Clinical Profile and the Circulating Genotypes of Hepatitis C Virus in a Tertiary Care Hospital in West Bengal

Abstract

Background and objectives- Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide, with majority of the patients being asymptomatic and when they present to clinicians, they have already advanced liver disease in form of cirrhosis or hepatocellular carcinoma. Data from developing countries on this evolving global health problem are sparse. Hence this study was planned with the aim to determine the HCV genotypes prevalant in patients attending a tertiary care hospital with their clinical prole. Materials and Methods- Detailed history taking and clinical examination were done of consecutive 30 patients who attended out-patient department or admitted at in- patient department of Tropical Medicine with chronic hepatitis C. Laboratory investigations like LFT, viral serology (HBsAg, AntiHCV, HIV), prothrombin time, ultrasonography of upper abdomen, HCV- RNA Quantative assay with genotyping were done. Data were collected and then analysed using standard statistical methods. Result- Of proposed 30 sample size, complete data could be collected of 28 patients and accordingly, analysis was done. Of the 28 HCV seroreactive individuals, majority (20) were males. The mode of transmission was unknown in 19 patients, blood transfusion in 5 patients who were thalassemic and hemodialysis in remaining 4 patients. Most of the patients (18/28) were asymptomatic even if their viral load was high. Most common presenting symptom was dyspepsia. LFT showed signicant transaminitis in 50% of the patients. Of the 28 seroreactive patients, 15 (53.57%) were HCV RNA positive based on RT-PCR. HCV rNA was below detectable level in 13 patients. HCV genotype 3 was the predominant genotype found in 11 individuals followed by genotype 1 found in 3 and genotype 2 was seen in one individual. Conclusion- Community screening specially among high risk individuals is needed for early diagnosis and prompt treatment of chronic hepatitis C to prevent its several complications and also to prevent community spread.