Recent trends in molecular epidemiology of hepatitis c virus in mardan, kpk Pakistan
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Infection, Genetics and Evolution
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 < 0.034) and genotype 3 (p < 0.004). 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=0.001) and genotype 3b (p=0.005) 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 prractices such as medical
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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.
Description
Keywords
HCV, viral load, genotypes, risk factors, qPCR, Mardan, Pakistan
Citation
Wahid, B., Waqar, M., Rasool, N., Rehman, Z., Saeed, J., Wasim, M., ... & Idrees, M. (2018). Recent trends in molecular epidemiology of Hepatitis C virus in Mardan, KPK Pakistan. Infection, Genetics and Evolution, 66, 66-71.