Hepatitis C Virus Genotype Distribution in Sakarya Province; Three-Year Retrospective Study

Abstract

The determination of HCV genotypes in the selection of antiviral therapy is helpful in planning treatment and predicting response to treatment. The aim of this study was to determine the HCV genotype distribution retrospectively. The study group consisted of 235 patients who were referred to Sakarya University Medical Microbiology Laboratory for the determination of HCV genotype between January 2015 and December 2017. The isolation of RNA from the samples was made by the manufacturer with automatic isolation system (QIAsymphony, Qiagen, Germany). The study group; 105 (44.7%) males and 130 (55.3%) females, a total of 235 patients. Genotype distributions; 200 of the samples (85.1%) were type 1, 2 (0.9%) type 2, 20 (8.5%) type 3, 7 (3.0%) type 4 and 6 (2.6%) mix type (type 1a + type 1b). In genotype 1, 13 (5.5%) were type 1a and 182 (77.4%) were type 1b. The prevalence of genotype 1b was significantly higher in women than in men (p = 0.009). The mean age of patients with genotype 1b was significantly higher than patients with other genotypes (p <0.001). There was no significant change in the distribution of type 1b according to years (p = 0.376). In our study; Genotypes were found in the majority of the samples in our region and type 1b in the subtype. Genotype 3 was the most common type after genotype 1. These studies are expected to contribute significantly to the treatment of HCV because of the guiding nature of the genotype in the selection of antiviral treatment and clinical follow-up.

Keywords

• Hepatitis C virus,genotype distribution,RNA

Sakarya İlinde Hepatit C Virüs Genotip Dağılımı; Üç Yıllık Retrospektif Çalışma

Öz

HCV genotiplerinin belirlenmesi antiviral tedavi seçiminde, tedavinin planlanması ve tedaviye yanıtın öngörülmesinde yol göstericidir. Bu çalışmada retrospektif olarak HCV genotip dağılımının belirlenmesi amaçlanmıştır. Çalışmada Ocak 2015-Aralık 2017 tarihleri arasında Sakarya Üniversitesi Tıbbi Mikrobiyoloji Laboratuvarına HCV genotip tayini amacıyla gönderilen 235 hastanın serum örneği çalışma grubunu oluşturdu. Örneklerden RNA izolasyonu üretici firmanın önerileriyle otomatik izolasyon sistemi (QIAsymphony, Qiagen, Almanya) ile yapıldı. Çalışma grubu; 105 (%44,7) erkek, 130 (%55,3) kadın olmak üzere toplam 235 hastadan oluştu. Genotip dağılımları; örneklerden 200’ü (%85,1) tip 1, 2’si (%0,9) tip 2, 20’si (%8,5) tip 3, 7’si (%3,0) tip 4 ve 6’sı (%2,6) mix tip (tip 1a+ tip 1b) idi. Genotip 1 içinde 13’ü (%5,5) tip 1a, 182’si (%77,4) tip 1b iken, 5 (%2,1) örnekte alt tip belirlenemedi. Kadınlarda genotip 1b görülme sıklığı erkeklere göre anlamlı olarak yüksekti (p=0,009). Genotip 1b saptanan hastaların yaş ortalaması diğer genotiplere sahip hastalara göre anlamlı olarak yüksekti (p<0,001). Yıllara göre tip1b dağılımında anlamlı bir değişiklik saptanamadı (p=0,376). Sonuç olarak çalışmamızda; bölgemizdeki örneklerin çoğunluğunda genotip 1, alt tipin ise tip 1b olduğu belirlenmiştir. Genotip 1’den sonra en sık, genotip 3 saptanmıştır. Klinik sürecin takibi ve antiviral tedavi seçiminde genotip belirlenmesinin yol gösterici olmasından dolayı bu çalışmaların HCV tedavisine önemli katkıları olacağı düşünülmektedir.

Anahtar Kelimeler

• Hepatit C virüs,genotip dağılımı

Kaynakça

1. Lauer GM, Walker BD. Hepatitis C virus infection. New England Journal of Medicine. 2001;345(1):41-52.
2. Hanafiah KM, Groeger J. Global epidemiology of hepatitis C virus infection: new estimates of age‐specific antibody to HCV seroprevalence. Hepatology. 2013;57(4):1333-42.
3. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012;380(9859):2095-128.
4. Perz JF, Armstrong GL. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. Journal of Hepatology. 2006;45(4):529-38.
5. Timm J, Roggendorf M. Sequence diversity of hepatitis C virus: implications for immune control and therapy. World Journal of Gastroenterology: WJG. 2007;13(36):4808.
6. Smith DB, Bukh J, Kuiken C, et al. Expanded classification of hepatitis C virus into 7 genotypes and 67 subtypes: updated criteria and genotype assignment web resource. Hepatology. 2014;59(1):318-27.
7. Gower E, Estes C. Global epidemiology and genotype distribution of the hepatitis C virus infection. Journal of Hepatology. 2014;61(1):S45-S57.
8. Messina JP, Humphreys I, Flaxman A, et al. Global distribution and prevalence of hepatitis C virus genotypes. Hepatology. 2015;61(1):77-87.

9. Mıstık R. Hepatit C Virüs enfeksiyonunun epidemiyolojisi. Editörler: Fehmi Tabak, Selma Tosun. Viral Hepatit Kitabı 2014, Viral Hepatitle Savaşım Derneği Yayını, İstanbul tıp Kitabevi 2013, İstanbul 2013; 83-112.
10. Yilmaz Sİ, Erol S. Distribution of viral genotypes and extrahepatic manifestations in patients with chronic hepatitis C in Eastern Turkey. Turkish Journal of Medical Sciences. 2015;45(1):70-5.
11. Altuglu I, Soyler I. Distribution of hepatitis C virus genotypes in patients with chronic hepatitis C infection in Western Turkey. International Journal of Infectious Diseases. 2008;12(3):239-44.
12. Liver EAFTSOT. EASL Clinical Practice Guidelines: management of hepatitis C virus infection. J hepatol. 2011;55:245-64.
13. Tüzüner U, Saran Gülcen B, Özdemir M, Feyzioğlu B, Baykan M. Seven-year Genotype Distribution Among Hepatitis C Patients in a City in the Central Anatolia Region of Turkey. Viral Hepat J. 2018;24:12-17.
14. Altindis M, Dal T, Akyar I, et al. Six-year distribution pattern of hepatitis C virus in Turkey: a multicentre study. Biotechnology & Biotechnological Equipment. 2016;30(2):335-40.
15. Zeytinli ÜO, Yücel FM. Distribution of hepatitis C virus genotypes in the region of Istanbul Northern Anatolian Association of Public Hospitals. Viral Hepatit Dergisis. 2017;23(1):10.
16. Kirdar S, Aydin N. Dynamics of HCV epidemiology in Aydin province of Turkey and the associated factors. Apmis. 2018;126(2):109-13.
17. Aktas O, Özbek A. Distribution of HCV genotypes in patients of with chronic hepatitis C in the eastern anatolia region. Viral Hepatit Dergisi. 2014;20(3).
18. Kayman T, Karakukcu C. Genotypic distribution of hepatitis C virus infection in Kayseri region. J Turk Mikrobiyol Soc. 2012;42:21-6.
19. Borcak D, Çagır U. Distribution of hepatitis C virus genotypes and their association with serum alanine aminotransferases and quantitative Serum HCV RNA levels. Journal of Antimicrobial Chemotherapy. 2015;29:36-40.
20. Gökahmetoğlu S, Atalay M. Determination of the hepatitis C virus genotypes with'pyrosequencing'method. Erciyes Medical Journal. 2011;33(2):99-102.
21. Sağlik İ, Mutlu D, Öngut G, et al. Distribution of hepatitis C virus genotypes among patients with chronic hepatitis C infection in Akdeniz University Hospital, Antalya, Turkey: a five-year evaluation. Mikrobiyoloji bulteni. 2014;48(3):429-37.
22. Çekin Y, Gür N. Antalya Eğitim ve Araştırma Hastanesinde kronik Hepatit C hastalarının genotip dağılımının araştırılması. Mikrobiyol Bul. 2014;48(3):484-90.
23. Çetin Duran A, Kibar F. Çukurova Üniversitesi Tıp Fakültesi Hastanesi’nde Hepatit C virus genotiplerinin ve HCV enfeksiyonu bulaş yollarının belirlenmesi. Türk Hijyen ve Deneysel Biyoloji Dergisi. 2017;74(3):201-10.
24. Agca H. Distribution of Hepatitis C Virus Genotypes in the South Marmara Region. Journal of Clinical and Analytical Medicine. 2014;6(98):190-2.