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World J Gastroenterol. Dec 14, 2014; 20(46): 17690-17692
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17690
Diagnostically untypable hepatitis C virus variants: It is time to resolve the problem
Muhammad Sohail Afzal, Muhammad Yousaf Khan, Muhammad Ammar, Sadia Anjum, Najm us Sahar Sadaf Zaidi
Muhammad Sohail Afzal, Sadia Anjum, Najm us Sahar Sadaf Zaidi, Atta Ur Rahman School of Applied Biosciences, National University of Science and Technology, Islamabad 44000, Pakistan
Muhammad Yousaf Khan, Muhammad Ammar, Genomic Research Labs and Diagnostics Center, Rawalpindi 46000, Pakistan
Author contributions: Afzal MS, Khan MY, Ammar M contributed to the conception and design of the study, acquisition, analysis and interpretation of data; Afzal MS, Anjum S contributed to drafting the article; Afzal MS, Zaidi NSS revised the manuscript; all authors have approved the final version of the article.
Correspondence to: Muhammad Sohail Afzal, PhD, Atta Ur Rahman School of Applied Biosciences, National University of Science and Technology, Sector-H-12, Islamabad 44000, Pakistan. sohail.ncvi@gmail.com
Telephone: +92-321-5244808 Fax: + 92-51-90856122
Received: July 6, 2014
Revised: August 10, 2014
Accepted: September 12, 2014
Published online: December 14, 2014
Processing time: 165 Days and 14 Hours
Abstract

Pakistan is a low income country with more than 10 million hepatitis C virus (HCV) infections and the burden is on continuous raise. Accurate viral genotyping is very critical for proper treatment of the infected individuals as the sustained virological response of the standard antiviral interferon therapy is genotype dependent. We observed at our diagnostic center that 15.6% of HCV patient’s samples were not genotype-able by using Ohno et al method. The genotyped samples showed that 3a (68.3%) is the major prevalent genotype in Pakistan followed by 2a (10.3%), 3b (2.6%), 1b (1.5%), 2b (1.2%) and 1a (0.5%). Presence of large number of untypable HCV variants in the current study highlights an important issue of health care setup in Pakistan. Untypable HCV cases create difficulties in treatment of these patients. The problem of routine diagnostics setup of Pakistan should be addressed on priority basis to facilitate the medical professionals in patient’s treatment and to help in achieving the maximum sustained virological response.

Keywords: Hepatitis C virus; Genotypes; Diagnostics; Untypable variants; Antiviral interferon therapy; Pakistan

Core tip: Hepatitis C virus (HCV) is a major health issue in Pakistan. Accurate HCV genotyping is very critical for the treatment of a patient because the duration and efficacy of standard antiviral therapy depends on viral genotype. We observed a large proportion (15.6%) of untypable HCV isolates during routine diagnostic. As HCV genotype information is mandatory prior to standard interferon ribavirin therapy, it is very important to be clear about the viral genotype. It is highly needed that the mystery of diagnostically untypable HCV variants in Pakistan should be resolved on priority basis to insure the proper treatment of the patients.