Epidemiological and Genotypical Features of HCV in District Upper Dir, Khyber Pakhtunkhwa, Pakistan

Abstract

Objectives: Objective: The incidence of Hepatitis C Virus (HCV) infection is high in Pakistan. The current study evaluates HCV risk factors, epidemiology, and genotype distribution in the less-developed Upper Dir Region, Khyber Pakhtunkhwa Province (KPK), Pakistan. Methods: Blood samples from 500 outpatients from the Upper Dir Region were collected for initial screening using a strip-based immunochromatography test (ICT). In this study, ICT analysis followed Polymerase chain reaction (PCR) analysis for HCV-RNA confirmation. In addition, PCR positive samples were subject to genotypic description using genotype-specific primers. Results: ICT analysis revealed that out of 500 patients, 13 (2.6%) were HCV positive. PCR analysis identified that 10 (2.0%) of the 13 HCV-positive patients were HCV-RNA positive. The overall incidence of HCV in the study group was 2.6%. The rate of HCV incidence was found to be higher in males (10/339 participants, 3.0%), while a lower incidence was found in females (3 of 161 participants, 1.9%). The patients between 45 and 60 years had the highest incidence rate (6 of 53 participants, 11.3%, P<0.05); while the patients between 25 and 44 years had an incidence rate of 4.2% (7 of 166 participants). Different HCV subtypes were also detected; 1a (two participants), 2b (one participant), 3a (two participants) and 3b (two participants). Three of the patients had untypable (UT) HCV genotype variants. Conclusion: The study results suggest that; most of the cases were males and between 25 and 60-year-old. At the same time, several HCV subtypes are present in the inhabitants of the study area. Therefore, the presence of untypable genotypes may lead to diagnostic and therapeutic difficulties or failures. J Microbiol Infect Dis 2021; 11(4):218-224.

Keywords

• Genotypes
• Hepatitis C Virus
• incidence
• Untypable

Kaynakça

1. 1. Choo QL, Kuo G, Weiner AJ, et al. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 1989; 244 (4902):359–362.
2. 2. Argentini C, Genovese D, Dettori S, Rapicetta M. HCV genetic variability
3. from quasispecies evolution to genotype classification. Future Microbiol 2009; 4(3):359-373.
4. 3. WHO. Diseases; Hepatitis C. http://www.who.int/csr/disease/hepatitis/wh ocdscsrlyo2003/en/index3.html. Accessed in 2017.
5. 4. Wild CP, Hall AJ. Primary prevention of hepatocellular carcinoma in developing countries. Mutat Res 2000; 46(2-3):381–393.
6. 5. Hanafiah K, Groeger J, Flaxman A, Wiersma S. Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatology 2013; 57(4):1333-1342.
7. 6. Raza S, Mubeen H, Farooqi S. Review: epidemic status of HCV in Pakistan. Glob J Engin Sci Res Man 2015; 12(2):
8. 7. Ruan Y, Qin G, Yin L, Chen K, Qian H, Hao C. Incidence of HIV, hepatitis C and hepatitis B viruses among injection drug users in southwestern China: a 3-year follow-up study. AIDS 2007; 21(8): S39-46

9. 8. Al-Tawfiq J, Anani A. Profile of viral hepatitis a, B, and C in a Saudi Arabian hospital. Med Sci Monit 2008; 14(1):56–52
10. 9. Touzet S, Kraemer L, Colin C et al. Epidemiology of hepatitis C virus infection in seven European Union countries a critical analysis of the literature. HENCORE Group. (Hepatitis C European Network for Cooperative Research). EUR J Gasterno Hepat 2000; 12(6):667-678
11. 10. Waheed Y, Saeed U, Safi SZ, Chaudhry WN, Qadri I. Awareness and risk factors associated with barbers in transmission of hepatitis B and C from Pakistani population barber’s role in viral transmission. Asian Biomed 2010; 4(3):435-442.
12. 11. Muzaffar F, Hussain I, Haroon TS. "Hepatitis C: the dermatologic profile." J. Pak Assoc 2008; 18(3):171-181.
13. 12. Ashraf S, Ahmad A. Viral hepatitis in Pakistan: challenges and priorities. Asian Pac J Trop Biomed 2015; 5(3):190–191.
14. 13. Hnatyszyn HJ. Chronic hepatitis C and genotyping: the clinical significance of determining HCV genotypes. Antivir Ther 2005; 10(1):1-11.
15. 14. Khan T, Mehr M, Ullah H, Khan H, Iman N. Frequency of hepatitis C genotypes in the north of Pakistan. Gomal J Med Sci 2014; 12(2):9–106.
16. 15. Abou, MAA, Eltahir YM, Ali, AS. Seroprevalence of hepatitis B virus and hepatitis C virus among blood donors in Nyala, South Dar Fur, Sudan. Virology 2009; 6(1):146-156.
17. 16. Idrees M. Common genotypes of hepatitis C virus present in Pakistan. Pak J Med Res 2001; 40 (2): 46–49
18. 17. Idrees M. Development of an improved HCV Genotyping Assay for the Detection of Common Genotypes and subtypes in Pakistan. J Virol Meth 2008; 150(1-2);50–56.
19. 18. Idrees M, Lal A, Naseem M, Khalid M. High prevalence of hepatitis C virus infection in the largest province of Pakistan. J Dig Dis 2008; 9(2):95-103.
20. 19. Ahmad N, Asgher M, Shafique M, Qureshi JA. "An Evidence of high prevalence of Hepatitis C virus in Faisalabad, Pakistan. Saudi Med J 2007; 28(3):390.
21. 20. Khan NU, Ijaz A, Naeem U, et al. prevalence of active HCV infection among the blood donors of Khyber Pakhtunkwa and FATA region of Pakistan and evaluation of the screening tests for anti-HCV. Virol J 2011; 8(1):1-3.
22. 21. Ali A, Ahmed H, Idrees M. Molecular epidemiology of Hepatitis C virus genotypes in Khyber Pakhtunkhwa of Pakistan. Virol J 2010; 7(1):1-7.
23. 22. Muhammad N, Jan MA. 2005. Frequency of hepatitis" C" in Buner, NWFP. J Coll Physicians Surg Pak 2005; 15(1):11-14.
24. 23. Inamullah I, Idrees M, Ahmed H, Ali M, Ali L, Ahmed A. Hepatitis C virus genotypes circulating in district Swat of Khyber Pakhtoonkhaw, Pakistan. Virol J 2011; 8(1): 1-5.
25. 24. Ogata N, Alter HJ, Miller RH, Purcel RH. Nucleotide sequence and mutation rate of the H strain of hepatitis C virus. Proc Natl Acad Sci USA 1991; 88(8): 3391-3396.
26. 25. Ohno O, Mizokami M, Wu RR, et al. New hepatitis C virus (HCV) genotyping system that allows for identification of HCV genotypes 1a, 1b, 2a, 2b, 3a, 3b, 4, 5a, and 6a. J clin Microbiol 1997; 35(1):201-207.
27. 26. Rehman I, Idrees M, Ali M, et al. Hepatitis C Virus genotype 3a with phylogenetically distinct origin is circulating in Pakistan. Genet Vaccine Ther 2011; 9(1):212-215.
28. 27. Khan MA, Khan SA, Hamayun M, Ali M, Idrees M. Sequence variability of HCV 3a isolates based on core gene in patients from Lahore, Pakistan. Future Virol 2019; 14(10):641-653.
29. 28. Ahmad W, Ijaz B, Javid TF, et al. HCV genotype distribution and possible transmission risks in Lahore, Pakistan. Gastroenterol 2010; 16(36): 4321-4328.
30. 29. Idrees M, Ur Rehman I, Manzoor S et al. Evaluation of three different hepatitis C virus typing methods for detection of mixed‐genotype infections. J dig dis 2011; 12(3):199-203.
31. 30. Saleha S, Kamal A, Ullah F, Khan N, Mahmood A, Khan S. Prevalence of hepatitis C virus genotypes in district Banu, Khyber Pakhtunkhwa, Pakistan. Hepat Res Treat 2014; 2014:1-5.