCV alone, and there was no difference of anti-HCV-positive rate among different levels of HCV RNA. HCV genotypes of HIV/HCV coinfected persons showed diversity across Guangxi, and the predominant ones were the 1b and mixed subtypes. The predominant HCV genotypes were 6a, mixed subtypes and 3b amongst patients that contracted HCV via drug use-related routes of transmission. The patients with HCV transmission routes other than drug-related routes possessed 1b and 1a+1b genotypes. In conclusion, there was a large proportion of HIV infected persons with mixed HCV infection in the Guangxi province of China. The present results show that 26.62% of HCV-infected persons will be fail to be diagnosed with hepatitis C virus coinfection if we simply use ELISA to detect HCV antibody. The predominant HCV genotypes were 1b, mixed, 6a and 3b in HIV/HCV coinfected persons.

Epidemiology of hepatitis C virus and genotype distribution in immigrants crossing to Europe from North and sub-Saharan Africa.

The association between the prevalence of hepatitis C virus (HCV) and immigration is rarely studied, particularly for the immigrants crossing to the resettlement countries. Most of the published data are confined to those immigrants who were resident in European countries and rarely immigrated before they reach the final destination. Libya is a large country in North Africa with the longest coast of the Mediterranean Sea facing the European Union. It has been considered as the main transient station for African immigrants to Europe. The objectives of this study were to determine: (1) the prevalence of HCV in African immigrants gathered in Libya from different African countries on their way to Europe and (2) HCV genotype distribution in these immigrants and its correlation with different demographic factors. A total of 14205 serum samples were collected in a 3-year period (2013-2015) from different immigrants from North and sub-Saharan Africa who resided in the African immigrant campus, Tripoli, Libya. The participants were interviewed, and relevant information was collected, including socio-demographic, ethnic, and geographic variables. Each serum sample was tested for anti-HCV antibody using ELISA. The genotypes were determined and assigned using a specific genotyping assay and correlated with demographic and potential risk factors of the recruited individuals. Of the immigrants studied, 1078 (7.6%) were positive for HCV. The prevalence of HCV infection ranged from 1.4% to 18.7%; it was higher among individuals arriving from Nile river (3.6-18.7%) of North Africa, followed by those who arrived from the West African region (2.1-14.1%), Horn of Africa (HOA, 6.8-9.9%), and Maghreb countries (1.4-2.7%). The relative risk factor attributable to gender variation was not significant (95% Cl: 0.8513-1.2381). Five genotypes were detected in 911 African immigrants. Genotypic analysis showed that the predominant HCV genotypes in this group were genotypes 4, 1, and 2 that accounted for 329 (36.1%), 326 (35.8%), and 131 (14.4%) strains, respectively, followed by genotype 3 that accounted for 87 (9.5%) strains. Genotype 5 was isolated mainly from 18 HOA (2%) and 20 West African (2.2%) individuals. The prevalence of HCV is considered high with a unique disparate distribution among African immigrants crossing to Europe. This indicated that the prevalence of HCV is high among these immigrants and thus may be reflected on the HCV prevalence in the guest countries. The broad genetic heterogeneity of HCV genotypes detected here may impact the efficacy of prevention and control efforts for HCV in both Europe and North and sub-Saharan Africa; hence, an integrated global policy of actions is needed.

Resistance-associated mutations to HCV protease inhibitors naturally pre-existed in HIV/HCV coinfected, treatment-naïve patients

Presently, it has been approved to treat hepatitis C virus (HCV) infection with protease inhibitors (PIs). In the present study, we aimed to illustrate the natural prevalence of HCV NS3/4A PI resistance mutations in HIV/HCV coinfected, treatment-naïve patients. Population sequence analysis of the NS3/4A protease was conducted in 96 HIV/HCV coinfected, treatment-naïve patients. Complete HCV NS3/4A sequence information was obtained from 70 (72.92%) samples, including 68 patients (97.14%) with genotype 1b and 2 patients (2.86%) with genotype 2a. A total of 21 patients (30.88%) of the 68 patients with HCV genotype 1b showed amino acid substitutions associated with HCV PI resistance. Mutation F43S was observed in 1.47% of patients with genotype 1b. The mutations of T54S, Q80K/R, R155K, A156G and D168A/E/G were found in 4.41%, 1.47%/1.47%, 2.94%, 23.53% and 1.47%/1.47%/1.47% of patients with genotype 1b, respectively. In addition, 4.41% of patients with genotype 1b showed double mutations in the NS3 region. The multiple mutations of Q80R+R155K+D168G and Q80K+R155K+A156G+D168A were detected in 1.47% and 1.47% of patients with HCV genotype 1b, respectively. The most predominant HCV genotype was 1b in patients with HIV/HCV coinfection. Naturally occurring mutations resistant to HCV PIs (simeprevir, vaniprevir, boceprevir, telaprevir, asunaprevir and paritaprevir) pre-existed in patients with HIV/HCV genotype 1b coinfection. The effects of baseline PI resistance on treatment outcome should be further analyzed.

The genotype distribution of hepatitis C in southeastern Taiwan: Clinical characteristics, racial difference, and therapeutic response

The genotypes of hepatitis C virus (HCV) are associated with the therapeutic response. The racial diversity of Taitung, Taiwan is heterogeneous and a distinguishing feature; how such racial differences influence the genotype distribution and treatment outcome has not been well studied. The objective of this study is to elucidate the HCV genotype distribution in southeastern Taiwan and to analyze the racial differences influencing genotypes and clinical implications. In this retrospective cohort study, we included 343 patients who had been treated with peginterferon-alpha plus ribavirin. The predominant HCV genotype in the southeastern area was type 1 (43.7%), followed by type 2 (37.0%). The proportion of patients mixed with genotype 1 was lower in indigenous vis-à-vis nonindigenous groups (46.1% and 60.2%, p = 0.02). The prevalence of genotype 6 (5.2%) seems higher than in the general population of Taiwan and showed no difference between indigenous and nonindigenous people. The sustained virological response rate was higher in patients without genotype 1, low baseline HCV RNA (≤ 400,000 IU/mL), and in patients who achieved rapid virological response. Racial differences did not influence the therapeutic response. In this retrospective study, the proportion of HCV genotype 6 appeared slightly higher in southeastern areas than in the general population in Taiwan. The prevalence of genotype 1 in indigenous people was statistically lower than in nonindigenous people. Sustained virological response rate did not show any significant difference between indigenous and nonindigenous people in the current study.

Co-infections and transmission networks of HCV, HIV-1 and HPgV among people who inject drugs.

Co-infections with human immunodeficiency virus type 1 (HIV-1) and human pegivirus (HPgV) are common in hepatitis C virus (HCV)-infected individuals. However, analysis on the evolutionary dynamics and transmission network profiles of these viruses among individuals with multiple infections remains limited. A total of 228 injecting drug users (IDUs), either HCV- and/or HIV-1-infected, were recruited in Kuala Lumpur, Malaysia. HCV, HIV-1 and HPgV genes were sequenced, with epidemic growth rates assessed by the Bayesian coalescent method. Based on the sequence data, mono-, dual- and triple-infection were detected in 38.8%, 40.6% and 20.6% of the subjects, respectively. Fifteen transmission networks involving HCV (subtype 1a, 1b, 3a and 3b), HIV-1 (CRF33_01B) and HPgV (genotype 2) were identified and characterized. Genealogical estimates indicated that the predominant HCV, HIV-1 and HPgV genotypes were introduced into the IDUs population through multiple sub-epidemics that emerged as early as 1950s (HCV), 1980s (HIV-1) and 1990s (HPgV). By determining the difference in divergence times between viral lineages (ΔtMRCA), we also showed that the frequency of viral co-transmission is low among these IDUs. Despite increased access to therapy and other harm reduction interventions, the continuous emergence and coexistence of new transmission networks suggest persistent multiple viral transmissions among IDUs.

The complete title: The effect of interleukin-28B rs12979860 polymorphism on the therapeutic response of Moroccan patients with chronic hepatitis C

Background/aimsThere is increasing evidence for the effect of rs12979860 IL28B polymorphism in response to the standard treatment PEG-IFN/RBV (i.e. combination of pegylated interferon and ribavirin) in chronic hepatitis C virus (HCV) infection. The present study aimed to determine the impact of IL28B associations in interferon responsiveness in 187 Moroccan patients with chronic HCV infection. MethodsHCV RNA levels were measured with a real-time RT-PCR assay and treatment efficacy was assessed by sustained virological response (SVR) and patients were classified as responders or non-responders. IL28B rs12979860 polymorphism genotyping was achieved by PCR-HRM technique. ResultsThe results demonstrated that SVR was achieved in 102 patients (55%); while 69 were non-responders (37%) and 16 relapsed (8%). Genotype 1 was the predominant HCV genotype detected in 112 patients followed by genotype 2 in 56 patients. The genotype CC was observed in 42 cases (25%); CT in 69 (41%) and TT in 57 (34%) demonstrating a C allele frequency of 46%. The SVR was observed in 32 patients with genotype CC accounting for 76%. The frequencies of rs12979860 CC type in infected individuals with HCV genotype 1 were 47% and 12% respectively in SVR and non-SVR groups. A highly statistically significant association between this SNP and SVR was found (p<0.001). Using multivariate logistic regression analysis, CC genotype was an independent factor for SVR. In the group of patients infected with genotype 2, SVR rate was 79%. The frequency of rs12979860 CC type in SVR group (n=4) was 9% and rs12979860 non-CC genotype was highly associated with SVR (p=0.001). ConclusionThis finding adds evidence that genotyping for the IL-28B rs12979860 SNP can be a good parameter for the prediction of treatment success in patients with chronic hepatitis C before initiation of antiviral therapy in Morocco.

Spectrum of Incidentally Detected Hepatitis C Virus Infection in Southern India- A Prospective Study

Purpose/Aims: The relationship between viral replication, genotypes, host biochemical characteristics, clinical outcomes and mode of transmission in Indian subjects with incidental detection of hepatitis C virus (HCV) infection is yet to attain. We evaluated the above parameters in incidentally detected asymptomatic subjects seropositive for HCV antibody (anti-HCV). Methods: Incidentally detected 96 anti-HCV positive subjects were evaluated by clinical, endoscopic, ultrasound and demographic parameters. Blood samples were assessed for biochemical and serological markers. Serum HCV RNA and genotypes were assessed by real time PCR and line probe assay respectively. Results: Majority (57%) of the subjects had non specific symptoms followed by detection during pre surgical checkup (20%) and blood donation (16%). Previous history of dental procedures (41.3%), surgical procedures (33.7%) and blood transfusions (25%) were identified as major risk factors. Genotype 3 was predominant (47%), followed by 1 (37%) 4 (15%) respectively while genotype 5 was identified in a single cirrhotic subject. Type 2 diabetes and esophageal varices were observed in 22% and 18% subjects respectively. Significant alterations of serum albumin, platelets count, AST and INR were evident in older subjects (＞50 years). Cirrhotic features were observed in a number of subjects having both low and high viral load. Conclusion: The probable risk factors for acquisition of HCV infection identified in almost all study subjects of which one fifth were though apparently asymptomatic had cirrhosis. The predominant HCV genotype was 3.Genotype 5 has been identified for the first time from southern India.

Assessment of Genetic and Immunological Factors Associated with Hepatitis C Infection in Saudi Hemodialysis Patients

The association of human leukocyte antigen (HLA) genotype and hepatitis C virus (HCV) infection has been reported in many populations. In addition, the HLA genotype distribution has been found to differ according to ethnicity. Currently, there are no published data concerning this relationship in the Saudi population. Therefore, the primary objective of this study was to determine the relationship between HLA genotype and HCV infection in a group of haemodialysis patients in a tertiary hospital in the Eastern Province of Saudi Arabia. A total of 152 haemodialysis patients and 160 controls were enrolled in the study. The patient group included 91 males and 61 females with a mean age of 48 years, who had been on haemodialysis for a period of 6 months to five years. The control group was randomly selected from donors attending the blood bank and included 155 males and five females with a mean age of 38 years. Of the patient group, 27 (17.8%) were found to have HCV antibodies by EIA. The seropositivity was confirmed by RIBA and by RT-PCR. The average viral load was 15 × 103 HCV RNA per 10 μl of plasma. The predominant HCV genotype was found to be genotype 4. HLA-class I and HLA class II were screened in 27 HCV-positive patients and in 30 age and sex matched controls by polymerase chain reaction/sequence specific primers (PCR/SSP) method. Measurements of cytokines Interleukin-2, 10, IFN-γ and TNFα showed that IL-2 level was 17.65 - 20.3 pg/l; IFN-γ was 22.15 - 41.1 pg/l; TNF-α was 2.5 - 5.6 pg/mL and IL-10 was 10.7 - 14.8 pg/mL. Measurement of CD markers showed the following: CD3 cells were measured. There was no correlation between infection with HCV and HLA type, cytokines levels and levels of different cell populations. CD markers are similar in the HCV-positive and HCV-negative hemodialysis patients. Further analysis and comparisons are needed, especially between the cytokines and CD markers in the hemodialysis patients and control groups.