HCV genotype-specific correlation with serum markers: Higher predictability for genotype 4a

Abstract

BackgroundSeveral factors have been proposed to assess the clinical outcome of HCV infection. The correlation of HCV genotypes to possible serum markers in clinical prediction is still controversial. The main objective of this study was to determine the existence of any correlation between HCV genotypes to viral load and different clinical serum markers.MethodsWe performed a prospective cross-sectional and observational study. About 3160 serum HCV RNA positive patients were chosen from 4020 randomly selected anti-HCV positive patients. Statistical analysis was performed using the SPSS 16 software package. ROC (receiver operating characteristics) curves were used to compare diagnostic values of serum markers to predict genotypes.ResultsThe most prevalent genotype was 3a (73.9%) followed by 1a (10.7%), 4a (6.4%) and 3b (6.1%) in Pakistani population. No correlation was found between viral load and serum markers for genotype 3a in a large no. of sample (n = 2336). While significant correlation was observed between viral load and AST in genotype 3b, ALP with viral load and ALT for genotype 1a. Patients with genotype 4a showed a significant inverse correlation with viral load and Hb level and AST with ALP. For genotype 4a, AUC (area under the curve) of ALT, ALP, AST, bilirubin, Hb level and viral load was 0.790, 0.763, 0.454, 0.664, 0.458 and 0.872 respectively.ConclusionsIn conclusion, there was a significant variable response of HCV genotypes with serum markers. Severity of disease is independent of serum marker level in genotype 3a, while the liver damage in genotype 4a may associate with viral cytopathic effect as well as the immune-mediated process. An index using six serum markers may correctly predict genotype 4a in patients with ≥75% accuracy.

Distribution of HCV Genotypes and RNA Viral Load Along with Hemato-Biochemical Analysis of HCV Patients in Rahim Yar Khan, Okara and Toba Tek Singh Districts of Punjab, Pakistan

“…This study also reported many rare genotypes like 5a, 1c, and 6a, which are uncommon and less reported. Unlike Ali et al (8) sudy findings, the findings of this study support the verdict of some previous studies that showed the presence of genotypes such as 5a, 4a, and 1c in spite of their rare status (9)(10)(11)16). These findings are in contradiction with those of some studies that have shown the partial absence of genotypes 4, 5, and 6 (8,17).…”

“…In the former studies, genotypes have not found to be correlated with enzyme profile of the patients (4,23,24). Possibly, due to less sample size, regression model and correlation could not provide any statistical significance, which is in contrast to recent studies (16). …”

The genetic diversity and evolutionary history of hepatitis C virus in Vietnam

“…In contrast, genotype 4 is primarily limited to indigenous populations in North Africa and the Middle East, 5a to South Africa, and genotype 6 to Southeast Asia and IDUs and expatriates from that region (Pybus et al , 2009; Pybus et al , 2007). HCV genotype is an important indicator for patient management because its genetic variation patterns are associated with responses to the therapy of pegylated interferon plus ribavirin (Ahmad et al , 2011; Fried et al , 2002). …”

Correlation of Viral Loads with HCV Genotypes: Higher Levels of Virus Were Revealed among Blood Donors Infected with 6a Strains

“…In contrast, genotype 4 is often found in North Africa and the Middle East [10], 5a in South Africa [11], and genotype 6 in Southeast Asia [12]. HCV genotypes are an important factor for patients' management because their variations are associated with different responses to the therapy with pegylated interferon plus ribarivin – the current standard regimen for treating chronic hepatitis C [13], [14], [15]. Although less understood, viral load may be another factor that affects the treatment duration, dosage, and responses [15], [16], [17].…”