Hepatitis C genotype distribution in patient and blood donor samples in South Africa for the period 2008–2012

Abstract

There are limited molecular epidemiological studies of hepatitis C at a national level in South Africa. The introduction of newer treatment modalities for hepatitis C requires knowledge of the genotypes as these may have different prognostic and therapeutic implications. This retrospective study describes genotype distributions of patients attending specialist clinics and a blood donor group studied during the period 2008-2012 in South Africa. Residual samples from diagnostic viral load testing from specialist clinics in South Africa (n=941) and from the South African National Blood Service (n=294) were analysed quantitatively by real-time PCR and genotyped using the Versant line probe assay or sequencing. Genotype 1 was predominant in blood donors (34%), whilst genotype 5a was prevalent in patients (36%). In the blood donor group, genotype 4 was detected for the first time. Genotype 2 was rare in the patient group and not detected in blood donors. Genotype 1 was the predominant genotype in the younger age groups (less than 30 years), whereas genotype 5a was found at higher proportions in the older age groups for both the patient and blood donor groups, comprising more than 60% of genotypes in those older than 50 years. Genotypes 1 and 5 were at highest proportions across all provinces compared to other genotypes. In blood donors, genotype 1 was predominant among Caucasians (43%) and genotype 5a among Blacks (54%). Such information is required for planning the impact on the health sector with regard to newly emerging therapies for hepatitis C and burden of disease.

Hepatitis B, hepatitis C and HIV prevalence and related risk practices among key populations in South Africa: findings from a seven-city cross-sectional survey

“…The circulating prevalence of HCV genotypes 1a and 3a is similar to other countries where HCV infection is networked and predominantly spread through the sharing of contaminated injecting equipment among PWID [43,44]. However, of note in South Africa, genotype 5a (a unique and prevalent genotype [45]) was not found and this suggests that 5a circulates in the general population and not in PWUD/ID or other KPs.…”

“…The overall HBsAg prevalence of 4% is similar to the general population [45,9]. This may seem somewhat surprising given that we would expect these high risk groups to show a higher prevalence than that of the general population.…”

Eliminating hepatitis C within low-income countries – The need to cure genotypes 4, 5, 6

“…6 An analysis of blood donors and the general population in South Africa showed that overall GT5 was a prevalent genotype and accounted for 54% of HCV infections in Black South Africans. 7 HCV GT5 has also been reported in some regions of Belgium, France, Spain, Greece, the Netherlands, Luxembourg and Syria. [8][9][10][11][12][13] These unusual pockets of GT5 infection in Europe are among individuals who have not travelled.…”

Hepatitis B, hepatitis C and HIV prevalence and related sexual and substance use risk practices among key populations who access HIV prevention, treatment and related services in South Africa: findings from a seven-city cross-sectional survey (2017)

“…However genotype 5a (a unique and prevalent genotype) was not found. A study of blood samples from patients attending specialist clinics (n=941) and blood donors (n=294 ) between 2008 and 2012 identi ed genotype 5a to be common among specialist clinic patients (36%) and particularly common (60%) among people over 50 years old in both groups, and among Black African people (54%) [56]. The lack of genotype 5a in this study suggests that the modes of transmission of identi ed genotypes among PWUD/ID and other KPs differs from older patients attending specialist clinics, some of whom contracted HCV through blood transfusions and unsafe medical injections [57], traditional practices such as tribal scari cation [58] or unknown risks.…”