Molecular epidemiology and viral load of HCV in different regions of Punjab, Pakistan

Abstract

BackgroundHepatitis C virus (HCV) is highly infectious pathogen which is responsible for causing Hepatitis around 200 million individuals worldwide. In Pakistan, 4.7% of HCV prevalence has been reported and HCV genotype 3a has been found to be the major source of infection in Pakistan but still there is lack of information on distribution of HCV genotypes and viral load in various geographical regions of Pakistan. Therefore, current study was designed to determine distribution of HCV genotypes as well viral load in different areas of Punjab province of Pakistan.FindingsA total of 995 serum samples were taken from those individuals in which antibodies against HCV were detected through ELISA, from different regions of Punjab i.e. Lahore 317(31.85%), Faisalabad 70(7.03%), Gujranwala 129(12.96%), Gujrat 106(10.65%), Sialkot 94(9.44%), Sargodha 60(6.03%), Mandibaha-ud-din 135(13.56%), Jhang 86(8.64%). Qualitative PCR was performed to determine viral load and genotyping was performed using Nested PCR. Chi-square test was used to determine the age and sex-wise prevalence of HCV. Out of 995 samples, 888 samples were found positive for HCV RNA. In all regions, genotype 3a showed highest prevalence (82.81%) followed by genotype 1 (3.41%), mixed genotypes (2.41%), genotype 2 (0.50%), genotype 5 (0.1%) and unclassified genotypes (10.75%). Viral load in 29.5% patients infected with genotype 3a was less than 600,000 IU/mL, while it was between 600,000-800,000 IU/mL in 27.9% patients and 25.22% patients had more than 800,000 IU/mL viral load.ConclusionHCV genotype 3a is the most prevalent genotype in various regions of Punjab. Viral load of HCV patients in these different regions of Punjab are reported for the first time. Moreover, based upon these results the Patients having viral load below 800,000 IU/mL would be expected to show better response of anti-HCV therapy.

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).…”

“…It has been well-established that HCV genotype 3a is highly prevalent in Pakistani population (9,11,14). On the other hand, a single study revealed that 1a genotype has a higher frequency in Balochistan (7).…”

Epidemiologic Study of Hepatitis C Virus Transmission in Lorestan Province (2011-14)

“…This is consistent with the results of other studies conducted in the European countries and the United States (12). The Genotype 3a was the predominant genotype in this study, which is in line with the findings of studies conducted in India, Pakistan and Nepal (13,14). However, these findings are inconsistent with the results of studies in Saudi Arabia (15), Kuwait (16), France (17), North American countries (18) and South Korea (19).…”

A Review of Hepatitis C in the General Population in Pakistan

“…HCV infection is endemic in Pakistan (22,23,24,25); according to a recent report, the incidence of the disease has increased from 4.7% (41) to 6.8% within a couple of years (28). Unfortunately, low literacy level, inadequate public health facilities and lack of awareness are main reasons behind insufficiency of significant data about the high incidence of the disease in Pakistan.…”

“…Unfortunately, low literacy level, inadequate public health facilities and lack of awareness are main reasons behind insufficiency of significant data about the high incidence of the disease in Pakistan. Several studies have reported various HCV infection rates in different geographical areas and ethnic groups in Pakistan (25,26,36,64). In this review, we investigated more than twenty articles on the prevalence of HCV in the country published recently in national and international journals ( Table 1).…”