Association of genotypes with viral load and biochemical markers in HCV-infected Sindhi patients

Abstract

The presented study had two objectives. The first was to examine distributions of Hepatitis C Virus (HCV) genotypes in Sindh, Pakistan, where HCV is prevalent. The other was to explore clinically relevant relationships between the genotypes, viral load (measured by real-time polymerase chain reaction assays) and biochemical markers. For this, 1471 HCV-infected patients in six cities in Sindh were recruited and sampled. HCV genotype distributions varied among the cities, but genotype 3a was most prevalent, followed by 3b, 1a and 1b (detected in 51.5, 22.7. 9.25 and 3.2% of the cases, respectively). No type-specific sequences were detected in serum samples from 189 (12.8%) of the 1471 patients. Frequencies of low (<200,000 IU/mL serum), intermediate (200,000–600,000 IU/mL serum) and high (>600,000 IU/mL serum) viral loads were respectively 45.4, 16.5 and 38.1% for patients infected with genotype 3, and 16.9, 36.9 and 46.2%, respectively, for patients with other genotypes. Infection with genotype 1a was associated with significantly higher (p < 0.005) alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase titers than infection with genotype 3a. The results will help in the formulation of treatment strategies.

Prediction of HCV load using genotype, liver biomarkers, and clinical symptoms by a mathematical model in patients with HCV infection

“…Several biochemical and molecular assays are now available for the diagnosis, monitoring, and clinical management of chronic HCV infection . In various studies, the optimal cut‐off point of some noninvasive markers of liver fibrosis has been determined using ROC curve analysis .…”

“…The measurement of the HCV RNA load has been introduced as a useful approach for monitoring disease progression and treatment response . In developing countries, most of the HCV infected cases could not be diagnosed and treated due to limited resources.…”

“…In developing countries, most of the HCV infected cases could not be diagnosed and treated due to limited resources. Therefore, simpler, less expensive, and more rapid methods and/or algorithms are required for the quantification of HCV viremia . Recently, Kao et al used the signal‐to‐cut (S/CO) ratio of anti‐HCV antibody to predict HCV viremia, among a hemodialysis population.…”

“…Throughout the world, variations in the HCV genome sequence are utilized to classify the virus, according to seven major genotypes and 67 subtypes. The most prevalent genotypes are 1, 2, and 3, while the remaining four are confined to specific regions of the world . Genotype 1 and genotype 3 are the most dominant HCV subtypes found among Iranian patients.…”

“…Aside from sequencing methods, real‐time PCR is among the most sensitive techniques for HCV genotyping. The major limitation of the HCV core Ag assay is that it offers a lower sensitivity than the RT‐PCR method …”