Hepatitis C virus (HCV) has infected approximately 170 million people worldwide. While the seroprevalence of anti-HCV antibody among Iranian blood donors is 0.13%, HCV infection is prevalent in 59-80% of Iranian injecting drug users. One hundred seventy-eight anti-HCV positive patients were referred to the Gastroenterology Department at the Taleghani Hospital (Tehran, Iran) between June 2007 and June 2012. Out of 178 samples, 142 were positive for HCV-RNA. HCV subtypes were determined using phylogenetic analysis of the NS5B or 5'UTR/core regions. Of 142 viremic patients, 71 (50%) were infected with HCV subtype 1a, 43 (30.3%) with subtype 3a, 20 (14.1%) with subtype 1b, 3 (2.1%) with subtype 4d, 2 (1.4%) with subtype 4a, 1 (0.7%) with subtype 2b, and 1 (0.7%) with subtype 6a. Interestingly, genetic analysis of a sub-genomic fragment from one patient identified a non-subtypeable HCV genotype-3 strain. There was a significant association between HCV subtype and a history of injecting drug use (P = 0.003). Subtype 3a was predominant among patients with such a history. Injecting drug use was associated with younger age (P < 0.001). HCV subtype was also significantly associated with a history of upper gastrointestinal endoscopy (P = 0.02). Subtype 1a was more frequent among patients with such a history. In addition, history of upper gastrointestinal endoscopy was significantly associated with older age (P = 0.002). In conclusion, while HCV subtype 1a is predominant among infected Iranian individuals, subtype 3a is predominant among Iranian injecting drug users.
Hepatitis C virus (HCV) isolates have been divided into six major genotypes, each of them further divided into several subtypes. Previous studies have shown that the most frequent genotype in Iranian patients with HCV infection is 1a, followed by 3a, 1b and 4. Infections with genotype 6 isolates have not previously been observed in these patients. In this report, we will describe the first diagnosis of HCV genotype-6 infection in Iran. The case was a 62-year-old man with positive anti-HCV antibody. Alanine aminotransferase and aspartate aminotransferase levels were 14 and 32 IU/L respectively. Viral RNA was extracted from plasma. HCV RNA level was determined using real-time reverse transcription polymerase chain reaction (PCR). Following the synthesis of the complementary DNA, 5'-UTR/core region of the HCV genome was amplified and subjected to direct sequencing. Genetic distances were estimated and phylogenetic tree was constructed. HCV viral load was 9,572,718 IU/mL. The mean inter-genotypic distance between the case sequence and the corresponding sequences of other genotype 6 isolates was 3.7%. In the phylogenetic tree, the 5'-UTR/core sequence of the subject was located in a cluster representing HCV subtype 6a. The patient was infected with HCV subtype 6a. Prior to this case, there have been no previous reports on the isolation of this genotype/subtype from any other Iranian patient. Previous epidemiological studies provide valuable information about the distribution patterns of different HCV genotypes. However, infection with genotypes other than common ones should be flagged by specialists and diagnostic laboratories, especially in patients with high-risk behavioral backgrounds.
BackgroundHepatitis C virus (HCV) is one of the leading causes of chronic liver disease. Seven genotypes and more than 80 subtypes have been identified for HCV so far. To date, 10 subtypes (3a to 3i; and 3k) of HCV genotype 3 have been identified. In 2006, two HCV isolates were reported from Iran that belonged to a new subtype of genotype 3. However, considering the consensus proposal for HCV genotype nomenclature, the available sequences of the new subtype did not correspond to the regions that are required to be analyzed prior to subtype assignment. During a study on the molecular epidemiology of HCV in Iran, an HCV isolate (FSM165) which seemed to belong to a new subtype of genotype 3 was obtained from a patient residing in Tehran, Iran.ObjectivesThe aim of this study was to assess the relatedness of isolate FM165 together with several sequences retrieved from the database to the new HCV-3 subtype reported from Iran in 2006.Materials and MethodsVarious parts of the genome including the core/E1 region and two segments of the NS5B region were amplified and sequenced for isolate FSM165. Furthermore, using the Basic Local Alignment Search Tool (BLAST), the HCV database was searched for sequences that had a high level of similarity with sequences of FSM165 isolate and such sequences were retrieved from the database. To investigate the relatedness of isolate FSM165 and also the retrieved sequences to a new HCV-3 subtype reported previously, phylogenetic analyses were performed using the Kimura two-parameter model and the neighbor joining method.ResultsPhylogenetic analysis of the partial NS5B region demonstrated the relatedness of isolate FSM165 to the new subtype reported from Iran in 2006. Moreover, some core/E1 and NS5B sequences that had a high level of similarity with FSM165 isolate were found through searching the HCV database. These sequences were previously either misclassified or could not be accurately classified. Phylogenetic analyses showed that all of the described sequences belonged to the new subtype of HCV genotype 3.ConclusionsData suggests that the new subtype has a vast geographical distribution in Iran. The core/E1 and the NS5B sequences described in this paper can be used as references for the new HCV-3 subtype in future studies.
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