Abstract:Hepatitis C virus (HCV) is an emerging infection worldwide and the numbers of persons infected are increasing every year. Poor blood transfusion methods along with unsafe injection practices are potential sources for the rapid spread of infection. Early detection of HCV is the need of the hour especially in high risk group population as these individuals are severely immunocompromised. Enzyme Immunoassays are the most common detection techniques but they provide no evidence of active viremia or identification … Show more
“…In the last decade, technologies to assess HCV Ab and RNA levels and our knowledge to use this information to treat HCV infection has improved significantly. 22 Additionally, DAAs have helped achieve >95% cure rates (defined as SVR at 12 weeks) for HCV infection. 11,13 Schlendorf et al 11 reported their single center experience of 11 adult HTs using HCV-viremic donor hearts.…”
“…In the last decade, technologies to assess HCV Ab and RNA levels and our knowledge to use this information to treat HCV infection has improved significantly. 22 Additionally, DAAs have helped achieve >95% cure rates (defined as SVR at 12 weeks) for HCV infection. 11,13 Schlendorf et al 11 reported their single center experience of 11 adult HTs using HCV-viremic donor hearts.…”
“…However, other than the 5 0 UTR region, the core region is also targeted for PCR based detection of HCV, as a recent study has shown that sequence divergence of the core region is greater than the divergence of the 5 0 UTR sequence. Hence, detection based on the sequence of the core region can reliably identify subtypes as well as major genotypes [13].…”
Section: Detection Of Hepatitis C Virus Ribonucleic Acidmentioning
Located within 5 0 untranslated region of HCV RNA is internal ribosome entry site (IRES) which directs cap-independent translation of viral polyprotein. Mutations in IRES sequence have been shown to cause changes in efficiency of protein translation in vitro in few instances. No study has been done to investigate association between frequency of nucleotide sequence variations in IRES region of HCV-3 RNA and response to pegylated interferon-a plus ribavirin therapy. Hence, this study was planned to analyze relationship between frequency of nucleotide sequence variations of HCV-3 IRES region and response to therapy. Twenty-seven HCV-3 patients were studied, of whom 19 responded to therapy and 8 did not. Alanine aminotransferase and aspartate aminotransferase levels were significantly lower in responders compared to non-responders. HCV RNA detection and genotyping was performed by nested-PCR and RFLP respectively. Viral load quantification in pre and post therapy samples was done by real time PCR. The viral load was significantly lower in the patients after treatment as compared to before treatment. HCV IRES region from pre-treatment sera of 27 HCV-3 infected patients was amplified by nested PCR and sequenced. Secondary structure of IRES region of HCV-3 was predicted using the M fold Web Server. Mutational analysis revealed hot spot of mutations in HCV-3 IRES region from 40-80 and 210-280 nucleotides. Though more mutations were found in non-responders as compared to responders, this difference was statistically insignificant. Therefore, in addition to IRES region of HCV-3, some other host and viral factors may contribute to therapy outcome.
“…Sofosbuvir, a newer antiviral drug has altered the situation with regard to HCV cures by pegylated/ standard interferon and ribavarin which previously achieved in some 23%-90% individuals. [11][12][13][14][15][16][17][18] Nowadays, not only sofosbuvir but also other newer oral antiviral agents are associated with complete cure rates of around 99%-100% with or without interferon. [19][20][21][22][23] The ELECTRON trial has shown 100% SVR with dual interferon-free regime containing sofosbuvir and ribavirin in genotypes 2 and 3.…”
Qualitative analysis is a cost-effective and sensitive method in patients treated with sofosbuvir for confirming RVR, especially in developing countries where patients are self-paying with significant financial constraints.
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