Molecular characterization of hepatitis C virus in liver disease patients in Botswana: a retrospective cross-sectional study

Abstract

BackgroundHepatitis C virus (HCV) infection is a major cause of chronic liver disease globally. Direct acting antivirals (DAAs) have proven effective in curing HCV. However, the current standard of care (SOC) in Botswana remains PEGylated interferon-α (IFN-α) with ribavirin. Several mutations have been reported to confer resistance to interferon-based treatments. Therefore, there is a need to determine HCV genotypes in Botswana, as these data will guide new treatment guidelines and understanding of HCV epidemiology in Botswana.MethodsThis was a retrospective cross-sectional pilot study utilizing plasma obtained from 55 participants from Princess Marina Hospital in Gaborone, Botswana. The partial core region of HCV was amplified, and genotypes were determined using phylogenetic analysis.ResultsFour genotype 5a and two genotype 4v sequences were identified. Two significant mutations – K10Q and R70Q – were observed in genotype 5a sequences and have been associated with increased risk of hepatocellular carcinoma (HCC), while R70Q confers resistance to interferon-based treatments.ConclusionGenotypes 5a and 4v are circulating in Botswana. The presence of mutations in genotype 5 suggests that some patients may not respond to IFN-based regimens. The information obtained in this study, in addition to the World health organization (WHO) recommendations, can be utilized by policy makers to implement DAAs as the new SOC for HCV treatment in Botswana.

Seroprevalence and risk factors of hepatitis B, C and D virus infection amongst patients with features of hepatitis in a referral hospital in Botswana: A cross-sectional study

“…3,14 The anti-HCV seroprevalence in this study was higher (4.3%) than the previously reported rates of 0.49% -0.8% in HIVinfected patients in Botswana, likely because of the fact that the enrolled patients had liver disease. 17,18,52 Higher anti-HCV seroprevalence between 6% and 22.5% has been reported from similar studies in Africa and Asia. 5,10,12,26 Similar to other studies in this region a slightly higher prevalence (57%) was found in females.…”

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“…19,27,28 In this study, we have confirmed that only two genotypes circulating in Kilifi County; this can form a basis for more targeted control for the 2 subtypes in the region.Hepatitis C Virus diversity is very essential in response to antiviral therapy. 21,29 More severe liver disease and more elevated liver enzymes have been highly associated with HCV genotype 1. 30 The endemicity of HCV genotypes in some areas is revered with multiplicity and diversity of subtypes and strains.…”

“…20 (Zymo, Irvine, CA, USA) according to the manufacturer's protocol to eliminate unincorporated primers and dNTPs. 21 The purified amplicons were sequenced with Big Dye kit, and the ABI PRIS M 3100 genetic analyzer (Applied Biosystems) according to manufacturer's instructions.…”

“…Homology and evolutionary distance pair-wise comparisons for percent nucleotide were made. 21 The phylogenetic analysis of HCV isolates was performed with MEGA7.0.14software.…”

Hepatitis C Virus Genotype 5 Variability in Treatment-Naïve Patients in South Africa

“…HCV genotype 5 was originally identified in South Africa [15,16], where it represents 35-60% of all HCV genotypes [16][17][18][19][20]. However, pockets of genotype 5 infections have been reported in France, Spain, Syria, Greece, Botswana, Ethiopia, India, and Belgium [21][22][23][24][25][26][27][28][29][30][31][32]. There is paucity of data on resistance-associated variants (RAVs) in South Africa.…”