Molecular epidemiology and viral load of HCV in different regions of Punjab, Pakistan
Tóm tắt
Hepatitis 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. A 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. HCV 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.
Tài liệu tham khảo
Robertson B, Myers G, Howard C, Brettin T, Bukh J, Gaschen B, Gojobori T, Maertens G, Mizokami M, Nainan O, et al.: Classification, nomenclature, and database development for hepatitis C virus (HCV) and related viruses: proposals for standardization, International Committee on Virus Taxonomy. Arch Virol 1998, 143: 2493-2503. 10.1007/s007050050479
Tsukiyama-Kohara K, Iisuka N, Kohara M, Nomoto A: Internal ribosome entry site within hepatitis C virus RNA. J Virol 1992, 66: 1476-1483.
Hnatyszyn HJ: Chronic hepatitis C and genotyping: the clinical significance of determining HCV genotypes. Antivir Ther 2005, 10: 1-11.
Simmonds P: Variability of hepatitis C virus. Hepatology 1995, 21: 570-583. 10.1002/hep.1840210243
Hoofnagle JH: Course and outcome of hepatitis C. Hepatology 2002, 36: S21-S29.
Jimenez-Mendez R, Uribe-Salas F, Lopez-Guillen P, Cisneros-Garza L, Castaneda-Hernandez G: Distribution of HCV genotypes and HCV RNA viral load in different regions of Mexico. Ann Hepatol 2010, 9: 33-39.
Idrees M, Riazuddin S: Frequency distribution of hepatitis C virus genotypes in different geographical regions of Pakistan and their possible routes of transmission. BMC Infect Dis 2008, 8: 69. 10.1186/1471-2334-8-69
Verbeeck J, Maes P, Lemey P, Pybus OG, Wollants E, Song E, Nevens F, Fevery J, Delport W, Van der Merwe S, Van Ranst M: Investigating the origin and spread of hepatitis C virus genotype 5a. J Virol 2006, 80: 4220-4226. 10.1128/JVI.80.9.4220-4226.2006
Pawlotsky JM: Hepatitis C virus genetic variability: pathogenic and clinical implication. Clin Liver Dis 2003, 7: 45-66. 10.1016/S1089-3261(02)00065-X
Ali A, Nisar M, Ahmad H, Saif N, Idrees M, Bajwa MA: Determination of HCV genotypes and viral loads in chronic HCV infected patients of Hazara Pakistan. Virol J 2011, 8: 466. 10.1186/1743-422X-8-466
Afridi SQ, Zahid MN, Shabbir MZ, Hussain Z, Mukhtar N, Tipu MY, Akhtar F, Yaqub T: Prevalence of HCV genotypes in district Mardan. Virol J 2013, 10: 90. 10.1186/1743-422X-10-90
Attaullah S, Khan S, Ali I: Hepatitis C virus genotypes in Pakistan: a systemic review. Virol J 2011, 8: 433. 10.1186/1743-422X-8-433
Raja NS, Janjua KA: Epidemiology of hepatitis C virus infection in Pakistan. J Microbiol Immunol Infect 2008, 41: 4-8.
Elasifer HA, Agnnyia YM, Al-Alagi BA, Daw MA: Epidemiological manifestations of hepatitis C virus genotypes and its association with potential risk factors among Libyan patients. Virol J 2010, 7: 317. 10.1186/1743-422X-7-317
Ahmad W, Ijaz B, Javed FT, Jahan S, Shahid I, Khan FM, Hassan S: HCV genotype distribution and possible transmission risks in Lahore, Pakistan. World J Gastroenterol 2010, 16: 4321-4328. 10.3748/wjg.v16.i34.4321
Sy T, Jamal MM: Epidemiology of hepatitis C virus (HCV) infection. Int J Med Sci 2006, 3: 41-46.
Mujeeb SA: HCV 3 in Pakistan: does it offer more hope for cure and control. J Pak Med Assoc 2002, 52: 191.
Schijman A, Colina R, Mukomolov S, Kalinina O, García L, Broor S, Bhupatiraju A, Karayiannis K, Khan B, Mogdasy C, Cristina J: Comparison of hepatitis C viral loads in patients with or without coinfection with different genotypes. Clin Diagn Lab Immunol 2004, 11: 433-435.
Dalgard O, Bjoro K, Hellum KB, Myrvang B, Ritland S, Skaug K, Raknerud N, Bell H: Treatment with pegylated interferon and ribavarin in HCV infection with genotype 2 or 3 for 14 weeks: a pilot study. Hepatology 2004, 40: 1260-1265. 10.1002/hep.20467
von Wagner M, Huber M, Berg T, Hinrichsen H, Rasenack J, Heintges T, Bergk A, Bernsmeier C, Haussinger D, Herrmann E, Zeuzem S: Peginterferon-alpha-2a (40KD) and ribavirin for 16 or 24 weeks in patients with genotype 2 or 3 chronic hepatitis C. Gastroenterology 2005, 129: 522-527.