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1
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Naveed A, Khalid A, Janjua N, Cloherty GA, Akhter S. Performance of HCV core antigen and PCR testing in a predominantly genotype 3 population. J Viral Hepat 2024; 31:320-323. [PMID: 38483043 DOI: 10.1111/jvh.13937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/21/2024] [Accepted: 03/02/2024] [Indexed: 05/18/2024]
Abstract
Hepatitis C core antigen (HCVcAg) is becoming increasingly recognized as an alternative to molecular testing for the confirmation of chronic hepatitis C. However, there are limited data on the performance of this assay in a genotype 3 (GT3) predominant country like Pakistan. We conducted a study to evaluate the diagnostic performance of HCVcAg against the HCV polymerase chain reaction (PCR) molecular test. HCV antibody-positive patients requiring confirmatory testing were recruited from August to October 2018 at the Pakistan Kidney and Liver Institute and Research Center (PKLI&RC), Lahore, Pakistan. Patients with previously known diagnoses or treatment histories were excluded. The Abbott HCV Ag assay was used for HCVcAg testing. Results ≥3.00 fmol/L were considered positive for HCVcAg. The Abbott RealTime HCV assay was used for PCR testing with a lower detection limit of ≥12 IU/mL. We computed the sensitivity, specificity and correlation of HCVcAg against HCV PCR. A total of 394 patients were recruited. The median age of the patients was 42 years. Most participants were females (51.5%, n = 203), 30.7% (n = 121) had HTN, 10.4% DM (n = 41) and 5% had APRI ≥2. The overall sensitivity was 98.0% and the specificity was 98.6%. The lowest detection limit of cAg was an HCV RNA value of 4657 IU/mL. The levels of cAg were highly correlated with those of HCV RNA by Spearman's rank correlation test (r = 0.935, p < .001). HCVcAg represents a suitable alternative with high sensitivity and specificity compared with HCV PCR in the GT3-predominant population and can be incorporated into algorithms to improve linkage to care.
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Affiliation(s)
- Ammara Naveed
- Gastroenterology and Hepatology, Pakistan Kidney & Liver Institute & Research Center (PKLI&RC), Lahore, Pakistan
| | - Abdullah Khalid
- Gastroenterology and Hepatology, Pakistan Kidney & Liver Institute & Research Center (PKLI&RC), Lahore, Pakistan
| | - Naveed Janjua
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Saeed Akhter
- Gastroenterology and Hepatology, Pakistan Kidney & Liver Institute & Research Center (PKLI&RC), Lahore, Pakistan
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2
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Farooq S, Faiz S, Wahab AT, Choudhary MI. Determination of hepatitis C virus subtype prevalent in Sindh, Pakistan: a phylogenetic analysis. Sci Rep 2024; 14:11159. [PMID: 38750152 PMCID: PMC11096182 DOI: 10.1038/s41598-024-59342-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/09/2024] [Indexed: 05/18/2024] Open
Abstract
Hepatitis is a major public health issue, affecting 10-17 million people worldwide, with its prevalence continuously increasing. The Hepatitis C virus (HCV) is responsible for liver related diseases, which include liver cirrhosis, hepatocellular carcinoma, and chronic hepatitis. Pakistan is experiencing a serious rise in HCV cases. This study aimed to assess the prevalence and distribution of HCV genotypes in Sindh, Pakistan. Serum samples from HCV-positive patients were collected from various local hospitals in Sindh. These samples were first screened for HCV antibodies using ELISA. Samples that tested positive for HCV RNA underwent further genotyping through sequencing using the standard Sanger method. The genotypes were identified by comparing the sequences with those available in the National Center for Biotechnology Information (NCBI) database, and a phylogenetic tree was constructed. The phylogenetic analysis showed that all isolates in this study were clustered with genotypes 3a and 3b, except for one sequence that was clustered with genotype 1a. No isolates were found to be clustered with reference genomes of genotypes 2, 4, 5, 6, and 7 suggesting that genotype 3a is endemic in this region. The analyzed sequences demonstrated a 98% similarity with reference and isolated sequences. In summary, sequencing of the HCV 5' UTR essential for identifying the predominant genotype of HCV RNA in the Sindh region Further research on the distribution of HCV genotypes in other regions of Pakistan could aid in improving screening processes, identifying more effective treatment options, and developing suitable prevention strategies.
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Affiliation(s)
- Saba Farooq
- Mediagnost Gesellschaft Für Forschung Und Herstellung Von Diagnostika, Reutlingen, Germany.
- National Institute of Virology, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center of Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan.
| | - Sirmast Faiz
- National Institute of Virology, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center of Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Atia-Tul Wahab
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center of Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - M Iqbal Choudhary
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center of Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, 21412, Jeddah, Saudi Arabia
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3
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Dopico E, Rodriguez-Frias F, Ubillos I, Rando-Segura A, Garcia-Cehic D, Gregori J, Rando-Matos Y, Solsona L, Niubó J, Esteban JI, Costa J, Martínez MJ, Quer J. Prevalence of Hepatitis C Virus Infection, Genotypes and Subtypes in Migrants from Pakistan in Barcelona, Spain. Infect Drug Resist 2022; 15:4637-4644. [PMID: 36003985 PMCID: PMC9394658 DOI: 10.2147/idr.s367715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background Hepatitis C virus (HCV) is a major cause of chronic liver infection with 71 million people infected worldwide. Pakistan has the second highest prevalence of HCV infection and more than half (52%) of Pakistani living in Spain reside in Barcelona. The aim of this study was to analyse the seroprevalence and viraemic rate and determine the genotypes and subtypes of HCV among Pakistanis living in the southern metropolitan area of Barcelona. Methods We included all Pakistani patients seeking primary healthcare in the southern metropolitan area of Barcelona from August 2011 to July 2014. Serum samples were screened for HCV antibodies. HCV viral load was determined by reverse transcription polymerase chain reaction and genotypes and subtypes were performed using Versant HCV Genotype and/or deep-sequencing. Screening for hepatitis B virus (HBV) was also carried out. Results Among 5877 Pakistani patients, 565 (9.61%) were screened for anti-HCV antibodies, with 68 (12.04%) being positive. The viral load was determined in 65, with 31 presenting active infection and the viraemic rate was 47.69% (95% confidence interval 36.02-59.62). HCV genotyping and subtyping were performed in 24 individuals. Most infections corresponded to HCV genotype 3 (91.67%), and high resolution HCV subtyping was performed in 18 samples, 16 of which presented subtype 3a. One subject presented HBV coinfection with undetectable HBV DNA. During the study period, we identified a possible case of HCV vertical transmission followed by spontaneous viraemia clearance in a chronically infected mother with a C/T IL28B genetic polymorphism. Conclusion These results suggest that general HCV screening protocols in patients from high prevalence countries, such as Pakistan, would be helpful to identify and treat active HCV infections. This could avoid further transmission and contribute to building targeted health policies for micro-elimination of HCV infection in specific communities.
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Affiliation(s)
- Eva Dopico
- Microbiology Department, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Francisco Rodriguez-Frias
- Biochemistry Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Biochemistry and Molecular Biology Department, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Itziar Ubillos
- Laboratory Clínic Territorial Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
| | - Ariadna Rando-Segura
- Biochemistry Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Damir Garcia-Cehic
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Liver Diseases-Viral Hepatitis, Liver Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Josep Gregori
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Liver Diseases-Viral Hepatitis, Liver Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Yolanda Rando-Matos
- Equip d'Atenció Primària Florida Nord, Gerència d'Àmbit d'Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Luis Solsona
- Equip d'Atenció Primària Florida Nord, Gerència d'Àmbit d'Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Jordi Niubó
- Microbiology Department, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juan Ignacio Esteban
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Liver Diseases-Viral Hepatitis, Liver Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Josep Costa
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Microbiology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Miguel J Martínez
- Microbiology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Josep Quer
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Biochemistry and Molecular Biology Department, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain.,Liver Diseases-Viral Hepatitis, Liver Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
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4
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Sahibzada KI, Ganova-Raeva L, Dimitrova Z, Ramachandran S, Lin Y, Longmire G, Arthur L, Xia GL, Khudyakov Y, Khan I, Sadaf S. Hepatitis C virus transmission cluster among injection drug users in Pakistan. PLoS One 2022; 17:e0270910. [PMID: 35839216 PMCID: PMC9286280 DOI: 10.1371/journal.pone.0270910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 06/21/2022] [Indexed: 11/19/2022] Open
Abstract
Hepatitis C virus (HCV) infections are public health problem across the globe, particularly in developing countries. Pakistan has the second highest prevalence of HCV infection worldwide. Limited data exist from Pakistan about persons who inject drugs (PWID) and are at significant risk of exposure to HCV infection and transmission. Serum specimens (n = 110) collected from PWID residing in four provinces were tested for molecular markers of HCV infection. Next generation sequencing (NGS) of the hypervariable region (HVR1) of HCV and Global Hepatitis Outbreak and Surveillance Technology (GHOST) were used to determine HCV genotype, genetic heterogeneity, and construct transmission networks. Among tested specimens, 47.3% were found anti-HCV positive and 34.6% were HCV RNA-positive and belonged to four genotypes, with 3a most prevalent followed by 1a, 1b and 4a. Variants sampled from five cases formed phylogenetic cluster and a transmission network. One case harbored infection with two different genotypes. High prevalence of infections and presence of various genotypes indicate frequent introduction and transmission of HCV among PWID in Pakistan. Identification of a transmission cluster across three provinces, involving 20% of all cases, suggests the existence of a countrywide transmission network among PWIDs. Understanding the structure of this network should assist in devising effective public health strategies to eliminate HCV infection in Pakistan.
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Affiliation(s)
- Kashif Iqbal Sahibzada
- School of Biochemistry and Biotechnology, University of the Punjab, Lahore, Pakistan
- Division of Viral Hepatitis, Center of Disease Control and Prevention, Molecular Epidemiology and Bioinformatics, Atlanta, GA, United States of America
| | - Lilia Ganova-Raeva
- Division of Viral Hepatitis, Center of Disease Control and Prevention, Molecular Epidemiology and Bioinformatics, Atlanta, GA, United States of America
| | - Zoya Dimitrova
- Division of Viral Hepatitis, Center of Disease Control and Prevention, Molecular Epidemiology and Bioinformatics, Atlanta, GA, United States of America
| | - Sumathi Ramachandran
- Division of Viral Hepatitis, Center of Disease Control and Prevention, Molecular Epidemiology and Bioinformatics, Atlanta, GA, United States of America
| | - Yulin Lin
- Division of Viral Hepatitis, Center of Disease Control and Prevention, Molecular Epidemiology and Bioinformatics, Atlanta, GA, United States of America
| | - Garrett Longmire
- Division of Viral Hepatitis, Center of Disease Control and Prevention, Molecular Epidemiology and Bioinformatics, Atlanta, GA, United States of America
| | - Leonard Arthur
- Division of Viral Hepatitis, Center of Disease Control and Prevention, Molecular Epidemiology and Bioinformatics, Atlanta, GA, United States of America
| | - Guo-liang Xia
- Division of Viral Hepatitis, Center of Disease Control and Prevention, Molecular Epidemiology and Bioinformatics, Atlanta, GA, United States of America
| | - Yury Khudyakov
- Division of Viral Hepatitis, Center of Disease Control and Prevention, Molecular Epidemiology and Bioinformatics, Atlanta, GA, United States of America
| | - Idrees Khan
- University of Peshawar, Peshawar, KPK, Pakistan
| | - Saima Sadaf
- School of Biochemistry and Biotechnology, University of the Punjab, Lahore, Pakistan
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5
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Khan A, Nawaz M, Ullah S, Rehman IU, Khan A, Saleem S, Zaman N, Shinwari ZK, Ali M, Wei DQ. Core amino acid substitutions in HCV-3a isolates from Pakistan and opportunities for multi-epitopic vaccines. J Biomol Struct Dyn 2022; 40:3753-3768. [PMID: 33246391 DOI: 10.1080/07391102.2020.1850353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hepatitis C virus (HCV), which infected 71 million worldwide and about 5%-6% are from Pakistan, is an ssRNA virus, responsible for end-stage liver disease. To date, no effective therapy is available to cure this disease. Hence, it is important to study the most prevalent genotypes infecting human population and design novel vaccine or small molecule inhibitors to control the infections associated with HCV. Therefore, in this study clinical samples (n = 35; HCV-3a) from HCV patients were subjected to Sanger sequencing method. The sequencing of the core gene, which is generally considered as conserved, involved in the detection, quantitation and genotyping of HCV was performed. Multiple mutations, that is, R46C, R70Q, L91C, G60E, N/S105A, P108A, N110I, S116V, G90S, A77G and G145R that could be linked with response to antiviral therapies were detected. Phylogenetic analysis suggests emerging viral isolates are circulating in Pakistan. Using ab initio modelling technique, we predicted the 3D structure of core protein and subjected to molecular dynamics simulation to extract the most stable conformation of the structure for further analysis. Immunoinformatic approaches were used to propose a multi-epitopes vaccine against HCV by using core protein. The vaccine constructs consist of nine CTL and three HTL epitopes joined by different linkers were docked against the two reported Toll-like receptors (TLR-3 and TLR-8). Docking of vaccine construct with TLR-3 and TLR-8 shows proper binding and in silico expression of the vaccine resulted in a CAI value of 0.93. These analyses suggest that specific immune responses may be produced by the proposed vaccine.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Ayyaz Khan
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Mehboob Nawaz
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Saeed Ullah
- Saidu Group of Teaching Hospital, Swat, Pakistan
| | - Irshad Ur Rehman
- Center of Biotechnology and Microbiology, University of Peshawar, Peshawar, Pakistan
| | - Abbas Khan
- Department of Bioinformatics and Biological Statistics, School of Life Sciences and Biotechnology, Shanghai Jiaotong University, Shanghai, China
| | - Shoaib Saleem
- National Center for Bioinformatics, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Nasib Zaman
- Center of Biotechnology and Microbiology, University of Swat, Swat, Pakistan
| | - Zabta Khan Shinwari
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan.,Pakistan Academy of Sciences, Islamabad, Pakistan
| | - Muhammad Ali
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Dong-Qing Wei
- Department of Bioinformatics and Biological Statistics, School of Life Sciences and Biotechnology, Shanghai Jiaotong University, Shanghai, China.,State Key Laboratory of Microbial Metabolism, Shanghai-Islamabad-Belgrade Joint Innovation Center on Antibacterial Resistances, Joint Laboratory of International Cooperation in Metabolic and Developmental Sciences, Ministry of Education and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, P.R. China.,Peng Cheng Laboratory, Shenzhen, Guangdong, P.R China
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6
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Noreen A, Alam N, Syed Z, Aftab A, Shamim F, Najeebullah S, Khan D, Kakar SJ, Ahmed T, Adnan F. Prevalence and assessment of the associated risk factors of hepatitis B and C infections in the low socioeconomic communities. Future Virol 2022. [DOI: 10.2217/fvl-2021-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: This study determined the prevalence and risk factors associated with hepatitis B and C among the low socioeconomic population. Materials & methods: A total of 1004 participants were screened for hepatitis B/C infection and risk factors from six different localities of Islamabad, Pakistan Results: The prevalence rate of hepatitis B and C was 1 and 4%, respectively. Chi-square test showed hepatitis B/C infection was related with marital status, hepatitis B vaccination, blood recipients and family income. Multivariable analysis showed hepatitis B vaccination, exposure to therapeutic injections, dental visits, exposure to HCV patients and age of participants were independently associated with hepatitis C infection. Conclusion: The risk of hepatitis B/C infection is multifactorial and the population needs to be vaccinated at a larger scale to avoid outbreaks.
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Affiliation(s)
- Aisha Noreen
- Department of Microbiology, Quaid-i-azam University, Islamabad, 44000, Pakistan
| | - Naik Alam
- Islamabad lab & research center, Lehtrar road, Islamabad, 44000, Pakistan
| | - Zainab Syed
- Department of Microbiology, Quaid-i-azam University, Islamabad, 44000, Pakistan
| | - Aroosa Aftab
- Department of Microbiology, Quaid-i-azam University, Islamabad, 44000, Pakistan
| | - Farah Shamim
- Department of Microbiology, Quaid-i-azam University, Islamabad, 44000, Pakistan
| | - Syed Najeebullah
- Islamabad lab & research center, Lehtrar road, Islamabad, 44000, Pakistan
| | | | - Salik Javed Kakar
- Atta ur Rahman School of Applied Biosciences (ASAB), National University of Sciences & Technology (NUST), Islamabad, 4000, Pakistan
| | - Tahir Ahmed
- Atta ur Rahman School of Applied Biosciences (ASAB), National University of Sciences & Technology (NUST), Islamabad, 4000, Pakistan
| | - Fazal Adnan
- Atta ur Rahman School of Applied Biosciences (ASAB), National University of Sciences & Technology (NUST), Islamabad, 4000, Pakistan
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Prevalence, Genotypic Distribution and the associated Risk Factors of Hepatitis C Infection in Pakistan Pediatric Patients. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.1.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
Hepatitis C virus (HCV) is an important contributor to chronic morbidity and mortality in developing countries. The study’s objective was to determine the genotype distribution and risk factors associated with the transmission of HCV infections in pediatric patients. Rapid screening and confirmation by the enzyme-linked immunosorbent assay (ELISA) were used to analyze 585 pediatric blood specimens hospitalized and visited the outpatient department of the largest tertiary care hospital in Pakistan. Detection and genotyping of HCV RNA were performed using a real-time polymerase chain reaction (RT-PCR). Demographic data and a history of risk factors were gathered through a survey questionnaire. HCV RNA was detected in 323 (72.4%) cases which showed viral load ranging from Log10 IU/mL < 3 to > 6 IU/mL. HCV genotype 3a was detected in 256 (79.3%) cases while type 3b and 1a was observed in 36 (11.1%) and 31 (9.6%) patients, respectively. HCV positivity was significantly associated with the cases from rural areas [p = 0.005; odds ratio (OR) 1.65; 95% CI 1.16-2.23] and also significantly associated with low-income group [p < 0.001; OR 5.75; 95% CI 3.90-8.40]. The primary risk factors associated with HCV transmission in children were family history (p = 0.002), blood transfusion (p = 0.03), surgical procedures (p = 0.02), and history of injections (p = 0.05). HCV genotype 3a is the most common genotype in children. The main risk factors for HCV transmission in children are blood transfusion, surgical procedures, and injection practices by informal health care providers.
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8
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Aftab A, Afzal S, Idrees M, Shahid AA. p53 and rb promoter methylation in hepatitis C virus-related chronic hepatitis and hepatocellular carcinoma. Future Virol 2021. [DOI: 10.2217/fvl-2020-0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: To identify methylation in p53 and rb during hepatitis C virus (HCV) infection in individuals in Pakistan. Materials & methods: Methylation-specific PCR was used on liver biopsies from hepatocellular carcinoma and chronic hepatitis C patients and on blood samples from healthy individuals. Real-time PCR was used to assess changes in the expression of p53 and rb in Huh-7 cells transfected with HCV-3a. Results: The p53 and rb promoters were methylated in hepatocellular carcinoma patients. The presence of HCV-3a- Core (p = 0.03), HCV-3a- NS-3 (p = 0.01) and HCV-3a- NS-5a (p = 0.02) downregulated p53 expression. Exposure to HCV-3a- Core (p = 0.04) downregulated rb expression. Conclusion: It can be hypothesized that HCV-induced epigenetic modifications may lead to the development of hepatic cancer that in turn inactivates p53 and rb.
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Affiliation(s)
- Ayma Aftab
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Samia Afzal
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Muhammad Idrees
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Ahmad Ali Shahid
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
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9
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Husseini AA, Islam Saeed KM, Yurdcu E, Bozdayı AM. Molecular epidemiology of Hepatitis B virus, Hepatitis C virus, and Hepatitis D virus in general population of Afghanistan. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 31:658-666. [PMID: 33090103 DOI: 10.5152/tjg.2020.19169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS This study gives a clue about genotypes, subgenotypes and subtypes of HBV, HCV and HDV viruses in general population of Afghanistan. MATERIALS AND METHODS A total of 234 HBsAg, 44 anti-HCV and 5 Anti-Delta positive patients belong to 25-70 age group were obtained through a rapid screening test among 5898 residents of Afghanistan. After quantifying viral load, genotyping of 61 HBV, 29 HCV and 1 HDV samples were accomplished by sequencing of a segment of the HBV Pre S, HCV NS5B, and HDV Delta antigen regions respectively. Clinically important variants of the HBV polymerase gene, the "a" determinant of HBsAg, HCV NS5B and NS3 regions were assessed. RESULTS All HBV isolates were dispersed throughout the genotype D branch and ayw2 was the only subtypes found. The anti-HDV prevalence among HBsAg positive individuals was 2.2% and the single HDV sample, belonged to HDV genotype I. Analysis of HCV isolates revealed subtype HCV-1b in 75.86%, HCV-3a in 20.69% and HCV-3b in 3.44% patients. The observed mutant variants in the MHR of HBsAg were Y100 15%, Q101 5%, G102 15%, T115 45%, P120 5%, T131 5%. Likewise, S213T 10%, Q215P 5% and N248H 100% mutations were detected in the HBV polymerase region. C316N mutation was prevalent in 72.7% of HCV 1b participants. CONCLUSION Genotypic variation in Afghan patients is in line with the ones existing in neighboring countries and regions. HBV genotypes D1, subtype ayw2, HDV RNA type I, and HCV RNA genotype 1b are likely to be dominant in Afghan patients.
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Affiliation(s)
- Abbas Ali Husseini
- Institute of Hepatology, Ankara University School of Medicine, Ankara, Turkey
| | - Khwaja Mir Islam Saeed
- Grant and Service Contract Management Unit (GCMU), Ministry of Public Health, Kabul, Afghanistan
| | - Esra Yurdcu
- Institute of Hepatology, Ankara University School of Medicine, Ankara, Turkey
| | - A Mithat Bozdayı
- Institute of Hepatology, Ankara University Faculty of Medicine, Ankara, Turkey
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10
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Khan MU, Sadia H, Irshad A, Baig AA, Ashiq S, Zahid B, Sheikh R, Roshan S, Ali A, Shamas S, Bhinder MA, Ahmad R. Detection, quantification and genotype distribution of HCV patients in Lahore, Pakistan by real-time PCR. Afr Health Sci 2020; 20:1143-1152. [PMID: 33402959 PMCID: PMC7751519 DOI: 10.4314/ahs.v20i3.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) is considered as "Viral Time Bomb" suggested by the World Health Organization and if it is not treated timely, it will lead towards cirrhosis and hepatocellular carcinoma (HCC). OBJECTIVE The purpose of the present research is to study possible risk factors, frequent genotypes of HCV and its association with different age groups. METHODS Suspected blood samples from HCV patients were collected from different hospitals of Lahore, Pakistan. Out of 1000 HCV suspected samples, 920 samples were found HCV positive detected by Anti-HCV ELISA, CobasR. kit. The quantification of HCV load was determined by HCV quantification kit and LINEAR ARRAY KIT (Roche) was used for genotype determination by Real-Time PCR (ABI). Statistical analysis was done by using Microsoft Excel. RESULTS Out of 920 subjects, 77 subjects (8.4%) were false positive and they were not detected by nested PCR. Three PCR positive samples were untypeable. Genotype 3 was predominant in Lahore which was 83.5%, whereas type 1 and 2 were 5.1% and 0.7% respectively. There were also mixed genotypes detected, 1 and 3 were 0.4%, 2 and 3 were 1.41% and 3 and 4 were 0.2% only. Male were more infected of HCV in the age <40 years and females >40years. CONCLUSION The major risk factor for HCV transmission is by use of unsterilized razors/blades. It is necessary to spread awareness among the general population of Pakistan about HCV transmission risk factors. Regular physical examination at least once a year is recommended, so that early detection of HCV could be done.
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Affiliation(s)
- Muhammad Umer Khan
- Faculty of Allied Health Sciences, The University of
Lahore, Lahore, Pakistan
| | - Haleema Sadia
- Department of Biotechnology, Balochistan University of
Information Technology, Engineering and Management Sciences, Quetta, Pakistan
- Center for Applied Molecular Biology, University of the
Punjab, Lahore, Pakistan
| | - Asma Irshad
- Department of Life Sciences, University of Management and
Technology (UMT) Lahore, Pakistan
| | - Atif Amin Baig
- Unit of Biochemistry, Faculty of Medicine, University,
Zainal Abidin
| | - Sana Ashiq
- Center for Applied Molecular Biology, University of the
Punjab, Lahore, Pakistan
| | - Beenish Zahid
- Department of Pathobiology, KBCMA, CVAS, Narowal
sub-campus of University of Veterinary and Animal Sciences, Pakistan
| | - Rozeena Sheikh
- Department of Biotechnology, Balochistan University of
Information Technology, Engineering and Management Sciences, Quetta, Pakistan
| | - Sadia Roshan
- Department of Zoology, University of Gujrat,
Pakistan
| | - Azam Ali
- Molecular Biology and Biotechnology, University of Lahore,
Lahore, Pakistan
| | - Shazia Shamas
- Department of Zoology, University of Gujrat,
Pakistan
| | - Munir Ahmed Bhinder
- Department of Human Genetics and Molecular Biology,
University of Health Sciences, Lahore, Pakistan
| | - Rais Ahmad
- Department of Microbiology, CUVAS, Cholistan,
Pakistan
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11
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Afzal M, Ali A, Sheikh N, Rafique S, Idrees M. Peripheral Expression of CXCL10 Gene in Chronic Hepatitis C Patients Treated with Sofosbuvir, Daclatasvir, and Ribavirin. J Interferon Cytokine Res 2020; 40:301-309. [PMID: 32486887 DOI: 10.1089/jir.2019.0185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Hepatitis C virus (HCV) causes persistent infection and invades host's innate and adaptive immune systems. During the eradication of this pathogen, the components of immune system may cause bystander damage to host, which might be even worse than the viral pathogenesis. Thus, the therapy should not only eliminate primary virus infection but also improve the inflammatory immune responses. The breakthrough of interferon free direct acting antiviral (DAA) drugs has provided the opportunity to unravel the association of HCV with immune response. This study aimed to examine the expression level of C-X-C motif chemokine ligand 10 (CXCL10) in the Peripheral blood mononuclear cells (PBMCs) of HCV infected patients treated with DAAs + Ribavirin. In this study we analyzed the expression levels of CXCL10 mRNA in the 90 chronic HCV patients using quantitative PCR (qPCR) prior, after, and during therapy with sofosbuvir/ribavirin (SOF+RBV) and sofosbuvir/daclatasvir/ribavirin (SOF+DCV+RBV), and further, the results were analyzed relative to treatment response. Significantly elevated CXCL10 mRNA was seen in naive patients having higher viral load (P = 0.005) and those suffering from hepatocellular carcinoma (P = 0.006). HCV patients had remarkable decline in CXCL10 level after 4, 12, and 24 weeks of therapy with DAAs. An approximate one-fold decrease was observed in patients who attained sustained virological response compared to untreated patients (P < 0.0001). Comparing the 2 regimens, the reduction in peripheral CXCL10 expression was more pronounced in patients undergoing SOF+DCV+RBV therapy. The current study implicitly shows the role of CXCL10 as an indicator of disruption of host-virus equilibrium and consequent pathogenesis of HCV during successful antiviral therapy. Furthermore, the drop in CXCL10 level after HCV viral clearance might reflect the DAA-induced alleviation in the extrahepatic manifestation of this infection.
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Affiliation(s)
- Maira Afzal
- Molecular Virology Laboratory, Centre for Applied Molecular Biology (CAMB), University of the Punjab, Lahore, Pakistan
| | - Amjad Ali
- Department of Genetics, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - Nadeem Sheikh
- Department of Zoology, University of the Punjab, Lahore, Pakistan
| | - Shazia Rafique
- Divison of Molecular Virology, Center of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore, Pakistan
| | - Muhammad Idrees
- Divison of Molecular Virology, Center of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore, Pakistan
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12
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Khan A, Nadir A, Mushtaq MH, Junaid K, Khan AM, Ali H, Waqar F, Khan TA, Khan AA. Molecular epidemiology and genotype distribution of hepatitis C in Pakistan; a multicenter cross-sectional study. INFECTION GENETICS AND EVOLUTION 2020; 84:104372. [PMID: 32454246 DOI: 10.1016/j.meegid.2020.104372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 04/13/2020] [Accepted: 05/19/2020] [Indexed: 11/30/2022]
Abstract
Pakistan has second highest burden of hepatitis C virus (HCV) infected patients in the World. Little is known about the molecular epidemiology and risk factors for prevailing HCV genotypes in Pakistan. Considering this a multicenter cross-sectional study was conducted at 23different viral hepatitis control and prevention centers. A total of 175,897 patients were registered and screened for HCV, out of which 73,180 (41.6%) were found positive on Architect screening test. The screened positive patients were sequentially tested on RT-PCR; where 41,241 (56.35%) were detected positive. Molecular characterization results showed genotype 3 (73.9%) as the most prevalent type, followed by genotype 1 (9.7%), and genotype 4 (0.3%) was isolated for the first time in Pakistan. On regression analysis; risk factors associated with genotype 3 and 1 included; age group of 30-50 years, rural residence, exposure to >10 injections, barber shaving, circumcision by barbers, and low literacy rate. Phylogenetic analysis based on genotypes identified in this study and sequences isolated from Pakistan in last 10 years demonstrated that genotype 3 and 1 are endemic locally in Punjab province. The high prevalence rate of HCV is a threat for a generalized epidemic and genetic recombination with such variability of genotypes identified here is an alarming condition. More focused attention and resources should be spent in awareness of the population to prevent the spread of HCV among high risk population.
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Affiliation(s)
- Amjad Khan
- Department of Community Medicine, King Edward Medical University, Lahore 75500, Pakistan.
| | - Abdul Nadir
- Pakistan Kidney and liver institute and research center, Lahore, Pakistan
| | | | - Khunsa Junaid
- Department of Public Health, Institute of Social and Cultural Studies, University of Punjab, Lahore 75500, Pakistan
| | - Aabish Mehreen Khan
- Department of Community Medicine, King Edward Medical University, Lahore 75500, Pakistan
| | - Hassan Ali
- Department of Public Health, Institute of Social and Cultural Studies, University of Punjab, Lahore 75500, Pakistan
| | - Fatmee Waqar
- Department of Community Medicine, King Edward Medical University, Lahore 75500, Pakistan
| | - Taimoor Akram Khan
- Department of Community Medicine, King Edward Medical University, Lahore 75500, Pakistan
| | - Ali Akram Khan
- Department of Community Medicine, King Edward Medical University, Lahore 75500, Pakistan
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13
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Genetic Diversity of Hepatitis C Virus Genotype 3a Based on Complete Core Protein in Peshawar, Pakistan. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.98942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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14
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Sustained Virologic Response Rates of Sofosbuvir and Velpatasvir in Patients with Hepatitis C Genotype 3: A Meta-Analysis. HEPATITIS MONTHLY 2020. [DOI: 10.5812/hepatmon.98798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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15
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Tran L, Nhu Y M, Le Ba Nghia T, Hendam A, Vuong NL, Alzalal E, Sayed AM, Hussain MM, Sharma A, Tieu T, Mathenge PG, Hirayama K, Alexander N, Huy NT. Frequent inappropriate use of unweighted summary statistics in systematic reviews of pathogen genotypes or genogroups. J Clin Epidemiol 2019; 119:26-35. [PMID: 31740320 DOI: 10.1016/j.jclinepi.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/11/2019] [Accepted: 11/12/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Our study aimed to systematically assess and report the methodological quality used in epidemiological systematic reviews (SRs) and meta-analysis (MA) of pathogen genotypes/genogroups. STUDY DESIGN AND SETTING Nine electronic databases and manual search of reference lists were used to identify relevant studies. The method types were divided into three groups: 1) with weighted pooling analysis (which we call MA), (2) unweighted analysis of the study-level measures (which we call summary statistics), and (3) without any data pooling (which we call SR only). Characteristics were evaluated using Assessment of Multiple Systematic Reviews (AMSTAR), Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Risk Of Bias In Systematic reviews (ROBIS) tools. The protocol was registered in PROSPERO with CRD42017078146. RESULTS Among 36 included articles, 5 (14%) studies conducted SR only, 16 (44%) performed MA, and 15 (42%) used summary statistics. The univariable and multivariable linear regression of AMSTAR and PRISMA scores showed that MA had higher quality compared with those with summary statistics. The SR only and summary statistics groups had approximately equal scores among three scales of AMSTAR, PRISMA, and ROBIS. The methodological quality of epidemiological studies has improved from 1999 to 2017. CONCLUSION Despite the frequent use of unweighted summary statistics, MA remains the most suitable method for reaching rational conclusions in epidemiological studies of pathogen genotypes/genogroups.
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Affiliation(s)
- Linh Tran
- Institute of Research and Development, Duy Tan University, Danang 550000, Vietnam
| | - Mai Nhu Y
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Thai Le Ba Nghia
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Abdulrahman Hendam
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nguyen Lam Vuong
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ebrahim Alzalal
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Menofia University, Shebin Elkom, Egypt
| | - Ahmed M Sayed
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Mustafa Mushtaq Hussain
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Akash Sharma
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Thuan Tieu
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Peterson Gitonga Mathenge
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Neal Alexander
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan.
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16
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Hussain A, Gul MA, Khalid MU. Validation of Novel Fibrosis Index (NFI) for assessment of liver fibrosis: comparison with transient elastography (FibroScan). BMJ Open Gastroenterol 2019; 6:e000316. [PMID: 31749977 PMCID: PMC6827736 DOI: 10.1136/bmjgast-2019-000316] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/26/2019] [Accepted: 07/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background In this study, we collated cheap and readily available non-invasive biomarkers and FibroScan score in predicting fibrosis stages in chronic hepatitis C virus (HCV) infection. Methods We studied 1898 patients with HCV infection confirmed by presence of HCV RNA in their serum. We compared the FibroScan score and fibrosis indices (FIs): aspartate transaminase (AST) to alanine transaminase (ALT) ratio (AAR), AST to Platelet Ratio Index (APRI), FI, fibrosis-4 (FIB-4), Age-Platelet Index (API), Pohl score, Fibrosis Cirrhosis Index (FCI). We developed a new FI, named Novel Fibrosis Index (NFI) calculated by the following formula: NFI=[(bilirubin×(ALP)2)/(platelet count (albumin)2)]−n. Results AAR, APRI, FI, FIB-4, API, Pohl score, FCI and NFI were able to predict fibrosis stage with correlation coefficient indices 0.848, 0.711, 0.618, 0.741, 0.529, 0.360, 0.477 and 0.26, respectively. Receiver operating characteristic curves showed sensitivity and specificity for predicting F3 by NFI=75.1% and 41.1% and F4 for NFI=72.1% and 47.1%, AAR=62.8% and 37.6%, APRI=74.6% and 87.6%, FIB-4=53.2% and 72.3%, FI=78.1% and 92.3%, API=78.1% and 60%, Pohl score=38.1% and 78.1% and FCI=78.1% and 88.1%. Conclusions Our NFI predicted F3 and has been found to have more sensitivity and specificity in predicting F4 fibrosis stage than other FIs.
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Affiliation(s)
- Azhar Hussain
- Ameer-ud-Din Medical College, PGMI, Lahore, Pakistan
| | - Muhammad Asif Gul
- Gastroenterology, Nishtar Medical College and Hospital, Multan, Pakistan
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17
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Haqqi A, Munir R, Khalid M, Khurram M, Zaid M, Ali M, Shah ZH, Ahmed H, Afzal MS. Prevalence of Hepatitis C Virus Genotypes in Pakistan: Current Scenario and Review of Literature. Viral Immunol 2019; 32:402-413. [PMID: 31556811 DOI: 10.1089/vim.2019.0058] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) is a major public health concern globally, resulting in liver-related complications. Approximately 6% population of Pakistan is infected with HCV. HCV is error prone, due to which it is classified into 7 genotypes and 67 subtypes. HCV genotype determination is critical for treatment and therapy response. In this study, 3,539 samples were collected from 2015 to 2019 from all over Punjab. RNA was extracted from samples using QIA Amp Viral RNA MINI kit (Qiagen, Germany) and viral genotyping was performed. Furthermore, a systemized literature search (2009-2018) was done to analyze the HCV genotype distribution pattern in Pakistan. In Punjab, genotype 3a (86.46%) is most prevalent, followed by untypable (7.17%) and genotype 1a (3.84%) and 3b (1.04%). Mixed genotype constitutes only 0.67% of total infections. Genotype 2a, 2b, 3c, and 4 were found to be rare. Data available from literature review when compiled showed that HCV genotype 3a (58.16%) was predominant in Pakistan, followed by genotypes 3b (9.05%), 2a (6.70%), 1a (6.22%), and 1b (2.39%). The frequency of mixed genotypes was found to be 4% and 12% of untypable HCV variants. This study highlights the HCV genotype distribution pattern in different regions of Pakistan. Therapy response and disease management depend on genotype, so HCV genotype determination is crucial. In Pakistan, the most prevalent genotype is 3a, followed by untypable genotype. Both interferon and sofosbuvir are effective against genotype 3a, but treatment with sofosbuvir has comparatively high sustained virological response, less adverse effects, and more tolerability.
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Affiliation(s)
- Aleena Haqqi
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - Rimsha Munir
- Cancer Biology Lab, MMG, University of the Punjab, Lahore, Pakistan.,Hormone Lab, Lahore, Pakistan
| | | | - Muhammad Khurram
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - Muhammad Zaid
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - Muhammad Ali
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - Zaheer Hussain Shah
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - Haroon Ahmed
- Department of Biosciences, COMSATS Institute of Information Technology, Islamabad, Pakistan
| | - Muhammad Sohail Afzal
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
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18
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A 2-year retrospective study of viral and host-associated risk factors in Pakistani hepatocellular carcinoma patients. Eur J Gastroenterol Hepatol 2019; 31:1103-1109. [PMID: 30829691 DOI: 10.1097/meg.0000000000001384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Persistent chronic hepatitis C (CHC) infection is associated strongly with serious complications such as hepatitis C virus-associated liver cirrhosis (HCV-LC) and hepatitis C virus-associated hepatocellular carcinoma (HCV-HCC). The aim of this study was to assess the distribution of hepatitis C virus (HCV) genotypes among HCV-positive patients and examine the potential associations between viral and host-associated factors with the risk of developing HCV-HCC. PATIENTS AND METHODS HCV-positive patients (n = 300) were enrolled and divided into three groups: CHC (n = 171), HCV-LC (n = 51), and HCV-HCC (n = 78). RESULTS HCV genotype 3a showed the highest prevalence among HCV-positive individuals (66% of patients), followed by genotype 1a (15% of patients). The proportion of individuals infected with mixed HCV genotypes was higher among HCV-HCC patients. Interestingly, there were a significantly higher proportion of women (54/78; 69.2%) among HCV-HCC patients compared with CHC patients (89/171 or 52%; χ = 6.47; P=1 × 10). Women with HCV had two-fold higher odds of developing HCV-HCC (odds ratio = 2.07, 95% confidence interval: 1.18-3.71). In comparison with CHC patients, significantly more HCV-HCC patients were 50 years of age or older (59/78 or 75.6% of HCV-HCC patients and 61/171 or 35.7% of CHC patients; χ = 34.27; P < 0.0001), suggesting that HCV-positive patients aged 50 years or older had an ~five-fold higher risk of developing HCV-HCC (odds ratio = 5.6, 95% confidence interval: 3.02-10.01). CONCLUSION In summary, HCV genotype 3a had the highest prevalence in the studied HCV-positive population, and women and older patients were at a higher risk of developing HCV-LC and HCV-HCC following CHC infections.
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19
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National prevalence rate of hepatitis B and C in Pakistan and its risk factors. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-019-01081-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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20
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Wahid B, Naeem N, Altaf S, Ilyas N. Increasing Prevalence of Untypable and Mixed Genotypes of Hepatitis C Virus in Pakistan: Latest Trends in 2018. Viral Immunol 2019; 32:192-194. [PMID: 30939104 DOI: 10.1089/vim.2018.0152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hepatitis C virus (HCV) genotyping is a critical parameter that acts as predictor of treatment response. According to previously reported findings, about 11 million population of Pakistan are HCV infected. Accumulating data suggest that genotype is the most prevalent genotype and mixed and untypable genotypes are the least prevalent genotypes of HCV. We observed that overall prevalence of mixed genotype (5.03%) and untypable genotype (3.3%) of HCV is on constant rise. This study highlights that the emergence of novel quasispecies could be reason of treatment failure in patients receiving direct-acting antiviral drugs.
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Affiliation(s)
- Braira Wahid
- Department of Life Sciences, School of Science, University of Management and Technology, Lahore, Pakistan
| | - Nabiha Naeem
- Department of Life Sciences, School of Science, University of Management and Technology, Lahore, Pakistan
| | - Saba Altaf
- Department of Life Sciences, School of Science, University of Management and Technology, Lahore, Pakistan
| | - Nimra Ilyas
- Department of Life Sciences, School of Science, University of Management and Technology, Lahore, Pakistan
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21
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Molecular Epidemiology of Hepatitis C Virus Genotypes Among Chronically Infected Patients in Pakistan. Jundishapur J Microbiol 2019. [DOI: 10.5812/jjm.86428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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22
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Real Time PCR Based Detection of Hepatitis C Virus Major Genotypes in Chronic HCV Patients in Khyber Pakhtunkhwa. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.80931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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23
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Wahid B, Waqar M, Rasool N, Rehman Z, Saeed J, Wasim M, Khan MA, Ali A, Rafique S, Sajjad, Idrees M. Recent trends in molecular epidemiology of Hepatitis C virus in Mardan, KPK Pakistan. INFECTION GENETICS AND EVOLUTION 2018; 66:66-71. [PMID: 30201500 DOI: 10.1016/j.meegid.2018.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 02/07/2023]
Abstract
To determine the genotypic distribution of HCV, frequency of risk factors involved in its transmission, and correlation of genotype with viral load in Mardan population which is the second largest city of Khyber Pakhtunkhwa (KPK), Pakistan. Blood samples of 1140 were collected from different regions of Mardan and major proportion of recruited patients were internally displaced people (IDPs), refugees, and slum dwellers. Complete patient's history was analyzed to assess the possible risks involved in HCV transmission. Viral genotype was determined by PCR (polymerase chain reaction) whereas, HCV RNA was measured by qRT-PCR. Data was analyzed using SPSS statistical software. Our results indicate 3a as the most abundant subtype in Mardan population followed by 3b, 2a, 2b, 4a, untypeable, mixed, 1a, and 1b. In contrast to previous findings, genotype 1 was the least prevalent genotype and the overall prevalence of HCV in Mardan population was significantly higher in females (n = 687, 60.2%) than males (n = 453, 39.7%). Significant difference between-genotypes and gender was observed in genotype 1 (p < .034) and genotype 3 (p < .004). The mean age was 44 (SD ± 9.51). The most frequently found mixed genotype was 3a + 1b and mixed genotype was more prevalent in males. The proportion of middle-aged people (41-49 years) was higher whereas, older and younger people were least infected with HCV. This is the first study that showed substantial correlation of genotype 3 with low and intermediate viral load in Mardan population. Moreover, high and extremely high viral load was associated with other genotypes. Our findings showed that most of the patients who experienced high and extremely high viremia in their blood were males and belonged to Takhat Bhai and Mardaan regions. There were significant difference in the prevalence of HCV genotype 3a (p = .001) and genotype 3b (p = .005) in different regions of Mardan. Pre-treatment viral load is significantly high (p 0.001) in tehsil Mardan patients infected with HCV genotype 3 as compared to other genotypes. Unsafe medical practices such as medical and dental surgeries, intravenous drug use, and blood transfusions were the main risk factors for HCV transmission in Mardan, KPK Pakistan. This study gives clear insights into the epidemiological status of HCV in Mardan population. Genotype 3 is correlated with low and intermediate viral load whereas high viral loads were revealed among patients infected with genotypes other than genotype 3. In the absence of better data and robust epidemiological information, this detailed analysis of HCV genotypes with special reference to risk factors, pretreatment viral load, gender, and age will provide the baseline data for development of optimal HCV eradication and preventive strategies.
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Affiliation(s)
- Braira Wahid
- Department of Life Sciences, School of Science, University of Management and Technology, Lahore, Pakistan.
| | - Muhammad Waqar
- Genome Centre for Molecular Based Diagnostics and Research, Cl-25 Block B Al-Sudais Plaza, Abdalian Cooperative Society, Lahore, Pakistan
| | - Nouman Rasool
- Department of Life Sciences, School of Science, University of Management and Technology, Lahore, Pakistan
| | - Zobaria Rehman
- Genome Centre for Molecular Based Diagnostics and Research, Cl-25 Block B Al-Sudais Plaza, Abdalian Cooperative Society, Lahore, Pakistan
| | - Jamaluddin Saeed
- Department of Medicine, Khyber Teaching Hospital, Peshawar, KPK, Pakistan
| | - Muhammad Wasim
- Department of Medicine, Khyber Teaching Hospital, Peshawar, KPK, Pakistan
| | - Muhammad Arif Khan
- Departments of Medicine, District Head Quarter Hospital, Mardan, Khyber Paktunkhwa, Pakistan
| | - Amjad Ali
- Centre for Applied Molecular Biology (CAMB), 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan
| | - Shazia Rafique
- Division of Molecular Virology and Diagnostics, Center of Excellence in Molecular Biology (CEMB), 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan
| | - Sajjad
- Genome Centre for Molecular Based Diagnostics and Research, Cl-25 Block B Al-Sudais Plaza, Abdalian Cooperative Society, Lahore, Pakistan
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Chaabna K, Cheema S, Abraham A, Alrouh H, Lowenfels AB, Maisonneuve P, Mamtani R. Systematic overview of hepatitis C infection in the Middle East and North Africa. World J Gastroenterol 2018; 24:3038-3054. [PMID: 30038471 PMCID: PMC6054949 DOI: 10.3748/wjg.v24.i27.3038] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/10/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the quality of and to critically synthesize the available data on hepatitis C infections in the Middle East and North Africa (MENA) region to map evidence gaps. METHODS We conducted an overview of systematic reviews (SRs) following an a priori developed protocol (CRD42017076736). Our overview followed the preferred reporting items for systematic reviews and meta-analyses guidelines for reporting SRs and abstracts and did not receive any funding. Two independent reviewers systematically searched MEDLINE and conducted a multistage screening of the identified articles. Out of 5758 identified articles, 37 SRs of hepatitis C virus (HCV) infection in populations living in 20 countries in the MENA region published between 2008 and 2016 were included in our overview. The nine primary outcomes of interest were HCV antibody (anti-) prevalences and incidences in different at-risk populations; the HCV viremic (RNA positive) rate in HCV-positive individuals; HCV viremic prevalence in the general population (GP); the prevalence of HCV co-infection with the hepatitis B virus, human immunodeficiency virus, or schistosomiasis; the HCV genotype/subtype distribution; and the risk factors for HCV transmission. The conflicts of interest declared by the authors of the SRs were also extracted. Good quality outcomes reported by the SRs were defined as having the population, outcome, study time and setting defined as recommended by the PICOTS framework and a sample size > 100. RESULTS We included SRs reporting HCV outcomes with different levels of quality and precision. A substantial proportion of them synthesized data from mixed populations at differing levels of risk for acquiring HCV or at different HCV infection stages (recent and prior HCV transmissions). They also synthesized the data over long periods of time (e.g., two decades). Anti-HCV prevalence in the GP varied widely in the MENA region from 0.1% (study dates not reported) in the United Arab Emirates to 2.1%-13.5% (2003-2006) in Pakistan and 14.7% (2008) in Egypt. Data were not identified for Bahrain, Jordan, or Palestine. Good quality estimates of anti-HCV prevalence in the GP were reported for Algeria, Djibouti, Egypt, Iraq, Morocco, Pakistan, Syria, Sudan, Tunisia, and Yemen. Anti-HCV incidence estimates in the GP were reported only for Egypt (0.8-6.8 per 1000 person-year, 1997-2003). In Egypt, Morocco, and the United Arab Emirates, viremic rates in anti-HCV-positive individuals from the GP were approximately 70%. In the GP, the viremic prevalence varied from 0.7% (2011) in Saudi Arabia to 5.8% (2007-2008) in Pakistan and 10.0% (2008) in Egypt. Anti-HCV prevalence was lower in blood donors than in the GP, ranging from 0.2% (1992-1993) in Algeria to 1.7% (2005) in Yemen. The reporting quality of the outcomes in blood donors was good in the MENA countries, except in Qatar where no time framework was reported for the outcome. Some countries had anti-HCV prevalence estimates for children, transfused patients, contacts of HCV-infected patients, prisoners, sex workers, and men who have sex with men. CONCLUSION A substantial proportion of the reported outcomes may not help policymakers to develop micro-elimination strategies with precise HCV infection prevention and treatment programs in the region, as nowcasting HCV epidemiology using these data is potentially difficult. In addition to providing accurate information on HCV epidemiology, outcomes should also demonstrate practical and clinical significance and relevance. Based on the available data, most countries in the region have low to moderate anti-HCV prevalence. To achieve HCV elimination by 2030, up-to-date, good quality data on HCV epidemiology are required for the GP and key populations such as people who inject drugs and men who have sex with men.
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Affiliation(s)
- Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Hekmat Alrouh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Albert B Lowenfels
- Department of Surgery and the Department of Family Medicine, New York Medical College, Valhalla, NY 10595, United States
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan 20141, Italy
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
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Sharma S, Mukherjee D, Nair RK, Datt B, Rao A. Role of Direct Antiviral Agents in Treatment of Chronic Hepatitis C Infection in Renal Transplant Recipients. J Transplant 2018; 2018:7579689. [PMID: 29796311 PMCID: PMC5896212 DOI: 10.1155/2018/7579689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 02/27/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Since the introduction of direct antiviral agents (DAAs), morbidity of HCV has considerably decreased but still no guidelines have been formulated in renal transplant recipients (RTRs). We studied efficacy and tolerability of direct antiviral agents in RTRs. METHODS This prospective observational study was conducted at Army Hospital Research & Referral, Delhi, from June 2016 to May 2017. Forty-five HCV infected RTRs with stable graft function were included. RESULTS Median time between renal transplantation and the start of anti-HCV therapy was 36 months (1-120 months). The majority (66.7%) were infected with genotype 3. Baseline median HCV RNA level was 542648 IU/ml (1189-55028534 IU/ml). Sofosbuvir-Ribavirin combination (24 weeks) was given to 30 patients including 3 cirrhotics, Ledipasvir-Sofosbuvir combination to 8 patients, and Daclatasvir-Sofosbuvir combination to 7 patients, including 2 cirrhotics. Rapid virological response was observed in 29 patients treated with Sofosbuvir/Ribavirin, all 8 patients on Sofosbuvir/Ledipasvir, and all 7 patients on Sofosbuvir/Daclatasvir. End treatment response and sustained virological response (12 weeks) were achieved in all patients irrespective of genotype or treatment regimen. Decrease in mean HCV RNA level and transaminase level was statistically significant (p < 0.01). Ribavirin was significantly associated with anaemia (p = 0.032). CONCLUSIONS DAA regimens are well tolerated and highly efficacious. Response to DAA is good irrespective of genotype, drug combination, initial HCV RNA level, age or sex of patient, or graft age. However, Sofosbuvir/Ledipasvir and Sofosbuvir/Daclatasvir combination is preferable.
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Affiliation(s)
| | | | | | | | - Ananth Rao
- Army Hospital Research & Referral, Delhi, India
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Mehta V, Mahajan R, Midha V, Narang V, Kaur K, Singh A, Malhotra A, Parvez A, Sood A. Impact of Direct Acting Antiviral Therapy for Treatment of Hepatitis C Genotypes 1, 3 and 4: A Real Life Experience from India. J Clin Exp Hepatol 2018; 8:7-14. [PMID: 29743791 PMCID: PMC5938329 DOI: 10.1016/j.jceh.2017.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 06/12/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To assess impact of Direct Acting Antiviral (DAA) therapies for treatment of Hepatitis C Virus (HCV) genotypes 1, 3 and 4 in a real-world cohort from India. METHODS Adults with chronic HCV infection treated with Sofosbuvir (SOF) and Ledipasvir (LDV) (genotypes 1 and 4) or SOF and Daclatasvir (DCV) (genotype 3), with or without Ribavirin (RBV) between December 2015 and December 2016 were included. The primary endpoint was Sustained Virological Response at Post-treatment Week 12 (SVR12). RESULTS Of the 648 patients, 181 received SOF/LDV (65 with RBV) and 467 received SOF/DCV (135 with RBV). Most patients were males (65.4%), aged 41-60 years (49.4%) and treatment-naïve (92.6%). Genotype 3 (72.1%) was most common, followed by genotypes 1 (22.4%) and 4 (5.6%). Forty two percent patients (n = 271) had cirrhosis (112 patients were decompensated). SVR12 (modified intention-to-treat) was achieved by 98.1% of patients (512/522) (100% in genotypes 1 and 4, and 97.3% (362/372) in genotype 3). On intention to treat analysis, SVR12 was 88.1% (512/581) [genotype 1-96.8% (121/125), genotype 3-85.2%, genotype 4-93.5% (29/31)]. Seventy patients had treatment failure (non response in 6, virological breakthrough in 2, 10 patients relapsed, 2 died and 50 were lost to follow up). High SVR was observed regardless of HCV genotype, presence of cirrhosis or past history of treatment. No major adverse events warranting discontinuation of treatment were noted. CONCLUSIONS DAA therapy for HCV genotypes 1, 3 and 4 achieves high SVR rates in all patients, including those with cirrhosis and previous non-responders.
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Key Words
- DAA, Direct Acting Antiviral
- DCV, Daclatasvir
- EASL, European Association of Study of the Liver (EASL)
- ETR, End of Treatment Response
- HBV, Hepatitis B
- HCC, Hepatocellular Carcinoma
- HCV, Hepatitis C Virus
- HIV, Human Immunedeficiency Virus
- ITT, intention to treat
- LDV, ledipasvir
- RBV, Ribavirin
- RVR, Rapid Virological Response
- SOF, Sofosbuvir
- SVR, Sustained Virological Response
- SVR12, sustained virological response at Post-treatment Week 12
- direct acting antivirals
- hepatitis C
- mITT, modified Intention-to-Treat
- real life experience
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Affiliation(s)
- Varun Mehta
- Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Ramit Mahajan
- Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Vandana Midha
- Department of Internal Medicine, Dayanand Medical College, Ludhiana, Punjab, India
| | - Vikram Narang
- Department of Pathology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Kirandeep Kaur
- Department of Pharmacology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Arshdeep Singh
- Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Anand Malhotra
- Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Aslam Parvez
- Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Ajit Sood
- Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India,Address for correspondence: Ajit Sood, Professor & Head, Department of Gastroenterology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
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Iqbal S, Yousuf MH, Yousaf MI. Dramatic response of hepatitis C patients chronically infected with hepatitis C virus genotype 3 to sofosbuvir-based therapies in Punjab, Pakistan: A prospective study. World J Gastroenterol 2017; 23:7899-7905. [PMID: 29209131 PMCID: PMC5703919 DOI: 10.3748/wjg.v23.i44.7899] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/06/2017] [Accepted: 09/13/2017] [Indexed: 02/07/2023] Open
Abstract
AIM To prospectively evaluate the efficacy of sofobuvir (SOF) in hepatitis C patients infected with hepatitis C virus (HCV) genotype 3 in Pakistan.
METHODS The present study was performed with the coordination of gastroenterology and pathology departments of Shalamar Hospital Lahore from August 2014 to May 2016. The total number of patients included in this study was 1375 and all of them were infected with HCV genotype 3. On the basis of drug combinations, all the patients were separated into two groups. The first group of patients was treated for 24 wk with SOF (Sovaldi® by Gilead Sciences) plus ribavirin (RBV) [Ribazol® by Getz Pharma Pakistan (PVT) Ltd], while the patients of the second group were treated with SOF + RBV + pegylated-interferon (pegIFN) alfa-2a (Ropegra by Roach) for 12 wk. HCV genotyping and viral load measurement were performed on fully automated Abbott Real-Time PCR system (Abbott m24sp automated nucleic acid extraction system and Abbott m2000rt amplification system; abbott Molecular, Des Plaines, IL, United States). For the assessment of sustained virological response (SVR), all HCV RNA negative patients were followed for 12 weeks after the treatment completion. Any patient with less than 12 IU/mL viral load after 12 wk of treatment completion was considered as a sustained virological responder (SVR-12).
RESULTS A total of 1375 patients chronically infected with HCV genotype 3 were treated with two drug combinations SOF + RBV and SOF + RBV + pegIFN alfa-2a. On the basis of these drug combinations, patients were divided into two groups (first and second). Overall SVR-12 was excellent in both groups (99.17% and 97.91%). Older patients (> 40 years) of second group showed lower SVR-12 (93.46%) compared to first group older patients (98.79%), while in the younger patients of both groups, the SVR-12 rate was almost the same (99.54% in first group and 99.05% in second group). No such difference regarding SVR-12 rate was seen in males and females of first group patients (99.68% and 98.88%, respectively), while in second group the males were found to be better responders compared to females (98.96% and 95%). The SVR-12 rate in previously treated patients of first group was better (99.34%) than second group (93.70%), while naïve patients of second group were marginally better responders (99.25%) than first group (97.80%). Rapid viral response at week-4 was found to be a very effective predictor for assessing the SVR rate at this stage of therapy in both groups. Headache, anemia and fatigue were common side effects in both groups either treated with SOF + RBV or SOF + RBV + pegIFN alfa-2a, while the overall percentage of the side effects was higher in second group.
CONCLUSION The remarkable SVR response rate of HCV genotype 3 infected patients to SOF provided a new way to look forward to eliminate hepatitis C from our region.
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Affiliation(s)
- Sajjad Iqbal
- Department of Pathology, Shalamar Hospital, Lahore 54840, Pakistan
| | - Muhammad Haroon Yousuf
- Department of Gastroenterology and Hepatology, Shalamar Hospital, Lahore 54840, Pakistan
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Pattern of hepatitis C virus genotypes and subtypes circulating in war-stricken Khyber Pakhtunkhwa, Pakistan: Review of published literature. ASIAN PAC J TROP MED 2017; 10:1037-1042. [DOI: 10.1016/j.apjtm.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/28/2017] [Accepted: 10/10/2017] [Indexed: 02/07/2023] Open
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Mehmood A, Asad MJ, Ovais M, Zaman N, Aziz H, Irfan J, Ahmad I, Raza A. The Absence of HCV RNA and NS5A Protein in Peripheral Blood Mononuclear Cells Is a Prognostic Tool for Sustained Virological Response. Viral Immunol 2017; 30:568-575. [DOI: 10.1089/vim.2017.0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Azhar Mehmood
- Nuclear Medicine, Oncology, and Radiotherapy, Institute NORI, Islamabad, Pakistan
- Department of Biochemistry, PMAS-Arid Agriculture University, Rawalpindi, Pakistan
| | - Muhammad Javaid Asad
- Department of Biochemistry, PMAS-Arid Agriculture University, Rawalpindi, Pakistan
| | - Muhammad Ovais
- Nuclear Medicine, Oncology, and Radiotherapy, Institute NORI, Islamabad, Pakistan
| | - Nasib Zaman
- Department of Biochemistry, PMAS-Arid Agriculture University, Rawalpindi, Pakistan
| | - Hafsa Aziz
- Nuclear Medicine, Oncology, and Radiotherapy, Institute NORI, Islamabad, Pakistan
| | - Javaid Irfan
- Nuclear Medicine, Oncology, and Radiotherapy, Institute NORI, Islamabad, Pakistan
| | - Irshad Ahmad
- Department of Life Sciences, King Fahd University of Petroleum and Minerals (KFUPM), Dhahran, Saudi Arabia
| | - Abida Raza
- Nuclear Medicine, Oncology, and Radiotherapy, Institute NORI, Islamabad, Pakistan
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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. HEPATITIS MONTHLY 2017. [DOI: 10.5812/hepatmon.58442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Attaullah S, Khan S, Zahid M. Heterogeneous distribution of HCV genotypes and growing menace of mixed HCV infection in blood recipients in Khyber Pakhtunkhwa. Braz J Infect Dis 2017; 21:489-490. [PMID: 28282507 PMCID: PMC9428041 DOI: 10.1016/j.bjid.2016.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 12/19/2016] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sobia Attaullah
- Islamia College Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Peshawar, Pakistan.
| | - Sanaullah Khan
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - Muhammad Zahid
- Islamia College Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Peshawar, Pakistan
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Abbas Z, Saad M, Nadeem R, Jawed F, Abbas M. Sofosbuvir and Ribavirin With or Without Pegylated Interferon for Hepatitis C Genotype 3: A Real World Experience. HEPATITIS MONTHLY 2017; 17. [DOI: 10.5812/hepatmon.45525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Abstract
Hepatitis C virus (HCV) is a hepatotropic RNA virus that causes progressive liver damage, which might result in liver cirrhosis and hepatocellular carcinoma. Globally, between 64 and 103 million people are chronically infected. Major risk factors for this blood-borne virus infection are unsafe injection drug use and unsterile medical procedures (iatrogenic infections) in countries with high HCV prevalence. Diagnostic procedures include serum HCV antibody testing, HCV RNA measurement, viral genotype and subtype determination and, lately, assessment of resistance-associated substitutions. Various direct-acting antiviral agents (DAAs) have become available, which target three proteins involved in crucial steps of the HCV life cycle: the NS3/4A protease, the NS5A protein and the RNA-dependent RNA polymerase NS5B protein. Combination of two or three of these DAAs can cure (defined as a sustained virological response 12 weeks after treatment) HCV infection in >90% of patients, including populations that have been difficult to treat in the past. As long as a prophylactic vaccine is not available, the HCV pandemic has to be controlled by treatment-as-prevention strategies, effective screening programmes and global access to treatment.
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Ghori NUH, Shafique A, Hayat MQ, Anjum S. The Phylogeographic and Spatiotemporal Spread of HCV in Pakistani Population. PLoS One 2016; 11:e0164265. [PMID: 27764129 PMCID: PMC5072696 DOI: 10.1371/journal.pone.0164265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 09/22/2016] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C Virus (HCV) is the most prevalent human pathogen in Pakistan and is the major cause of liver cirrhosis and hepatocellular carcinoma in infected patients. It has shifted from being hypo-endemic to being hyper-endemic. There was no information about the origin and evolution of the local variants. Here we use newly developed phyloinformatic methods of sequence analysis to conduct the first comprehensive investigation of the evolutionary and biogeographic history in unprecedented detail and breadth. Considering evolutionary rate and molecular-clock hypothesis in context, we reconstructed the spatiotemporal spread of HCV in the whole territory of its circulation using a combination of Bayesian MCMC methods utilizing all sequences available in GenBank. Comparative analysis were performed and were addressed. Whole genome and individual gene analysis have shown that sub-types 1a, 1b and 3a are recognized as epidemic strains and are distributed globally. Here we confirm that the origin of HCV 3a genotypes is in South Asia and HCV has evolved in the region to become stably adapted to the host environment.
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Affiliation(s)
- Noor-Ul-Huda Ghori
- School of Earth and Environment, The University of Western Australia, Perth, Australia
- Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad, Pakistan
- * E-mail:
| | - Atif Shafique
- Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Muhammad Qasim Hayat
- Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Sadia Anjum
- Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad, Pakistan
- Department of Biology, College of Sciences, University Of Hail, PO Box 2440, Hail, Kingdom of Saudi Arabia
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Niu Z, Zhang P, Tong Y. Age and gender distribution of Hepatitis C virus prevalence and genotypes of individuals of physical examination in WuHan, Central China. SPRINGERPLUS 2016; 5:1557. [PMID: 27652130 PMCID: PMC5021643 DOI: 10.1186/s40064-016-3224-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/05/2016] [Indexed: 12/16/2022]
Abstract
Approximately 170 million people in the world are infected with Hepatitis C virus (HCV). There are no published population based studies about the prevalence of HCV genotypes and the associations of genotype and Infection frequency with gender and age in WuHan. We aimed to investigate the distribution of HCV prevalence and genotypes among different gender and age patients with chronic HCV infection in WuHan from 2011 to 2015. A total of 2685 anti-HCV positive serum samples from individuals of physical examinationwere recruited from the Renmin Hospital of WuHan University, Hubei Province in China from January 2011 to December 2015. From these 2685 anti-HCV positive serum samples, 496 samples were with a positive PCR for HCV RNA. The number of HCV infection showed an increase with year, but the annual infection rate has remained similar (χ2 = 2.94, P = 0.568). 2685 cases were infected with HCV from 2011 to 2015 in WuHan city of China. Blood transfusion (18.14 %) was the main routs of transmission, followed by Surgery (8.94 %). The highest prevalence of HCV infection was at the age group 50–59 (25.85 % of 2685) and the lowest prevalence was 0–9 (0.93 % of 2685). HCV genotype 1 was the most prevalent (73.39 %), followed by genotypes 2 (17.14 %), 3 (5.25 %) and 6 (3.22 %). Genotype 4 and 5 was not detected in these patients. The most prevalent subtype was subtype 1b (71.98 %), followed by genotypes 2a (17.14 %). Five patients had mixed infection across the HCV subtypes. Among all genotypes, genotype 1 was highest in both male (73.27 %) and female (73.47 %) patients, followed by genotype 2. Genotype 1 (male: 29.84 % of 496, vs female: 43.55 % of 496, χ2 = 20.07, P < 0.0001), genotype 2 (male: 6.25 % of 496, vs female: 10.89 % of 496, χ2 = 6.81, P = 0.009), and 6 (male: 1.41 % of 496, vs female: 1.81 % of 496, χ2 = 0.626, P = 0.401) were more common in female patients than males, while no significant gender differences were observed for genotype 6. Among age group 50–59 years Genotype 1 was most common in male patients (29.05 % of 148) followed in 20–29 years (23.65 % of 148), genotype 2 in the age group 60–69 (12 cases of 31) and genotype 3 in the age group 50–59 (4 cases of 13) and genotype 6 was most frequent in the age group 30–39 (4 cases of 7). The frequency of HCV prevalence was significantly higher in female patients compared to males before ages 60, while the opposite result was observed after 60 years. The most common HCV genotype in WuHan was subtype 1b followed by 2a and more common among women than males patients. Further studies are needed to collect a large number of samples to estimate the different epidemiology of the HCV genotypes, because the sample size of non-genotype 1b and 2a is not large enough and other factors like disease history/monthly income/etc. are not included in our study.
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Affiliation(s)
- ZhiLi Niu
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan City, 430060 Hu Bei Province China
| | - PingAn Zhang
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan City, 430060 Hu Bei Province China
| | - YongQing Tong
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan City, 430060 Hu Bei Province China
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Ashraf NM, Bilal M, Mahmood MS, Hussain A, Mehboob MZ. In-silico analysis of putative HCV epitopes against Pakistani human leukocyte antigen background: An approach towards development of future vaccines for Pakistani population. INFECTION GENETICS AND EVOLUTION 2016; 43:58-66. [DOI: 10.1016/j.meegid.2016.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/26/2016] [Accepted: 05/04/2016] [Indexed: 10/21/2022]
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Ghaderi-Zefrehi H, Gholami-Fesharaki M, Sharafi H, Sadeghi F, Alavian SM. The Distribution of Hepatitis C Virus Genotypes in Middle Eastern Countries: A Systematic Review and Meta-Analysis. HEPATITIS MONTHLY 2016; 16:e40357. [PMID: 27826320 PMCID: PMC5097177 DOI: 10.5812/hepatmon.40357] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 08/14/2016] [Indexed: 12/11/2022]
Abstract
CONTEXT The hepatitis C virus (HCV) is classified into seven genotypes and more than 100 subtypes. The treatment regimen, duration and efficacy of HCV therapy may vary according to the HCV genotype. Therefore, the HCV genotype should be determined prior to antiviral therapy. The objective of the current study was to review systematically all studies reporting the distribution of HCV genotypes in the countries that make up the Middle East. EVIDENCE ACQUISITION Articles were identified by searching electronic databases, including Scopus, PubMed and Google scholar, with timeline limits (articles published between 1995 and 2016). We carried out a systematic search regarding the distribution of HCV genotypes in Middle Eastern countries. RESULTS A total of 579 studies were identified by the electronic search. Of these, a total of 187 were identified as eligible papers including 60,319 patients who were meta-analyzed for pooled distribution of HCV genotypes. In Turkey, Israel, Cyprus, and Iran, genotype 1 was the most prevalent HCV genotype with rates of 82% (95% CI, 82%-83%), 68% (95% CI, 67%-69%), 68% (95% CI, 59%-77%), and 55% (95% CI, 54%-55%), respectively. In Egypt, Iraq, Saudi Arabia, and Syria, HCV genotype 4 was the most common genotype with rates of 86% (95% CI, 85%-88%), 60% (95% CI, 56%-64%), 56% (95% CI, 54%-55%), and 57% (95% CI, 54%-61%), respectively. On the basis of adjusted data, HCV genotype 4 was the most prevalent genotype in the Middle East region, with a rate of 74.7% (95% CI, 73.4%-76%), followed by genotype 1 at 15.1% (95% CI, 14.1%-16%). CONCLUSIONS Our results showed that HCV genotype 4 is the most prevalent genotype in the Middle East region. However, HCV genotype 1 is the most prevalent among non-Arab countries in the region including Turkey, Iran, Cyprus, and Israel.
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Affiliation(s)
- Hossein Ghaderi-Zefrehi
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
| | | | - Heidar Sharafi
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Farzin Sadeghi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR Iran
| | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Seyed Moayed Alavian, Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188945186, Fax: +98-2188945188, E-mail:
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Gabr SA, Alghadir AH, Allam AA, Ajarem J, Al-Basher G, Abdel-Maksoud MA, Ghfar AA, Aboud A. Correlation between vitamin D levels and apoptosis in geriatric patients infected with hepatitis C virus genotype 4. Clin Interv Aging 2016; 11:523-33. [PMID: 27217734 PMCID: PMC4862759 DOI: 10.2147/cia.s104599] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Vitamin D levels play a pivotal role in most biological processes and differ according to age. A deficiency of vitamin D in chronic hepatitis C (CHC) patients has been shown to be linked with the severity of liver fibrosis, but little is known about the mechanism of this association. Objective In this study, we evaluate the potential interrelation between vitamin D levels, oxidative stress, and apoptosis, based on liver fibrosis in geriatric patients infected with hepatitis C virus (HCV) genotype 4. Subjects and methods A total of 120 adult individuals aged 30–68 years were recruited in this study. Of these, 20 healthy subjects (15 men and five women) with a mean age of 48.3±6.1 years were selected as controls, and 100 patients with a mean age of 47.8±4.9 years with chronic HCV (CHC) who had undergone liver biopsy (80 men and 20 women) were included in this study. Based on liver radiographic (computed tomography, magnetic resonance imaging) and histological Metavir system analyses, the CHC patients were classified into three groups: asymptomatic CHC carriers (n=30), fibrosis (n=25), and cirrhosis (n=45). HCV RNA, HCV genotypes, inflammatory cytokines AFP and TNFα, 25-hydroxyvitamin D (25[OH]D) levels, apoptotic markers single-stranded DNA (ssDNA) and soluble Fas (sFas), and oxidative stress markers nitric oxide (NO) and total antioxidant capacity (TAC) were estimated by using molecular, immunoassay, and colorimetric techniques. Results Approximately 30% of the study population (n=30) were diagnosed as asymptomatic CHC carriers, and 70% of the study population (n=70) had severe fibrosis; these were classified into fibrosis and cirrhosis. There was a significant reduction in 25(OH)D levels and TAC activity, along with an increase in levels of NO, AFP, TNFα, ssDNA, and sFas in fibrosis and cirrhosis subjects compared with those of asymptomatic CHC carriers and health controls. The deficiency in 25(OH)D levels correlated positively with sFas, ssDNA, AFP, TNFα, NO, and TAC, and negatively with age, sex, liver function, body mass index, homeostatic model assessment – insulin resistance, HCV RNA, and viral load. Significant intercorrelation was reported between serum 25(OH)D concentrations and apoptotic and oxidative markers, which suggested progression of liver pathogenesis and fibrogenesis via oxidative and apoptotic mechanisms. Conclusion The data showed that vitamin D status was significantly correlated with pathogenesis and fibrogenesis of the liver in geriatric patients infected with HCV genotype 4. The deficiency in 25(OH)D levels was shown to have a pivotal role in the pathogenesis of liver via apoptotic, oxidative stress, and inflammatory mechanistic pathways. The data point to adequate vitamin D levels being recommended for a good response to treatment strategies, especially in older CHC patients.
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Affiliation(s)
- Sami A Gabr
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia; Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed A Allam
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia; Zoology Department, Faculty of Science, Beni-Suef University, Beni Suef, Egypt
| | - Jamaan Ajarem
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Ghada Al-Basher
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | | | - Ayman A Ghfar
- Department of Chemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Alaa Aboud
- Internal Endemic Medicine Department, College of Medicine, Beni-Suef University, Beni Suef, Egypt
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Hyperammonemia Is Associated with Increasing Severity of Both Liver Cirrhosis and Hepatic Encephalopathy. Int J Hepatol 2016; 2016:6741754. [PMID: 27847646 PMCID: PMC5099455 DOI: 10.1155/2016/6741754] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 10/02/2016] [Accepted: 10/09/2016] [Indexed: 12/20/2022] Open
Abstract
Background. Hyperammonemia resulting from chronic liver disease (CLD) can potentially challenge and damage any organ system of the body, particularly the brain. However, there is still some controversy regarding the diagnostic or prognostic values of serum ammonia in patients with over hepatic encephalopathy, especially in the setting of acute-on-chronic or chronic liver failure. Moreover, the association of serum ammonia with worsening Child-Pugh grade of liver cirrhosis has not been studied. Objective. This study was conducted to solve the controversy regarding the association between hyperammonemia and cirrhosis, especially hepatic encephalopathy in chronically failed liver. Material and Methods. In this study, 171 cirrhotic patients had their serum ammonia measured and analyzed by SPSS version 16. Chi-squared test and one-way ANOVA were applied. Results. The study had 110 male and 61 female participants. The mean age of all the participants in years was 42.33 ± 7.60. The mean duration (years) of CLD was 10.15 ± 3.53 while the mean Child-Pugh (CP) score was 8.84 ± 3.30. Chronic viral hepatitis alone was responsible for 71.3% of the cases. Moreover, 86.5% of participants had hepatic encephalopathy (HE). The frequency of hyperammonemia was 67.3%, more frequent in males (N = 81, z-score = 2.4, and P < 0.05) than in females (N = 34, z-score = 2.4, and P < 0.05), and had a statistically significant relationship with increasing CP grade of cirrhosis (χ2(2) = 27.46, P < 0.001, Phi = 0.40, and P < 0.001). Furthermore, serum ammonia level was higher in patients with hepatic encephalopathy than in those without it; P < 0.001. Conclusion. Hyperammonemia is associated with both increasing Child-Pugh grade of liver cirrhosis and hepatic encephalopathy.
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New patterns of HCV subtypes distribution in the Khyber Pakhtunkhwa province of Pakistan. Braz J Infect Dis 2016; 20:107-8. [PMID: 26626168 PMCID: PMC9425417 DOI: 10.1016/j.bjid.2015.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 09/27/2015] [Accepted: 09/29/2015] [Indexed: 12/04/2022] Open
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Liakina V, Hamid S, Tanaka J, Olafsson S, Sharara AI, Alavian SM, Gheorghe L, El Hassan ES, Abaalkhail F, Abbas Z, Abdou A, Abourached A, Al Braiki F, Al Hosani F, Al Jaberi K, Al Khatry M, Al Mulla MA, Al Quraishi H, Al Rifai A, Al Serkal Y, Alam A, Alashgar HI, Alawadhi S, Al-Dabal L, Aldins P, Alfaleh FZ, Alghamdi AS, Al-Hakeem R, Aljumah AA, Almessabi A, Alqutub AN, Alswat KA, Altraif I, Alzaabi M, Andrea N, Assiri AM, Babatin MA, Baqir A, Barakat MT, Bergmann OM, Bizri AR, Blach S, Chaudhry A, Choi MS, Diab T, Djauzi S, El Khoury S, Estes C, Fakhry S, Farooqi JI, Fridjonsdottir H, Gani RA, Ghafoor Khan A, Goldis A, Gottfredsson M, Gregorcic S, Hajarizadeh B, Han KH, Hasan I, Hashim A, Horvath G, Hunyady B, Husni R, Jafri W, Jeruma A, Jonasson JG, Karlsdottir B, Kim DY, Kim YS, Koutoubi Z, Lesmana LA, Lim YS, Löve A, Maimets M, Makara M, Malekzadeh R, Matičič M, Memon MS, Merat S, Mokhbat JE, Mourad FH, Muljono DH, Nawaz A, Nugrahini N, Priohutomo S, Qureshi H, Rassam P, Razavi H, Razavi-Shearer D, Razavi-Shearer K, Rozentale B, Sadik M, Saeed K, Salamat A, Salupere R, Sanai FM, Sanityoso Sulaiman A, Sayegh RA, Schmelzer JD, Sibley A, Siddiq M, Siddiqui AM, Sigmundsdottir G, Sigurdardottir B, Speiciene D, Sulaiman A, Sultan MA, Taha M, Tarifi H, Tayyab G, Tolmane I, Ud Din M, Umar M, Valantinas J, Videčnik-Zorman J, Yaghi C, Yunihastuti E, Yusuf MA, Zuberi BF, Gunter J. Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 3. J Viral Hepat 2015; 22 Suppl 4:4-20. [PMID: 26513445 DOI: 10.1111/jvh.12475] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/06/2015] [Indexed: 02/05/2023]
Abstract
Detailed, country-specific epidemiological data are needed to characterize the burden of chronic hepatitis C virus (HCV) infection around the world. With new treatment options available, policy makers and public health officials must reconsider national strategies for infection control. In this study of 15 countries, published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates were gathered from the literature and validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Iran and Lebanon to 4.2% in Pakistan. The largest viraemic populations were in Pakistan (7 001 000 cases) and Indonesia (3 187 000 cases). Injection drug use (IDU) and a historically unsafe blood supply were major risk factors in most countries. Diagnosis, treatment and liver transplant rates varied widely between countries. However, comparison across countries was difficult as the number of cases changes over time. Access to reliable data on measures such as these is critical for the development of future strategies to manage the disease burden.
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Affiliation(s)
- V Liakina
- Centre of Hepatology, Gastroenterology, and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of Biomechanics, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - S Hamid
- The Aga Khan University, Karachi, Pakistan
| | - J Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan
| | - S Olafsson
- Division of Gastroenterology and Hepatology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - A I Sharara
- Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon
| | - S M Alavian
- Baqiatallah Research Center for Gastroenterology and Liver Diseases, Baqiatallah University of Medical Sciences, Tehran, Iran.,Middle East Liver Diseases Centre, Tehran, Iran
| | - L Gheorghe
- Center of Gastroenterology & Hepatology, Fundeni Clinical Institute, Bucharest, Romania
| | | | - F Abaalkhail
- Department of Liver and Small Bowel Transplantation, King Faisal Specialist Hospital and Research Center, Alfaisal University, Riyadh, Saudi Arabia
| | - Z Abbas
- Ziauddin University, Karachi, Pakistan
| | - A Abdou
- Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - A Abourached
- National Hepatitis Program, Ministry of Public Health, Beirut, Lebanon
| | - F Al Braiki
- Abu Dhabi Health Services Company, Abu Dhabi, UAE
| | - F Al Hosani
- Communicable Diseases Department, Health Authority Abu Dhabi, Abu Dhabi, UAE
| | - K Al Jaberi
- Health Regulation Division, Health Authority Abu Dhabi, Abu Dhabi, UAE
| | - M Al Khatry
- Ras Al Khaimah Hospital, Ras Al Khaimah, UAE
| | - M A Al Mulla
- Communicable Diseases Department, Health Authority Abu Dhabi, Abu Dhabi, UAE
| | | | | | - Y Al Serkal
- Hospitals Sector, Ministry of Health, Al-Ain, UAE
| | - A Alam
- Shaikh Zayed Hospital, Lahore, Pakistan
| | - H I Alashgar
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - S Alawadhi
- Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - L Al-Dabal
- Department of Pulmonary Medicine, Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - P Aldins
- Infection Control Department, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - F Z Alfaleh
- Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia
| | - A S Alghamdi
- Gastroenterology and Hepatology Unit, Medical Specialties Department, King Fahad Hospital, Riyadh, Saudi Arabia
| | - R Al-Hakeem
- Department of Preventive Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - A A Aljumah
- King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - A Almessabi
- Abu Dhabi Health Services Company, Abu Dhabi, UAE
| | - A N Alqutub
- Gastroenterology and Hepatology Unit, Medical Specialties Department, King Fahad Hospital, Riyadh, Saudi Arabia
| | - K A Alswat
- Department of Medicine, King Saud University Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - I Altraif
- King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - M Alzaabi
- Zayed Military Hospital, Abu Dhabi, UAE
| | - N Andrea
- Daman National Health Insurance Company, Abu Dhabi, UAE
| | - A M Assiri
- Department of Preventive Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - M A Babatin
- Gastroenterology and Hepatology Unit, Medical Specialties Department, King Fahad Hospital, Riyadh, Saudi Arabia
| | - A Baqir
- Seyal Medical Centre, Multan, Pakistan
| | | | - O M Bergmann
- Division of Gastroenterology and Hepatology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - A R Bizri
- Faculty of Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - S Blach
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - A Chaudhry
- Gujranwala Liver Foundation, Siddiq Sadiq Hospital, Gujranwala, Pakistan
| | - M S Choi
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - T Diab
- Al Ain Hospital, Al Ain, UAE
| | - S Djauzi
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - S El Khoury
- Gastroenterology Department, Saint George Hospital, University of Balamand, Balamand, Lebanon
| | - C Estes
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - S Fakhry
- Abu Dhabi Police, Abu Dhabi, UAE
| | - J I Farooqi
- Postgraduate Medical Institute, Khyber Medical University, Peshawar, Pakistan.,Government Lady Reading Hospital, Peshawar, Pakistan
| | - H Fridjonsdottir
- Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - R A Gani
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A Ghafoor Khan
- Department of Gastroenterology & Hepatology, Lady Reading Hospital, Peshawar, Pakistan
| | - A Goldis
- Clinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania
| | - M Gottfredsson
- Faculty of Medicine, School of Health Sciences, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - S Gregorcic
- Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre, Ljubljana, Slovenia
| | - B Hajarizadeh
- The Kirby Institute, University of New South Wales Australia, Sydney, NSW, Australia.,The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - K H Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - I Hasan
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A Hashim
- Liver Transplantation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - G Horvath
- Hepatology Center of Buda, Budapest, Hungary
| | - B Hunyady
- Department of Gastroenterology, Somogy County Kaposi Mor Teaching Hospital, Kaposvar, Hungary.,First Department of Medicine, University of Pecs, Pecs, Hungary
| | - R Husni
- Lebanese American University Medical Center, Rizk Hospital, Beirut, Lebanon
| | - W Jafri
- Aga Khan University, Karachi, Pakistan
| | - A Jeruma
- Department of Hepatology, Infectology Center of Latvia, Riga, Latvia.,Department of Infectology and Dermatology, Riga Stradins University, Riga, Latvia
| | - J G Jonasson
- Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Icelandic Cancer Registry, Reykjavik, Iceland.,The Faculty of Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - B Karlsdottir
- Division of Infectious Disease, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - D Y Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Y S Kim
- Department of Internal Medicine, Soon Chun Hyang University Bucheon Hospital, Bucheon, Korea
| | - Z Koutoubi
- Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - L A Lesmana
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Digestive Disease and GI Oncology Center, Medistra Hospital, Jakarta, Indonesia
| | - Y S Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - A Löve
- Faculty of Medicine, School of Health Sciences, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Department of Virology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - M Maimets
- University of Tartu, Tartu University Hospital, Tartu, Estonia
| | - M Makara
- Central Outpatient Clinic, Saint Laszlo Hospital, Budapest, Hungary
| | - R Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Matičič
- Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre, Ljubljana, Slovenia
| | - M S Memon
- Asian Institute of Medical Science (AIMS), Hyderabad, Pakistan
| | - S Merat
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - J E Mokhbat
- Division of Infectious Diseases and Division of Clinical Microbiology, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon
| | - F H Mourad
- Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon
| | - D H Muljono
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia.,Department of Hepatitis & Emerging Infectious Diseases, University of Sydney, Sydney, NSW, Australia
| | - A Nawaz
- Department of Gastroenterology, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan
| | - N Nugrahini
- Sub-Directorate for Gastrointestinal Infection, Diarrheal Diseases, and Hepatitis, Directorate of Direct Transmitted Disease Control, Disease Control & Environmental Health, Ministry of Health, Jakarta, Indonesia
| | - S Priohutomo
- Directorate of Direct Transmitted Disease Control, Disease Control & Environmental Health, Ministry of Health, Jakarta, Indonesia
| | - H Qureshi
- Pakistan Medical Research Council, Islamabad, Pakistan
| | - P Rassam
- Gastroenterology Department, Saint George Hospital, University of Balamand, Balamand, Lebanon
| | - H Razavi
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | | | | | - B Rozentale
- Department of Hepatology, Infectology Center of Latvia, Riga, Latvia.,Department of Infectology and Dermatology, Riga Stradins University, Riga, Latvia
| | - M Sadik
- Asian Institute of Medical Science (AIMS), Hyderabad, Pakistan
| | - K Saeed
- Khawar Clinic, Sahiwal, Pakistan
| | - A Salamat
- Department of Gastroenterology, Military Hospital, Rawalpindi, Pakistan
| | - R Salupere
- University of Tartu, Tartu University Hospital, Tartu, Estonia
| | - F M Sanai
- Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia
| | - A Sanityoso Sulaiman
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - R A Sayegh
- Department of Hepatology and Gastroenterology, School of Medical Science, Saint Joseph University, Beirut, Lebanon
| | - J D Schmelzer
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - A Sibley
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - M Siddiq
- Jinnah Memorial Hospital, Rawalpindi, Pakistan.,Yusra Medical College, Rawalpindi, Pakistan
| | | | - G Sigmundsdottir
- Centre for Health Security and Communicable Disease Control, Directorate of Health in Iceland, Reykjavik, Iceland
| | - B Sigurdardottir
- Division of Infectious Disease, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - D Speiciene
- Centre of Hepatology, Gastroenterology, and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Sulaiman
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Klinik Hati Prof. Ali Sulaiman, Jakarta, Indonesia
| | - M A Sultan
- Health Funding Department, Enaya Insurance Company, Abu Dhabi, UAE
| | - M Taha
- Department of Medicine, Tawam Hospital, Al Ain, UAE
| | - H Tarifi
- Pharmacy Department, Tawam Hospital, Al Ain, UAE
| | - G Tayyab
- Postgraduate Medical Institute, Lahore General Hospital, Lahore, Pakistan.,Doctors Hospital and Medical Center, Lahore, Pakistan
| | - I Tolmane
- Department of Hepatology, Infectology Center of Latvia, Riga, Latvia.,Department of Infectology and Dermatology, Riga Stradins University, Riga, Latvia
| | - M Ud Din
- Pakistan Society of Gastroenterology, Karachi, Pakistan
| | - M Umar
- Department of Medicine, Rawalpindi Medical College, Rawalpindi, Pakistan.,Department of Medicine, Holy Family Hospital, Rawalpindi, Pakistan
| | - J Valantinas
- Centre of Hepatology, Gastroenterology, and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - J Videčnik-Zorman
- Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre, Ljubljana, Slovenia
| | - C Yaghi
- Department of Hepatology and Gastroenterology, School of Medical Science, Saint Joseph University, Beirut, Lebanon
| | - E Yunihastuti
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - M A Yusuf
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | | | - J Gunter
- Center for Disease Analysis (CDA), Louisville, CO, USA
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Arain SQ, Talpur FN, Channa NA. A comparative study of serum lipid contents in pre and post IFN-alpha treated acute hepatitis C patients. Lipids Health Dis 2015; 14:117. [PMID: 26403989 PMCID: PMC4582939 DOI: 10.1186/s12944-015-0119-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 09/14/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To study the effect of Interferon (INF) alpha-2b therapy on the serum lipids and fatty acid (FA) level in pre and post treated hepatitis C (HCV) patients. METHODS Fifty samples were collected from pre and post treated patients along with age and gender matched controls. After separating serum, lipid contents were analyzed by microlab and gas chromatography. RESULTS The hepatitis C infection results in hypolipidemia with reduced level of triglyceride (113 mg/dl), high density lipoprotein (37.1 mg/dl), low density lipoprotein (74.3 mg/dl), cholesterol (149.9 mg/dl) that increase the infection resolution and after the IFN treatment, the lipid profile of the patients were increased. The myristic (2.8 g/100 g) and palmitic acids (26.6 g/100 g) were significantly higher while linoleic acid (20.94 g/100 g) was significantly lower in HCV patients. The higher oleic: stearic (1.4) and palmitoleic: palmitic acid (0.2) ratios were detected in HCV patients, showing enhanced stearoyl-CoA desaturase activity. The levels of serum saturated (44.9 g/100 g) and monounsaturated FA's (26.98 g/100 g) were higher while polyunsaturated FA's (25.9 g/100 g) were found lower in HCV patients in comparison of controls (40.1; 25.01; 33.44 g/100 g respectively). An inverse correlation was found HCV RNA viral load and PUFA (R(2) = 0.4555). Elevated levels of serum saturated free FA (45.7 g/100 g) in HCV patients indicates stimulated lipoapoptosis. CONCLUSION The present study conclude that serum PUFA level was lower in HCV patients, hence PUFA may provide synergistic antiviral effects when given as a food supplement during the INF based anti- HCV therapy.
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Affiliation(s)
- Sadia Qamar Arain
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan.,Institute of Biochemistry University of Sindh, Jamshoro, Pakistan
| | - Farah Naz Talpur
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan.
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Caliskan A, Kirisci O, Ozkaya E, Ozden S, Tumer S, Caglar S, Guler SA, Senol H. Distribution and predominance of genotype 3 in hepatitis C virus carriers in the province of kahramanmaras, Turkey. HEPATITIS MONTHLY 2015; 15:e25142. [PMID: 25972903 PMCID: PMC4426333 DOI: 10.5812/hepatmon.15(4)2015.25142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 03/02/2015] [Accepted: 04/02/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The hepatitis C virus (HCV) has six major genotypes and more than 100 subtypes, and the determination of the responsible genotype, collection of epidemiological data, tailoring antiviral therapy, and prediction of prognosis have an important place in disease management. OBJECTIVES The aim of the present study was to determine the distribution of HCV genotypes across geographic regions and compare these data with those obtained from other geographic locations. PATIENTS AND METHODS The HCV genotypes were identified in HCV RNA positive blood samples, obtained from different centers. The HCV genotype was determined using molecular methods [Real-Time Polymerase Chain Reaction (RT-PCR)] in 313 patients, who were found to be positive for HCV RNA. The presence of HCV RNA was investigated using the RT-PCR method in serum samples delivered to the Microbiology Laboratory at Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey, from the centers located in Kahramanmaras City center and peripheral districts of the province, between March 2010 and August 2014. The HCV genotype analysis was performed in HCV RNA positive samples, using RT-PCR reagents kit. Urine samples from the patients were tested for amphetamine with an Amphetamines II (AMPS2) kit, cocaine was tested with a Cocaine II (COC2) kit, opiates were tested with an Opiates II (OPI2) kit, and cannabinoids were tested with a Cannabinoids II (THC2) kit in Roche/Hitachi Cobas c501 device. RESULTS The blood samples collected from 313 patients were included in the study. Of these patients, 212 (67.7%) were male and 101 (32.3%) were female. The mean age of the patients was 41.29 ± 20.32 years. In terms of HCV genotype distribution, 162 patients (51.7%) had genotype 1, 144 patients (46%) had genotype 3, four patients (1.3%) had genotype 2, and three patients (1%) had genotype 4. The results of urine drug tests were available in only 65 patients (20.2%). Of these, 61 (93.8%) patients had HCV genotype 3. CONCLUSIONS In conclusion, the prevalence of HCV genotype 1 was 51.7%, which was lower than the rates reported in other studies in Turkey, while the prevalence of HCV genotype 3 was 46%, which was remarkably higher than the reported Turkish data. In addition, the prevalence rate for genotype 3 reported in the present study is the highest that has ever been reported in the literature.
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Affiliation(s)
- Ahmet Caliskan
- Department of Medical Microbiology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Ozlem Kirisci
- Department of Medical Microbiology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Esra Ozkaya
- Department of Medical Microbiology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Sevinc Ozden
- Department of Medical Microbiology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Seray Tumer
- Department of Medical Microbiology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Serkan Caglar
- Department of Medical Biohemistry, Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Selma Ates Guler
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Sutcu Imam University, Kahramanmaras, Turkey
| | - Hande Senol
- Department of Biostatistics, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Solgi G, Sabouri Ghannad M, Khalilian A, Majlesi A, Hajiloo M. Molecular epidemiology of hepatitis C virus and its relation with persistence or clearance of infection in Hamadan, West-Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2015; 7:109-17. [PMID: 26622972 PMCID: PMC4662778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Hepatitis C Virus genotyping appears to be vital for predicting the response to antiviral therapy. The present study aimed to analyze the HCV genotypes in relation to persistence or clearance of the virus in residents of Hamadan Province, West-Iran. MATERIAL AND METHODS A total of 1159 recorded questionnaires of HCV infected people were evaluated in this prospective study. Several parameters including HCV genotypes, anti-HCV antibodies, viral load, drug treatment, response to therapy and amount of ALT and AST were analyzed. RESULTS HCV genotyping in 637 samples revealed a predominance of type 1a (52.1%) followed by 3a (42.4%), type 1b (2.7%) and type 2 (0.2%) respectively. Mixed genotypes (3a-1a) were detected in 0.9%, and 1.7% had untypable genotype. High frequency of genotypes 1a and 3a were observed in drug-resistant (group-a) and drug-sensitive (group-b) patients respectively (P<0.0001). Additionally, duration of drug treatment was significantly higher in group-a than group-b (P<0.0001). During follow-up period, 92 cases showed spontaneous clearance of HCV infection and more importantly 86 of 92 cases were positive for anti-HCV antibodies compared with 59 of 455 antibody positive cases with treatment-induced clearance of HCV infection (P<0.0001). CONCLUSION HCV genotyping and also antibody screening could be useful for proper therapeutic intervention in HCV infected subjects.
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Affiliation(s)
- Ghasem Solgi
- Immunology Department, Medical School, Hamadan University of Medical Sciences, Hamadan, IRAN
| | - Masoud Sabouri Ghannad
- Department of Microbiology, Medical school, Hamadan University of Medical Sciences, Hamadan, IRAN
| | - Alireza Khalilian
- Department of Gastroenterology, Medical School, Hamadan University of Medical Sciences, Hamadan, IRAN
| | - Amir Majlesi
- Department of Gastroenterology, Medical School, Hamadan University of Medical Sciences, Hamadan, IRAN
| | - Mehrdad Hajiloo
- Immunology Department, Medical School, Hamadan University of Medical Sciences, Hamadan, IRAN.,Corresponding author: Mehrdad Hajilooi, Ph.D Address: Immunology Department, School of Medicine, Hamadan University of Medical Sciences, Mahdeh Ave, Lona Park, Hamadan, IRAN. Post code: 6517838736, Tel: +98 8118380160, Fax: +98 811 8380208, E-mail:
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Khodabandehloo M, Roshani D. Prevalence of hepatitis C virus genotypes in Iranian patients: a systematic review and meta-analysis. HEPATITIS MONTHLY 2014; 14:e22915. [PMID: 25685164 PMCID: PMC4310018 DOI: 10.5812/hepatmon.22915] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/09/2014] [Accepted: 11/09/2014] [Indexed: 02/07/2023]
Abstract
CONTEXT Hepatitis C virus (HCV) is a global public health problem and a major etiology of chronic liver disease, which may develop into cirrhosis and hepatocellular carcinoma. Genotypes of HCV indicate the route of acquisition, the clinical outcome, response to treatment, prognosis and control strategies. OBJECTIVES The aim of this study was to estimate the overall prevalence and trend of HCV genotypes or subtypes in Iran. DATA SOURCES A literature review was done for papers reporting HCV genotypes in Iranian patients in PubMed, Magiran, IranMedex, Scientific Information Databank, and Google scholar databases. STUDY SELECTION Data were selected according to inclusion and exclusion criteria. DATA EXTRACTION Data were abstracted by two independent authors. Data were analyzed based on random-effects model using the Meta R. Pooled statistical software. Prevalence of HCV genotypes in cities and provinces of Iran with 95% confidence interval (CI) were calculated. RESULTS Fifty-three articles published between 1999 and 31 June 2014 including 22952 HCV infected individuals were included in the meta-analysis. Subtype 1a was predominant with a rate of 39% (95% CI: 34-44%); followed by subtype 3a, 32% (95% CI: 26-39%); subtype 1b, 13% (95% CI: 10-15%); genotype 4, 5.18% (95% CI: 3.27-7.5%); and genotype 2, 3.6% (95% CI: 1.6-8.3%). Untypeable HCV had a rate of 0.11% (95% CI: 0.07-0.16%). CONCLUSIONS The most frequent subtypes of HCV in Iran were 1a, 3a and 1b, respectively. This frequency differed in various provinces of Iran and fluctuated with time. It is important to determine the distribution of HCV genotypes in different geographical areas and its trend with time for epidemiological and patients' management purposes.
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Affiliation(s)
- Mazaher Khodabandehloo
- Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, IR Iran
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, IR Iran
- Corresponding Author: Mazaher Khodabandehloo, Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, P. O. Box: 6617713446, Sanandaj, IR Iran. Tel: +98-8731827292, Fax: +98-8733664674, E-mail:
| | - Daem Roshani
- Social Determinants of Health Kurdistan Research Center, Kurdistan University of Medical Sciences, Sanandaj, IR Iran
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A SPECIAL MEETING REVIEW EDITION: Highlights in the Treatment of Hepatitis C Virus From the 2014 Liver Meeting: A Review of Selected Presentations From the 2014 Liver Meeting November 7-11, 2014 • Boston, MassachusettsSpecial Reporting on:• Evaluation of Sofosbuvir and Simeprevir-Based Regimens in the TRIO Network• Safety and Efficacy of New DAA-Based Therapy for Hepatitis C Post-Transplant: Interval Results From the HCV-TARGET Longitudinal, Observational Study• Efficacy and Safety of MK-5172 and MK-8742 ± Ribavirin in Hepatitis C Genotype 1 Infected Patients With Cirrhosis or Previous Null Response: Final Results of the C-WORTHY Study (Parts A & B)• Safety and Efficacy of Sofosbuvir in Combination With Simeprevir + Ribavirin in Patients With Genotype 1: Interim Results of a Prospective, Observational Study• All-Oral Fixed-Dose Combination Therapy With Daclatasvir/Asunaprevir/BMS-791325, ± Ribavirin, for Patients With Chronic HCV Genotype 1 Infection and Compensated Cirrhosis: UNITY-2 Phase 3 SVR-12 Results• TURQUOISE-II: Regimens of ABT-450/R/Ombitasvir and Dasabuvir With Ribavirin Achieve High SVR12 Rates in HCV Genotype 1-Infected Patients With Cirrhosis, Regardless of Baseline CharacteristicsPLUS Meeting Abstract Summaries With Expert Commentary by: Ira M. Jacobson, MDChief of the Division of Gastroenterology and HepatologyVincent Astor Distinguished Professor of MedicineWeill Cornell Medical CollegeAttending PhysicianNewYork-Presbyterian HospitalNew York, New York. Gastroenterol Hepatol (N Y) 2014; 10:1-19. [PMID: 26491413 PMCID: PMC4603418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Aziz S. Treatment of Hepatitis C Virus Infection in Children Less than 12 Years of Age in Developing Countries. J Clin Transl Hepatol 2014; 2:247-52. [PMID: 26356647 PMCID: PMC4521235 DOI: 10.14218/jcth.2014.00034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 11/28/2014] [Accepted: 12/02/2014] [Indexed: 02/06/2023] Open
Abstract
The treatment of hepatitis c virus (HCV) infection in children is difficult as few options are available. The standard therapy is combination pegylated interferon (PEG-IFN) α-2a or 2b and ribavirin, and the duration of therapy depends on HCV genotype. New oral drug therapies available for adults have still not been approved for treatment in children. Here, we review the causes of HCV infection in children, the therapeutic options for children, and the side effects of these treatments. The problems faced by physicians managing HCV infection in children less than 12 years of age in a developing country are also discussed.
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Affiliation(s)
- Sina Aziz
- Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
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Shahid I, ALMalki WH, Hafeez MH, Hassan S. Hepatitis C virus infection treatment: An era of game changer direct acting antivirals and novel treatment strategies. Crit Rev Microbiol 2014; 42:535-47. [PMID: 25373616 DOI: 10.3109/1040841x.2014.970123] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chronic hepatitis C virus infection and associated liver diseases represent a major health care burden all over the world. The current standard of care, i.e. peginterferon-alfa (PEG-IFNα) plus ribavirin (RBV) are associated with frequent and sometimes serious adverse effects and contraindications, which further limit their therapeutic efficacy. The approval of first and second generation HCV protease inhibitors represents a major breakthrough in the development of novel direct acting antivirals (DAAs) against different HCV genotypes and establishes a new standard of care for chronically infected HCV genotypes 1 patients. Similarly, next generation protease inhibitors and HCV RNA polymerase inhibitors have shown better pharmacokinetics and pharmacodynamics in terms of broader HCV genotypes coverage, better safety profile, fewer drug interactions and possible once daily administration than first generation direct acting antivirals. The testing of adenovirus-based vector vaccines, which escalates the innate and acquired immune responses against the most conserved regions of the HCV genome in chimpanzees and humans, may be a promising therapeutic approach against HCV infection in coming future. This review article presents up-to-date knowledge and recent developments in HCV therapeutics, insights the shortcomings of current HCV therapies and key lessons from the therapeutic potential of improved anti-HCV treatment strategies.
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Affiliation(s)
- Imran Shahid
- a Department of Molecular Biology , Applied and Functional Genomics Lab, CEMB, University of the Punjab , Near Thokar Niaz Baig , Lahore , Pakistan .,b Department of Pharmacology and Toxicology , College of Pharmacy, Umm Al Qura University , Al-Abidiyah , Makkah , Saudi Arabia
| | - Waleed Hassan ALMalki
- b Department of Pharmacology and Toxicology , College of Pharmacy, Umm Al Qura University , Al-Abidiyah , Makkah , Saudi Arabia
| | - Muhammad Hassan Hafeez
- c Department of Gastroenterology and Hepatology , Fatima Memorial Hospital and College of Medicine and Dentistry , Shadman , Lahore , Pakistan , and
| | - Sajida Hassan
- a Department of Molecular Biology , Applied and Functional Genomics Lab, CEMB, University of the Punjab , Near Thokar Niaz Baig , Lahore , Pakistan .,d Viral Hepatitis Program, Laboratory of Medicine, University of Washington , Seattle , WA , USA
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Khan N, Akmal M, Hayat M, Umar M, Ullah A, Ahmed I, Rahim K, Ali S, Bahadar S, Saleha S. Geographic distribution of hepatitis C virus genotypes in pakistan. HEPATITIS MONTHLY 2014; 14:e20299. [PMID: 25477975 PMCID: PMC4250967 DOI: 10.5812/hepatmon.20299] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 08/19/2014] [Accepted: 09/02/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND Distribution of Hepatitis C Virus (HCV) genotypes may be changed over time. Epidemiological Studies on distribution patterns of HCV genotypes in Pakistani population might assist for better treatment options and preventive strategies. OBJECTIVES This study was conducted to determine distribution patterns of HCV genotypes in different geographical regions of Pakistan. PATIENTS AND METHODS In this cross-sectional study, 1818 randomly selected patients from different geographical regions of Pakistan, diagnosed with HCV infection by the third generation Enzyme Linked Immunosorbent Assay (ELISA), were included between April 2011 and December 2013. HCV RNA was detected in serum samples of patients by Reverse Transcription Polymerase Chain Reaction (RT- PCR) of the core region. Qualitative PCR was performed to determine viral load. HCV genotyping was performed by RT-nested PCR using type-specific primers of the core region. Frequency of different genotypes among patients was assessed according to gender, age and geographical region at the time of sampling. RESULTS Of 1818 HCV RNA positive samples, HCV genotypes PCR fragments were detected in 1552 (85.5%) samples. HCV genotype 3a was the predominant genotype (39.4%) followed by genotype 2a (24.93%). HCV genotype 3 was the predominant genotype in Punjab and Sindh regions, while genotype 2 was the most predominant genotype in Khyber Pakhtunkhwa region and the second predominant genotype after genotype 3 in Sindh region. The incidence of genotype 2a is increasing in our country with decrease in the incidence of genotype 3a. A higher incidence of HCV various genotypes were observed among male patients and those younger than 45 years. CONCLUSIONS This study may facilitate treatment options and preventive strategies in Pakistan.
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Affiliation(s)
- Nasar Khan
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
| | - Muhammad Akmal
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
| | - Muhammad Hayat
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
| | - Muhammad Umar
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
| | - Atta Ullah
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
| | - Iqbal Ahmed
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
| | - Kashif Rahim
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
| | - Sadar Ali
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
| | - Sulaiman Bahadar
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
| | - Shamim Saleha
- Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan
- Corresponding Author: Shamim Saleha, Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan. Tel: +92-252915545, Fax: +92-3339642532, E-mail:
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Razzaq Z, Malik A. Viral load is associated with abnormal serum levels of micronutrients and glutathione and glutathione-dependent enzymes in genotype 3 HCV patients. BBA CLINICAL 2014; 2:72-8. [PMID: 26674880 PMCID: PMC4633942 DOI: 10.1016/j.bbacli.2014.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/12/2014] [Accepted: 09/24/2014] [Indexed: 01/03/2023]
Abstract
Background Oxidative stress in hepatitis C patients has been linked to hepatitis C virus. We verified this assumption in HCV genotype 3 patients by detecting the relationship between viral load and certain specific oxidative stress markers like Cu, Mn, Fe, Se, Zn and glutathione and glutathione-dependent enzymes. Method Subjects (n = 200, average age 24 years) with quantitative HCV RNA polymerase chain reaction-proven genotype 3 hepatitis C were simultaneously evaluated. Cu, Mn, Fe, Se and Zn serum levels were by using atomic absorption spectrophotometer. Internationally accepted methods were used for viral load quantification of glutathione, GR and Gpx serum levels. Result There was a significant correlation between HCV viral load and studied parameters. With the increase of viral load from mild group (200,000–1,000,000 copies/ml) to severe group (5,000,000–25,000,000 copies/ml) the serum levels of Cu, Mn, Zn, and Fe and glutathione reductase were found to be abnormally high. However, in severe viral load group serum concentration of Se and glutathione was less than the healthy controls. Conclusion As a significant correlation was detected between the study parameters in genotype 3 HCV patients, it is concluded that the studied micronutrients and glutathione and glutathione-dependent enzymes are the biomolecular targets of HCV to induce oxidative stress. General significance Constant monitoring and regulation of the recommended biomolecular targets of HCV can improve the plight of more than 170 million patients suffering from hepatitis C virus around the globe.
Viral load, micronutrients, antioxidants are key factors involved in oxidative stress. We investigated viral load GSH, GPx, GR, Cu, Mn, Zn, Se, and Fe in genotype 3 HCV patients. Abnormal levels of GSH, GPx, Gr and micronutrients are linked with the progression of hepatitis C. These parameters are associated to immune response, mitochondrial damage and inflammation.
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