Geographic Distribution of Hepatitis C Virus Genotypes in Pakistan

Abstract

Background:Distribution of Hepatitis C Virus (HCV) genotypes may be changed over time. Epidemiological Studies on distribution patterns of HCV genotypes in Pakistani population might assist for better treatment options and preventive strategies.Objectives:This study was conducted to determine distribution patterns of HCV genotypes in different geographical regions of Pakistan.Patients and Methods:In this cross-sectional study, 1818 randomly selected patients from different geographical regions of Pakistan, diagnosed with HCV infection by the third generation Enzyme Linked Immunosorbent Assay (ELISA), were included between April 2011 and December 2013. HCV RNA was detected in serum samples of patients by Reverse Transcription Polymerase Chain Reaction (RT- PCR) of the core region. Qualitative PCR was performed to determine viral load. HCV genotyping was performed by RT-nested PCR using type-specific primers of the core region. Frequency of different genotypes among patients was assessed according to gender, age and geographical region at the time of sampling.Results:Of 1818 HCV RNA positive samples, HCV genotypes PCR fragments were detected in 1552 (85.5%) samples. HCV genotype 3a was the predominant genotype (39.4%) followed by genotype 2a (24.93%). HCV genotype 3 was the predominant genotype in Punjab and Sindh regions, while genotype 2 was the most predominant genotype in Khyber Pakhtunkhwa region and the second predominant genotype after genotype 3 in Sindh region. The incidence of genotype 2a is increasing in our country with decrease in the incidence of genotype 3a. A higher incidence of HCV various genotypes were observed among male patients and those younger than 45 years.Conclusions:This study may facilitate treatment options and preventive strategies in Pakistan.

An overview on hepatitis C virus genotypes and its control

“…The frequency of HCV is highest in few countries and areas, such as in Europe 25 million cases are HCV positive [17]. In Pakistan, HCV is 5% prevalent [18], whereas 5-9% prevalence is detected in Khyber Pakhtunkhwa province of Pakistan [19] causing liver cancer [20]. HCV-4 is prevalent among Middle East and Africa causing more than 80% of HCV infections and has recently spread to several European countries.…”

Sofosbuvir based therapy in Hepatitis C patients with and without cirrhosis: Is there difference?

“…Predominant genotype in Pakistan is 39 and with Sofosbuvir, the only available DAA we needed to explore the outcome of this treatment in our patients especially those with advanced liver fibrosis. We planned a study to compare outcome of Sofosbuvir based therapy in terms of sustained viral response at 12 (SVR12) in patients with chronic hepatitis C with and without liver cirrhosis.…”

Prevalence of Hepatitis C virus infections among the general population of Buner, Khyber Pakhtunkhwa, Pakistan

“…They reported the highest prevalence of HCV in males that was 282 (53.1%) and females 255 (46.9%). The HCV genotype details were shown as: Type 3a were 355 (66.11%), 3b were 14 (2.61%), 2a were 40 (7.45%), 2b were 5 (0.93%), type 1a were 9 (1.67%), 1b were 9 (1.67%) and patients with mixed types 2a and 3b, 3 (0.56%) were combined 3a and 3b and unable to type were 101 (18.81%) (Khan et al, 2014).…”