Frequency of active HCV infection among anti-HCV positive patients in selected districts of Khyber Pakhtunkhwa, Pakistan

Year 2013, , 199 - 202, 01.12.2013

Sajid Ali Bashir Ahmad İjaz Ali Nourin Mehmood

https://doi.org/10.5799/ahinjs.02.2013.04.0108

Abstract

Objective: The objective of this study was to determine frequency of active HCV infection among confirmed anti-HCV positive subjects of KPK in order to help the infected subjects decide about anti-viral treatment options. Methods: Blood samples (3075 samples) were collected from patients in selected districts of KPK and were transported to Centre of Biotechnology and Microbiology, Diagnostic laboratory, University of Peshawar. These patients were already screened for anti-HCV by ICT (Immuno Chromatographic Technique) and ELISA (Enzyme Linked Immunosorbant Assay) in the local laboratories of the concern districts. Subsequently, viral RNA was isolated from serum sample and subjected to Real-time PCR. The frequency of the results was calculated for the HCV-RNA positive and negative samples. Results: Out of 3075 confirmed anti-HCV samples, HCV-RNA positive and negative samples were 2055 (66.6%) and 1020 (33.3%) respectively. The frequency of male and female HCV-RNA positive samples was 57.6% and 42.4% respectively. Rate of false anti-HCV positivity was 33.3%. Moreover, rate of active HCV infection was found more in district Bunir followed by districts Dir and Mardan. Comparatively less positive percent frequency of active HCV infection was found in districts Swabi, Peshawar and Kohat, respectively. Conclusion: It is concluded that viremia is present in more than 50% of confirmed anti-HCV positive patients. Anti-HCV positive, but HCV-RNA negative samples represent either false- positivity of anti-HCV or a spontaneous clearance of HCV.

Keywords

HCV, Khyber Pakhtunkhwa, viremia, active infection, PCR

Frequency of active HCV infection among anti-HCV positive patients in selected districts of Khyber Pakhtunkhwa, Pakistan

Abstract

Amaç: Bu çalışmanın amacı, Khyber Pakhtunkhwa eyaletinde (KPK) antiviral tedavi seçeneklerini değerlendirmek amacıyla, anti-HCV pozitif olan kişiler arasında aktif HCV enfeksiyonu sıklığını belirlemektirYöntemler: Kan örnekleri (3075 adet) KPK’nın seçilmiş bölgelerindeki hastalardan toplandı ve Peşaver Üniversitesi Biyoteknoloji ve Mikrobiyoloji Merkezi Teşhis Laboratuvarına nakledildi. Bu hastalar zaten yaşadıkları bölgedeki yerel laboratuvarlarda immuno kromatografik teknik ve Enzim Linked Immunosorbant Assay yöntemleri ile anti-HCV için taranmış bulunuyorlardı. Daha sonra, viral RNA serum örneklerinden izole edildi ve gerçek zamanlı PCR ile araştırıldılar. HCV-RNA sıklığı negatif ve pozitif numuneler için hesaplandı.Bulgular: Anti-HCV pozitif olan 3075 serum örneğinin 2055’inde (% 66,6) HCV-RNA pozitif bulunurken 1020’sinde (% 33,3) negatif bulundu. Erkekler ve kadınlar arasında HCV-RNA pozitiflik yüzdeleri sırasıyla % 57,6 ve % 42,4 idi. Yalancı anti-HCV pozitiflik oranı % 33,3 idi. Aktif HCV enfeksiyon sıklığı en çok Bunir bölgesinde idi ve onu Dir ve Mardan bölgeleri izledi. Aktif HCV enfeksiyonu sırasıyla Swabi, Peşaver ve Kohat bölgelerinde nispeten daha az sıklıkta bulundu.Sonuç: Anti-HCV pozitif hastaların % 50’sinden fazlasında vireminin varlığı gösterildi. Anti-HCV pozitif olduğu halde HCV-RNA’nın negatif olması bu kişilerin anti-HCV pozitifliğinin yalancı olduğunu veya HCV’nin kendiliğinden temizlendiğini göstermektedir

Keywords

HCV, Khyber Pakhtunkhwa, viremi, aktif enfeksiyon, PCR

References

• WHO: Weekly epidemiological record No 49,1999.
• Global burden of disease (GBD) for hepatitis C. J Clin Phar- macol 2004;44:20-29.
• Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, Hough- ton M. Isolation of a cDNA clone derived from a blood- borne non-A, non-B viral hepatitis genome. Science 1989; 244:359-362.
• Centers for Disease Control and Prevention. Recommenda- tions for prevention and control of hepatitis C virus (HCV) infection and HCV related chronic disease. MMWR Recomm Rep 1998;47:1-39.
• World Health Organization. Department of Measurement and Health Information. 2004. http://www.who.int/healthinfo/sta- tistics/bodgbddeathdalyestimates.xls
• United Nations Development Program. Human Development Report 1996. New York: Oxford University Press, 1996.
• Hamid S, Umar M, Alam A, Siddiqui A, Qureshi H, Butt J. PSG consensus statement on management of hepatitis C virus infection. 2003. J Pak Med Assoc 2004;54:146-150.
• Najib UK, Ijaz A, Naeem UA, et al. Prevalence of active HCV infection among the blood donors of Khyber Pakhtunkhwa and FATA region of Pakistan and evaluation of the screening tests for anti-HCV. Virology J 2011;8:154.
• Srivastava AV, Czerska B, Williams C, et al. High rates of false-positive hepatitis C antibody tests can occur after left ventricular assist device implantation. J Heart Lung Trans- plant 2009;28:159-160.
• Rahman M, Khan SA, Lodhi Y. Unconfirmed reactive screen- ing tests and their impact on donor management. Pak J Med Sci 2008;24:517-519.
• Grobusch MP, Alpermann U, Schwenke S, Jelinek T, War- hurst DC. False positive rapid tests for malaria in patients with rheumatoid factor. Lancet 1999;353:297.
• Khan MSA, Khalid M, Ayub N, Javed M. Seroprevalence and risk factors of Hepatitis C virus (HCV) in Mardan, NWFP. Rawal Med J 2004;29:57-60.
• Ahmad A, Ahmad B, Ali A, Ahmad Y. Seroprevalence of HB- sAg and anti-HCV in general healthy population of SWAT District with frequency of different HCV Genotypes. Pak J Med Sci 2009;25:744-748.
• Ahmed A. Anti-HCV in healthy voluntary blood donors in Dis- trict SWAT. JPMI 2006;20:187-190.
• Yasir W, Talha S, Sher ZS, Ishtiaq Q. Hepatitis C virus in Pakistan: A systematic review of prevalence, genotypes and risk factors. World J Gastroenterol 2009;15:5647-5653.
• Sajid A, Ijaz A, Sadiq A, Bashir A. Frequency Distribution of HCV genotypes among Chronic Hepatitis C Patients of Khy- ber Pakhtunkhwa. Virology J 2011;8:193.
• Muhammad N, Jan MA. Frequency of hepatitis “C” in Buner, NWFP. J Coll Physicians Surg Pak 2005; 15:11-14.