Prevalence of active HCV infection and genotypic distribution among the general population of district Mardan, Pakistan / Prevalência de infecção HCV ativa a distribuição genotípica entre a população geral do distrito de Mardan, Paquistão

Hepatitis C virus (HCV) is the serious global public health burden of liver disease. Approximately 170 million people in the world are infected with (HCV). In Pakistan, where the disease has high occurrence rate. The present study envisages an up-to-date prevalence of HCV and genotypic distribution in the general population of Mardan District, Khyber Pakhtunkhwa (KP), Pakistan. The blood samples from 6,538 individuals including 3,263 males and 3,275 females were analyzed for hepatitis C surface antigen by Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (PCR). It was found that 396 (12.13%) out of 3263 individuals contained antibodies in their blood against HCV, while among the different age groups, the highest incidences of HCV antibodies were found in the 31-40 age group (11.01%). The ICT positive samples were further screened by nested PCR to determine the existence of active HCV-RNA. It was identified that 7.11% (3263) of the total population (6538) tested was positive, among which the 461 (14.07%) females possessed antibodies in their blood against HCV. Our data showed total HCV infection in the investigated population was 5.78%. Higher percentage of HCV prevalence was detected in males than females in the age group 31-40 and 41-50. To compare the prevalence of HCV genotypes age-wise in male and female genotype 3a was found most prevalent genotype followed by 1a, 2a and 3b, respectively.

O vírus da hepatite C (HCV) é o grave problema de saúde pública das doenças hepáticas. Aproximadamente 170 milhões de pessoas no mundo estão infectadas com HCV; no Paquistão, a doença tem alto índice de ocorrência. O presente estudo prevê uma prevalência atualizada do HCV e distribuição genotípica na população geral do distrito de Mardan, Khyber Pakhtunkhwa (KP), Paquistão. As amostras de sangue de 6.538 indivíduos, incluindo 3.263 homens e 3.275 mulheres, foram analisadas para o antígeno de superfície da hepatite C por teste imunocromatográfico (ICT), ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase de transcrição reversa (PCR). Verificou-se que 396 (12,13%) de 3.263 indivíduos continham anticorpos no sangue contra o HCV, enquanto entre as diferentes faixas etárias as maiores incidências de anticorpos anti-HCV foram encontradas na faixa etária de 31 a 40 anos (11,01%). As amostras positivas para ICT foram posteriormente rastreadas por nested PCR para determinar a existência de HCV-RNA ativo. Identificou-se que 7,11% (3.263) do total da população (6.538) testada foram positivos, dentre os quais 461 (14,07%) mulheres possuíam anticorpos no sangue contra o HCV. Nossos dados mostraram que a infecção total pelo HCV na população investigada foi de 5,78%. Maior porcentagem de prevalência de HCV foi detectada em homens do que em mulheres nas faixas etárias de 31-40 e 41-50. Para comparar a prevalência de genótipos de HCV com relação à idade no genótipo masculino e feminino 3a foi encontrado o genótipo mais prevalente seguido por 1a, 2a e 3b, respectivamente.

Prevalence of active HCV infection and genotypic distribution among the general population of district Mardan, Pakistan

Abstract Hepatitis C virus (HCV) is the serious global public health burden of liver disease. Approximately 170 million people in the world are infected with (HCV). In Pakistan, where the disease has high occurrence rate. The present study envisages an up-to-date prevalence of HCV and genotypic distribution in the general population of Mardan District, Khyber Pakhtunkhwa (KP), Pakistan. The blood samples from 6,538 individuals including 3,263 males and 3,275 females were analyzed for hepatitis C surface antigen by Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (PCR). It was found that 396 (12.13%) out of 3263 individuals contained antibodies in their blood against HCV, while among the different age groups, the highest incidences of HCV antibodies were found in the 31-40 age group (11.01%). The ICT positive samples were further screened by nested PCR to determine the existence of active HCV-RNA. It was identified that 7.11% (3263) of the total population (6538) tested was positive, among which the 461 (14.07%) females possessed antibodies in their blood against HCV. Our data showed total HCV infection in the investigated population was 5.78%. Higher percentage of HCV prevalence was detected in males than females in the age group 31-40 and 41-50. To compare the prevalence of HCV genotypes age-wise in male and female genotype 3a was found most prevalent genotype followed by 1a, 2a and 3b, respectively.

Resumo O vírus da hepatite C (HCV) é o grave problema de saúde pública das doenças hepáticas. Aproximadamente 170 milhões de pessoas no mundo estão infectadas com HCV; no Paquistão, a doença tem alto índice de ocorrência. O presente estudo prevê uma prevalência atualizada do HCV e distribuição genotípica na população geral do distrito de Mardan, Khyber Pakhtunkhwa (KP), Paquistão. As amostras de sangue de 6.538 indivíduos, incluindo 3.263 homens e 3.275 mulheres, foram analisadas para o antígeno de superfície da hepatite C por teste imunocromatográfico (ICT), ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase de transcrição reversa (PCR). Verificou-se que 396 (12,13%) de 3.263 indivíduos continham anticorpos no sangue contra o HCV, enquanto entre as diferentes faixas etárias as maiores incidências de anticorpos anti-HCV foram encontradas na faixa etária de 31 a 40 anos (11,01%). As amostras positivas para ICT foram posteriormente rastreadas por nested PCR para determinar a existência de HCV-RNA ativo. Identificou-se que 7,11% (3.263) do total da população (6.538) testada foram positivos, dentre os quais 461 (14,07%) mulheres possuíam anticorpos no sangue contra o HCV. Nossos dados mostraram que a infecção total pelo HCV na população investigada foi de 5,78%. Maior porcentagem de prevalência de HCV foi detectada em homens do que em mulheres nas faixas etárias de 31-40 e 41-50. Para comparar a prevalência de genótipos de HCV com relação à idade no genótipo masculino e feminino 3a foi encontrado o genótipo mais prevalente seguido por 1a, 2a e 3b, respectivamente.

Prevalence of active HCV infection and genotypic distribution among the general population of district Mardan, Pakistan / Prevalência de infecção HCV ativa a distribuição genotípica entre a população geral do distrito de Mardan, Paquistão

Abstract Hepatitis C virus (HCV) is the serious global public health burden of liver disease. Approximately 170 million people in the world are infected with (HCV). In Pakistan, where the disease has high occurrence rate. The present study envisages an up-to-date prevalence of HCV and genotypic distribution in the general population of Mardan District, Khyber Pakhtunkhwa (KP), Pakistan. The blood samples from 6,538 individuals including 3,263 males and 3,275 females were analyzed for hepatitis C surface antigen by Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (PCR). It was found that 396 (12.13%) out of 3263 individuals contained antibodies in their blood against HCV, while among the different age groups, the highest incidences of HCV antibodies were found in the 31-40 age group (11.01%). The ICT positive samples were further screened by nested PCR to determine the existence of active HCV-RNA. It was identified that 7.11% (3263) of the total population (6538) tested was positive, among which the 461 (14.07%) females possessed antibodies in their blood against HCV. Our data showed total HCV infection in the investigated population was 5.78%. Higher percentage of HCV prevalence was detected in males than females in the age group 31-40 and 41-50. To compare the prevalence of HCV genotypes age-wise in male and female genotype 3a was found most prevalent genotype followed by 1a, 2a and 3b, respectively.

Resumo O vírus da hepatite C (HCV) é o grave problema de saúde pública das doenças hepáticas. Aproximadamente 170 milhões de pessoas no mundo estão infectadas com HCV; no Paquistão, a doença tem alto índice de ocorrência. O presente estudo prevê uma prevalência atualizada do HCV e distribuição genotípica na população geral do distrito de Mardan, Khyber Pakhtunkhwa (KP), Paquistão. As amostras de sangue de 6.538 indivíduos, incluindo 3.263 homens e 3.275 mulheres, foram analisadas para o antígeno de superfície da hepatite C por teste imunocromatográfico (ICT), ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase de transcrição reversa (PCR). Verificou-se que 396 (12,13%) de 3.263 indivíduos continham anticorpos no sangue contra o HCV, enquanto entre as diferentes faixas etárias as maiores incidências de anticorpos anti-HCV foram encontradas na faixa etária de 31 a 40 anos (11,01%). As amostras positivas para ICT foram posteriormente rastreadas por nested PCR para determinar a existência de HCV-RNA ativo. Identificou-se que 7,11% (3.263) do total da população (6.538) testada foram positivos, dentre os quais 461 (14,07%) mulheres possuíam anticorpos no sangue contra o HCV. Nossos dados mostraram que a infecção total pelo HCV na população investigada foi de 5,78%. Maior porcentagem de prevalência de HCV foi detectada em homens do que em mulheres nas faixas etárias de 31-40 e 41-50. Para comparar a prevalência de genótipos de HCV com relação à idade no genótipo masculino e feminino 3a foi encontrado o genótipo mais prevalente seguido por 1a, 2a e 3b, respectivamente.

Prevalence of active HCV infection and genotypic distribution among the general population of district Mardan, Pakistan / Prevalência de infecção HCV ativa a distribuição genotípica entre a população geral do distrito de Mardan, Paquistão

Hepatitis C virus (HCV) is the serious global public health burden of liver disease. Approximately 170 million people in the world are infected with (HCV). In Pakistan, where the disease has high occurrence rate. The present study envisages an up-to-date prevalence of HCV and genotypic distribution in the general population of Mardan District, Khyber Pakhtunkhwa (KP), Pakistan. The blood samples from 6,538 individuals including 3,263 males and 3,275 females were analyzed for hepatitis C surface antigen by Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (PCR). It was found that 396 (12.13%) out of 3263 individuals contained antibodies in their blood against HCV, while among the different age groups, the highest incidences of HCV antibodies were found in the 31-40 age group (11.01%). The ICT positive samples were further screened by nested PCR to determine the existence of active HCV-RNA. It was identified that 7.11% (3263) of the total population (6538) tested was positive, among which the 461 (14.07%) females possessed antibodies in their blood against HCV. Our data showed total HCV infection in the investigated population was 5.78%. Higher percentage of HCV prevalence was detected in males than females in the age group 31-40 and 41-50. To compare the prevalence of HCV genotypes age-wise in male and female genotype 3a was found most prevalent genotype followed by 1a, 2a and 3b, respectively.(AU)

O vírus da hepatite C (HCV) é o grave problema de saúde pública das doenças hepáticas. Aproximadamente 170 milhões de pessoas no mundo estão infectadas com HCV; no Paquistão, a doença tem alto índice de ocorrência. O presente estudo prevê uma prevalência atualizada do HCV e distribuição genotípica na população geral do distrito de Mardan, Khyber Pakhtunkhwa (KP), Paquistão. As amostras de sangue de 6.538 indivíduos, incluindo 3.263 homens e 3.275 mulheres, foram analisadas para o antígeno de superfície da hepatite C por teste imunocromatográfico (ICT), ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase de transcrição reversa (PCR). Verificou-se que 396 (12,13%) de 3.263 indivíduos continham anticorpos no sangue contra o HCV, enquanto entre as diferentes faixas etárias as maiores incidências de anticorpos anti-HCV foram encontradas na faixa etária de 31 a 40 anos (11,01%). As amostras positivas para ICT foram posteriormente rastreadas por nested PCR para determinar a existência de HCV-RNA ativo. Identificou-se que 7,11% (3.263) do total da população (6.538) testada foram positivos, dentre os quais 461 (14,07%) mulheres possuíam anticorpos no sangue contra o HCV. Nossos dados mostraram que a infecção total pelo HCV na população investigada foi de 5,78%. Maior porcentagem de prevalência de HCV foi detectada em homens do que em mulheres nas faixas etárias de 31-40 e 41-50. Para comparar a prevalência de genótipos de HCV com relação à idade no genótipo masculino e feminino 3a foi encontrado o genótipo mais prevalente seguido por 1a, 2a e 3b, respectivamente.(AU)

Episode of Hepatitis C viral infection in the people of Swat, Pakistan / Episódio de infecção viral por Hepatite C no povo de Swat, Paquistão

Infectious agents cause serious diseases in humans worldwide and are responsible for the high rate of morbidity and mortality. The prevalence and epidemiology of infectious disease (HCV) in the hospital visited patients referred by the physicians through the initial findings and their associated risk factors were studied in Swat. The data of 174 infected patients were collected during the period of 2015 to 2017 from two clinical laboratories of Tehsil Matta Swat. Inform consent form was taken before blood collection. After taking informed consent blood samples were collected and ICT test was performed and then ICT positive cases were conform through PCR. A total of 174 ICT positive samples [106 male and 68 females] were included in this study. Age was considered from 10 to 72 years. Of the 174 ICT strip positive, 99 [63 males, 36 females] were confirmed through PCR. The prevalence rate was recorded 56.89%. I.V/I.M injection was recorded in 100% of the individuals. Visits to the barber shop was reported in (58%) of the individuals, married individuals were (81.0), surgical operation was reported in (44.8%), sharing toothbrush was observed in (29.9%), piercing was reported in (39.7%), family history was reported in (26.4%), dental treatment was observed in (21.8%), jaundice were (13.2%) and tattooing was (1.7%). Blood transfusion, surgical operations, Jaundice, family history and dental treatment were found significant risk factors for acquiring HCV infection. It was concluded that proper implementation of precautionary measures should be needed to control the spread of HCV in far near future.

Agentes infecciosos causam doenças graves em humanos em todo o mundo, e são responsáveis pelo alto índice de morbimortalidade. A prevalência e a epidemiologia das doenças infecciosas no hospital que atendeu pacientes encaminhados pelos médicos por meio dos achados iniciais e seus fatores de risco associados foram estudadas em Peshawar. Os dados de 174 pacientes infectados foram coletados durante o período de 2015 a 2017 oriundos de dois laboratórios clínicos de Tehsil Matta Swat. O formulário de consentimento informado foi obtido antes da coleta de sangue. Após a obtenção do consentimento informado, foram coletadas amostras de sangue e foi realizado o teste ICT e, em seguida, os casos ICT positivos foram confirmados por PCR. Um total de 174 amostras ICT positivas [106 homens e 68 mulheres] foi incluído neste estudo. A idade considerada foi de 10 a 72 anos. Das 174 tiras de ICT positivas, 99 casos [63 homens, 36 mulheres] foram confirmados por PCR. A taxa de prevalência foi de 56,89%. A injeção IV / IM foi registrada em 100% dos indivíduos. A visita à barbearia foi relatada em (58%) dos indivíduos, os números de casados foram (81,0%), e a operação cirúrgica foi relatada em (44,8%), o compartilhamento de escova de dente foi observado em (29,9%), o piercing foi relatado em (39,7%), antecedentes familiares foram relatados em (26,4%), tratamento odontológico em (21,8%), icterícia (13,2%) e tatuagem em (1,7%). Transfusão de sangue, operações cirúrgicas, icterícia, histórico familiar e tratamento odontológico foram fatores de risco significativos para adquirir infecção por Vírus da Hepatite C (VHC). Concluiu-se que a implementação adequada de medidas de precaução deve ser necessária para controlar a propagação do VHC em um futuro próximo.

Episode of Hepatitis C viral infection in the people of Swat, Pakistan

ABSTRACT Infectious agents cause serious diseases in humans worldwide and are responsible for the high rate of morbidity and mortality. The prevalence and epidemiology of infectious disease (HCV) in the hospital visited patients referred by the physicians through the initial findings and their associated risk factors were studied in Swat. The data of 174 infected patients were collected during the period of 2015 to 2017 from two clinical laboratories of Tehsil Matta Swat. Inform consent form was taken before blood collection. After taking informed consent blood samples were collected and ICT test was performed and then ICT positive cases were conform through PCR. A total of 174 ICT positive samples [106 male and 68 females] were included in this study. Age was considered from 10 to 72 years. Of the 174 ICT strip positive, 99 [63 males, 36 females] were confirmed through PCR. The prevalence rate was recorded 56.89%. I.V/I.M injection was recorded in 100% of the individuals. Visits to the barber shop was reported in (58%) of the individuals, married individuals were (81.0), surgical operation was reported in (44.8%), sharing toothbrush was observed in (29.9%), piercing was reported in (39.7%), family history was reported in (26.4%), dental treatment was observed in (21.8%), jaundice were (13.2%) and tattooing was (1.7%). Blood transfusion, surgical operations, Jaundice, family history and dental treatment were found significant risk factors for acquiring HCV infection. It was concluded that proper implementation of precautionary measures should be needed to control the spread of HCV in far near future.

RESUMO Agentes infecciosos causam doenças graves em humanos em todo o mundo, e são responsáveis pelo alto índice de morbimortalidade. A prevalência e a epidemiologia das doenças infecciosas no hospital que atendeu pacientes encaminhados pelos médicos por meio dos achados iniciais e seus fatores de risco associados foram estudadas em Peshawar. Os dados de 174 pacientes infectados foram coletados durante o período de 2015 a 2017 oriundos de dois laboratórios clínicos de Tehsil Matta Swat. O formulário de consentimento informado foi obtido antes da coleta de sangue. Após a obtenção do consentimento informado, foram coletadas amostras de sangue e foi realizado o teste ICT e, em seguida, os casos ICT positivos foram confirmados por PCR. Um total de 174 amostras ICT positivas [106 homens e 68 mulheres] foi incluído neste estudo. A idade considerada foi de 10 a 72 anos. Das 174 tiras de ICT positivas, 99 casos [63 homens, 36 mulheres] foram confirmados por PCR. A taxa de prevalência foi de 56,89%. A injeção IV / IM foi registrada em 100% dos indivíduos. A visita à barbearia foi relatada em (58%) dos indivíduos, os números de casados foram (81,0%), e a operação cirúrgica foi relatada em (44,8%), o compartilhamento de escova de dente foi observado em (29,9%), o piercing foi relatado em (39,7%), antecedentes familiares foram relatados em (26,4%), tratamento odontológico em (21,8%), icterícia (13,2%) e tatuagem em (1,7%). Transfusão de sangue, operações cirúrgicas, icterícia, histórico familiar e tratamento odontológico foram fatores de risco significativos para adquirir infecção por Vírus da Hepatite C (VHC). Concluiu-se que a implementação adequada de medidas de precaução deve ser necessária para controlar a propagação do VHC em um futuro próximo.

Episode of Hepatitis C viral infection in the people of Swat, Pakistan / Episódio de infecção viral por Hepatite C no povo de Swat, Paquistão

Infectious agents cause serious diseases in humans worldwide and are responsible for the high rate of morbidity and mortality. The prevalence and epidemiology of infectious disease (HCV) in the hospital visited patients referred by the physicians through the initial findings and their associated risk factors were studied in Swat. The data of 174 infected patients were collected during the period of 2015 to 2017 from two clinical laboratories of Tehsil Matta Swat. Inform consent form was taken before blood collection. After taking informed consent blood samples were collected and ICT test was performed and then ICT positive cases were conform through PCR. A total of 174 ICT positive samples [106 male and 68 females] were included in this study. Age was considered from 10 to 72 years. Of the 174 ICT strip positive, 99 [63 males, 36 females] were confirmed through PCR. The prevalence rate was recorded 56.89%. I.V/I.M injection was recorded in 100% of the individuals. Visits to the barber shop was reported in (58%) of the individuals, married individuals were (81.0), surgical operation was reported in (44.8%), sharing toothbrush was observed in (29.9%), piercing was reported in (39.7%), family history was reported in (26.4%), dental treatment was observed in (21.8%), jaundice were (13.2%) and tattooing was (1.7%). Blood transfusion, surgical operations, Jaundice, family history and dental treatment were found significant risk factors for acquiring HCV infection. It was concluded that proper implementation of precautionary measures should be needed to control the spread of HCV in far near future.

Agentes infecciosos causam doenças graves em humanos em todo o mundo, e são responsáveis pelo alto índice de morbimortalidade. A prevalência e a epidemiologia das doenças infecciosas no hospital que atendeu pacientes encaminhados pelos médicos por meio dos achados iniciais e seus fatores de risco associados foram estudadas em Peshawar. Os dados de 174 pacientes infectados foram coletados durante o período de 2015 a 2017 oriundos de dois laboratórios clínicos de Tehsil Matta Swat. O formulário de consentimento informado foi obtido antes da coleta de sangue. Após a obtenção do consentimento informado, foram coletadas amostras de sangue e foi realizado o teste ICT e, em seguida, os casos ICT positivos foram confirmados por PCR. Um total de 174 amostras ICT positivas [106 homens e 68 mulheres] foi incluído neste estudo. A idade considerada foi de 10 a 72 anos. Das 174 tiras de ICT positivas, 99 casos [63 homens, 36 mulheres] foram confirmados por PCR. A taxa de prevalência foi de 56,89%. A injeção IV / IM foi registrada em 100% dos indivíduos. A visita à barbearia foi relatada em (58%) dos indivíduos, os números de casados foram (81,0%), e a operação cirúrgica foi relatada em (44,8%), o compartilhamento de escova de dente foi observado em (29,9%), o piercing foi relatado em (39,7%), antecedentes familiares foram relatados em (26,4%), tratamento odontológico em (21,8%), icterícia (13,2%) e tatuagem em (1,7%). Transfusão de sangue, operações cirúrgicas, icterícia, histórico familiar e tratamento odontológico foram fatores de risco significativos para adquirir infecção por Vírus da Hepatite C (VHC). Concluiu-se que a implementação adequada de medidas de precaução deve ser necessária para controlar a propagação do VHC em um futuro próximo.

Episode of Hepatitis C viral infection in the people of Swat, Pakistan / Episódio de infecção viral por Hepatite C no povo de Swat, Paquistão

Infectious agents cause serious diseases in humans worldwide and are responsible for the high rate of morbidity and mortality. The prevalence and epidemiology of infectious disease (HCV) in the hospital visited patients referred by the physicians through the initial findings and their associated risk factors were studied in Swat. The data of 174 infected patients were collected during the period of 2015 to 2017 from two clinical laboratories of Tehsil Matta Swat. Inform consent form was taken before blood collection. After taking informed consent blood samples were collected and ICT test was performed and then ICT positive cases were conform through PCR. A total of 174 ICT positive samples [106 male and 68 females] were included in this study. Age was considered from 10 to 72 years. Of the 174 ICT strip positive, 99 [63 males, 36 females] were confirmed through PCR. The prevalence rate was recorded 56.89%. I.V/I.M injection was recorded in 100% of the individuals. Visits to the barber shop was reported in (58%) of the individuals, married individuals were (81.0), surgical operation was reported in (44.8%), sharing toothbrush was observed in (29.9%), piercing was reported in (39.7%), family history was reported in (26.4%), dental treatment was observed in (21.8%), jaundice were (13.2%) and tattooing was (1.7%). Blood transfusion, surgical operations, Jaundice, family history and dental treatment were found significant risk factors for acquiring HCV infection. It was concluded that proper implementation of precautionary measures should be needed to control the spread of HCV in far near future.(AU)

Agentes infecciosos causam doenças graves em humanos em todo o mundo, e são responsáveis pelo alto índice de morbimortalidade. A prevalência e a epidemiologia das doenças infecciosas no hospital que atendeu pacientes encaminhados pelos médicos por meio dos achados iniciais e seus fatores de risco associados foram estudadas em Peshawar. Os dados de 174 pacientes infectados foram coletados durante o período de 2015 a 2017 oriundos de dois laboratórios clínicos de Tehsil Matta Swat. O formulário de consentimento informado foi obtido antes da coleta de sangue. Após a obtenção do consentimento informado, foram coletadas amostras de sangue e foi realizado o teste ICT e, em seguida, os casos ICT positivos foram confirmados por PCR. Um total de 174 amostras ICT positivas [106 homens e 68 mulheres] foi incluído neste estudo. A idade considerada foi de 10 a 72 anos. Das 174 tiras de ICT positivas, 99 casos [63 homens, 36 mulheres] foram confirmados por PCR. A taxa de prevalência foi de 56,89%. A injeção IV / IM foi registrada em 100% dos indivíduos. A visita à barbearia foi relatada em (58%) dos indivíduos, os números de casados foram (81,0%), e a operação cirúrgica foi relatada em (44,8%), o compartilhamento de escova de dente foi observado em (29,9%), o piercing foi relatado em (39,7%), antecedentes familiares foram relatados em (26,4%), tratamento odontológico em (21,8%), icterícia (13,2%) e tatuagem em (1,7%). Transfusão de sangue, operações cirúrgicas, icterícia, histórico familiar e tratamento odontológico foram fatores de risco significativos para adquirir infecção por Vírus da Hepatite C (VHC). Concluiu-se que a implementação adequada de medidas de precaução deve ser necessária para controlar a propagação do VHC em um futuro próximo.(AU)

Virucidal activity of oriental hornet Vespa orientalis venom against hepatitis C virus

Background Hepatitis C virus (HCV) infection is a major worldwide health problem that can cause liver fibrosis and hepatocellular carcinoma (HCC). The clinical treatment of HCV infection mainly relies on the use of direct-acting antivirals (DAAs) that are usually expensive and have side effects. Therefore, achieving the discovery of more successful agents is always urgent. In this context, antiviral compounds that inhibit viral infections and disease progression with important therapeutic activities have been identified in animal venoms including arthropod toxins. This indicates that arthropod venoms represent a good natural source of promising candidates for new antivirals. Methods The antiviral activity of the wasp venom (WV), isolated from the Oriental hornet (Vespa orientalis), was assessed using cell culture technique with human hepatocellular carcinoma-derived cell line (Huh7it-1) and the recombinant strain of HCV genotype 2a (JFH1). Results The results revealed that WV inhibited HCV infectivity with 50% inhibitory concentration (IC50) of 10 ng/mL, while the 50% cytotoxic concentration (CC50) was 11,000 ng/mL. Time of addition experiment showed that the WV blocked HCV attachment/entry to the cells probably through virucidal effect. On the other hand, the venom showed no inhibitory effect on HCV replication. Conclusion WV can inhibit the entry stage of HCV infection at non-cytotoxic concentrations. Therefore, it could be considered a potential candidate for characterization of natural anti-HCV agents targeting the entry step.(AU)

Virucidal activity of oriental hornet Vespa orientalis venom against hepatitis C virus

Abstract Background Hepatitis C virus (HCV) infection is a major worldwide health problem that can cause liver fibrosis and hepatocellular carcinoma (HCC). The clinical treatment of HCV infection mainly relies on the use of direct-acting antivirals (DAAs) that are usually expensive and have side effects. Therefore, achieving the discovery of more successful agents is always urgent. In this context, antiviral compounds that inhibit viral infections and disease progression with important therapeutic activities have been identified in animal venoms including arthropod toxins. This indicates that arthropod venoms represent a good natural source of promising candidates for new antivirals. Methods The antiviral activity of the wasp venom (WV), isolated from the Oriental hornet (Vespa orientalis), was assessed using cell culture technique with human hepatocellular carcinoma-derived cell line (Huh7it-1) and the recombinant strain of HCV genotype 2a (JFH1). Results The results revealed that WV inhibited HCV infectivity with 50% inhibitory concentration (IC50) of 10 ng/mL, while the 50% cytotoxic concentration (CC50) was 11,000 ng/mL. Time of addition experiment showed that the WV blocked HCV attachment/entry to the cells probably through virucidal effect. On the other hand, the venom showed no inhibitory effect on HCV replication. Conclusion WV can inhibit the entry stage of HCV infection at non-cytotoxic concentrations. Therefore, it could be considered a potential candidate for characterization of natural anti-HCV agents targeting the entry step.

Aplicações de Metagenômica Viral em Medicina Veterinária: Análise de Viromas

As novas abordagens metagenômicas virais permitem a detecção imparcial de uma ampla gama de agentes infecciosos de maneira independente da cultura, facilitando o diagnóstico e, consequentemente, o monitoramento de doenças, o que está intimamente atrelado ao conceito One World, One Health. Além disso, abrem possibilidades para análises genéticas comparativas e enriquecimento de bancos de dados genômicos. O gênero Hepacivirus (família Flaviviridae) é um exemplo expressivo de gênero viral que cresceu rapidamente com o advento da metagenômica. Desde 1996, quando o gênero Hepacivirus foi criado, o vírus da hepatite C (HCV) era a única espécie conhecida. No entanto, os hepacivírus (HVs) têm sido detectados em diversos animais domésticos e selvagens, incluindo, equinos, cães, roedores, morcegos, bovinos, tubarões, entre outros. O objetivo geral desta tese foi aprofundar o conhecimento acerca da ecologia viral em diferentes hospedeiros, através da metagenômica na ciência veterinária, destacando diferentes subáreas em que a mesma pode ser empregada. O Capitulo 1 aborda a detecção de um hepacivírus bovino (HNV) através da plataforma de sequenciamento de alto desempenho, Illumina MiSeq. As análises revelaram uma sequência com alta divergência nucleotídica quando comparada aos demais HNVs conhecidos mundialmente. Além disso, baseado na classificação proposta na literatura, trata-se de um provável novo genótipo. Esse estudo, intitulado Highly Divergent Cattle Hepacivirus N in Southern Brazil foi publicado em 2019, na revista científica Archives of Virology. O Capítulo 2 trata-se de dois estudos de metagenômica realizados para análise de viroma. O primeiro intitulado "New Polyomavirus in Nutria, Myocastor coypus Polyomavirus 1" no qual obtivemos o sequenciamento de genoma completo de uma nova espécie de PyVs em ratão-do-banhado, pertencente ao gênero Alphapolyomavirus, que foi publicado na revista científica Archives of Virology. No segundo estudo, "Liver Virome of Healthy Pigs Reveals Diverse Small ssDNA Viral Genomes", foi analisado o viroma de figados de suínos de um abatedouro. Nesse estudo detectamos, pela primeira vez no Brasil, a presença de alguns vírus como Porcine Circovirus 1 e Porcine Parvovirus 6 e 7, além da ausência de vírus potencialmente zoonóticos. A pesquisa foi publicada na revista científica Infection, Genetics and Evolution em 2020. Concluindo, a metagenômica viral foi aplicada com sucesso na investigação de três importantes estudos para a ciência veterinária. Os resultados contribuíram com a expansão do conhecimento na área, através da descrição e caracterização de novos e conhecidos vírus, além de enriquecer os bancos de dados genômicos, provendo informação para futuras pesquisas

The viral metagenomic approaches, a culture-independent technique, allow the impartial detection of a wide range of pathogens, improving the diagnosis and, consequently, the monitoring of diseases, which is closely linked to the One World, One Health concept. Furthermore, open possibilities for comparative genetic analysis and genomic databases enrichment. Hepacivirus genus (family Flaviviridae) is an expressive example of a viral genus that grew with the advent of metagenomics. Since 1996, when the genus Hepacivirus was created, the hepatitis C virus (HCV) was the only known species. However, hepaciviruses (HVs) have been detected in several domestic and wild animals, including, horses, dogs, rodents, bats, cattle, sharks, among others. The main objective of this thesis was improving the knowledge of different hosts viral ecology through metagenomics in veterinary science, highlighting different sub-areas in which it can be applied. Chapter 1 addresses bovine hepacivirus (HNV) detection through the high-throughput sequencing (HTS), using Illumina MiSeq. The analyzes revealed a sequence with high nucleotide divergence when compared to HNVs worldwide known. In addition, based on the ICTV classification, it is a putative new genotype. This study, entitled Highly Divergent Cattle Hepacivirus N in Southern Brazil was published in 2019, in the scientific journal Archives of Virology. Chapter 2 is about two metagenomics studies performed for virome analysis. The first one entitled "New Polyomavirus in Nutria, Myocastor coypus Polyomavirus 1" in which we obtained a new PyVs complete genome species of in nutria, belonging to the genus Alphapolyomavirus, which was published in the scientific journal Archives of Virology. In the second research, "Liver Virome of Healthy Pigs Reveals Diverse Small ssDNA Viral Genomes", the swine liver virome of a slaughterhouse was analyzed. In this study, we detected, for the first time in Brazil, the presence of some viruses such as Porcine Circovirus 1 and Porcine Parvovirus 6 and 7, in addition to the absence of potentially zoonotic viruses. In conclusion, viral metagenomics has been successfully applied in important veterinary science studies. The results contributed to the knowledge expansion in the area, through the description and characterization of new and known viruses, in addition to enriching the genomic databases, providing information for future research.

Association of genotypes with viral load and biochemical markers in HCV-infected Sindhi patients

The presented study had two objectives. The first was to examine distributions of Hepatitis C Virus (HCV) genotypes in Sindh, Pakistan, where HCV is prevalent. The other was to explore clinically relevant relationships between the genotypes, viral load (measured by real-time polymerase chain reaction assays) and biochemical markers. For this, 1471 HCV-infected patients in six cities in Sindh were recruited and sampled. HCV genotype distributions varied among the cities, but genotype 3a was most prevalent, followed by 3b, 1a and 1b (detected in 51.5, 22.7. 9.25 and 3.2% of the cases, respectively). No type-specific sequences were detected in serum samples from 189 (12.8%) of the 1471 patients. Frequencies of low ( 200,000 IU/mL serum), intermediate (200,000-600,000 IU/mL serum) and high (>600,000 IU/mL serum) viral loads were respectively 45.4, 16.5 and 38.1% for patients infected with genotype 3, and 16.9, 36.9 and 46.2%, respectively, for patients with other genotypes. Infection with genotype 1a was associated with significantly higher (p 0.005) alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase titers than infection with genotype 3a. The results will help in the formulation of treatment strategies.(AU)

HEPEVÍRUS E HEPACIVÍRUS EM ANIMAIS DE PRODUÇÃO: UMA ABORDAGEM MOLECULAR E EPIDEMIOLÓGICA

Os cinco principais vírus da hepatite humana, denominados de A-E, possuem estruturas genômicas e estratégias de replicação distintas, além de pertencerem a cinco famílias virais diferentes. As infecções pelo vírus da hepatite A (HAV) e vírus da hepatite E (HEV) são, geralmente, agudas e transmitidas por rotas oro fecais. Em contraste, as infecções pelo vírus da hepatite B (HBV), vírus da hepatite C (HCV) e vírus da hepatite D (HDV) podem ser transitórias ou crônicas e são transmitidas por via parenteral. Apesar dessas diferenças, todos possuem importantes características em comum, como replicação e infecção primária no fígado. HEV, que pertence à família Hepeviridae, possui distribuição mundial e é responsável por causar uma hepatite aguda em humanos com grave apresentação clínica em pacientes imunodeprimidos e mulheres grávidas. Os genótipos HEV-3 e HEV-4 são considerados zoonóticos, sendo os suínos os principais portadores assintomáticos e responsáveis pela manutenção dessa rota de transmissão. O HCV, pertencente à família Flaviviridae, era a única espécie de hepacivírus (HVs) conhecida desde 1989. Recentemente, HVs foram descritos em diversas espécies animais e, apesar de não haver evidência de transmissão zoonótica, o estudo dessas espécies homólogas auxilia no entendimento da origem do HCV, além de fornecer possíveis modelos experimentais para estudos de patogenicidade e compreensão de sua biologia. Assim, o presente estudo estrutura-se em dois capítulos. O Capítulo 1 aborda a soroprevalência e diversidade genética de HEV em suínos de subsistência do Estado do Rio Grande do Sul (RS) provenientes de dois inquéritos soroepidemiológicos (2012 e 2014). Através de um ELISA in house para detecção de anticorpos IgG anti-HEV, os resultados mostraram uma alta soroprevalência de HEV nos suínos do RS (80,6% em 2012 e 67,4% em 2014). Além disso, a análise filogenética confirmou a circulação de HEV-3 zoonótico (0,8%), com a presença de três subtipos distintos que apresentaram alta identidade nucleotídica com sequências de HEV isoladas de humanos. O Capítulo 2 aborda a presença de HVs em amostras de soro de bovinos provenientes do Nordeste do Brasil resultando numa frequência de 0,6%. O sequenciamento completo de duas amostras foi realizado e, a partir de sua análise e de todas as sequências de hepacivírus bovinos (HNVs) disponíveis no GenBank, propusemos uma classificação a nível de genótipo e subtipo, resultando em um genótipo (Genótipo 1) e quatro subtipos (A-D). Além disso, baseado na região NS3, foi realizada uma análise filogenética por inferência Bayesiana e análise de tempo de divergência por datação molecular, utilizando o critério de relógio molecular relaxado. Essa análise indicou uma origem em comum entre os HNVs que circulam na Alemanha e no Brasil; e um maior tempo de circulação desse vírus no continente Africano. O entendimento sobre vírus em animais é de extrema importância para a saúde animal e pública e, além disso, tem o objetivo de mapear reservatórios de doenças zoonóticas e auxiliar na compreensão da origem e evolução viral

The five major human hepatitis viruses, named AE, have distinct genomic structures and replication strategies and belong to five different virus families. Hepatitis A virus (HAV) and hepatitis E virus (HEV) infections are transient and transmitted mainly by oralfecal routes. In contrast, hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis delta virus (HDV) infections may be either transient or chronic and are transmitted by parenteral routes. Despite these differences, all viruses share important features, like primary infection and replication in hepatocytes. HEV, which belongs to Hepeviridae family, are worldwide distributed and responsible to acute human hepatitis with severe clinical presentation in immunocompromised patients and pregnant women. HEV-3 and HEV-4 genotypes are zoonotic, and swine are the mainly asymptomatic reservoirs, responsible for this transmission route maintenance. HCV belongs to the Flaviviridae family, and since 1989, was the only recognized HVs specie. Recently, HVs has been detected in several animal species, and besides no zoonotic transmission evidence, this study helps to understand HCV origin. Besides that, it could provide animal models to pathogenesis and biology HCV studies. Therefore, the present study is structured in two chapters. The Chapter 1 addresses HEV seroprevalence and genetic diversity in backyard pigs from two surveillance studies (2012 and 2014) in Rio Grande do Sul State (RS). Through an in-house ELISA for anti-HEV IgG antibodies detection, the results showed a high HEV seroprevalence in pigs in RS (80.6% em 2012 e 67.4% em 2014). Also, phylogenetic analysis confirmed zoonotic HEV-3 presence and three different subtypes with high nucleotide identity with human HEV sequences. Chapter 2 addresses the presence of HVs in bovine serum samples from Northeastern Brazil resulting in 0.6% frequency. Complete sequencing of two samples was performed, and from its analysis with all bovine hepacivirus (HNVs) sequences available on GenBank, we proposed a genotype and subtype classification, resulting into unique genotype (Genotype 1) and four subtypes (A-D). In addition, based on NS3 region, Bayesian phylogenetic inference analysis and molecular clock dating were performed. The analyses indicated a common origin of the HNV circulating in Germany and Brazil, and a long time of circulation of these viruses in the African continent. The understanding of animal viruses is extremely important for animal and public health, and, in addition, aims to map zoonotic reservoirs and assist in evolution and viral origin understanding

Diagnostic performance of an immunoassay for simultaneous detection of HCV core antigen and antibodies among haemodialysis patients

Nosocomial transmission of HCV is a concern in haemodialysis (HD) units worldwide. Diagnosis of HCV infection among dialysis patients is currently based on the detection of anti HCV antibodies by ELISA, and is confirmed by HCV RNA. The average window period between HCV infection and seroconversion with new generations of HCV antibody tests remains approximately 70 days with more prolonged period among dialysis patients. In this study we assessed the diagnostic performance of an immunoassay designed for simultaneous detection of anti HCV antibodies and core antigen in one step in comparison to qualitative RT-PCR and anti HCV antibodies detection test among Egyptian haemodialysis patients. The studied patients were 39 chronic renal failure patients on maintenance haemodialysis. The results obtained in the present study revealed HCV infection of 56.4%. Combined Ag/Ab test detected 3 out of the 4 anti-HCV negative viraemic patients who were in the window period. The sensitivity, specificity and accuracy of the test were higher than that of anti HCV antibodies detection test (95.45%, 94.1% and 94.87% versus 81.8%, 88.23% and 84.6%) and they were raised to 100% on combining its positivity with liver enzymes elevation results. Therefore, this simple combined Ag/Ab test can be applied for early detection of HCV infection during window period among HD patients as an alternative to HCV RNA detection.

Levels of interleukins 12 (IL-12) and 13 (IL-13), hepatitis B and C serology, and blood cultures among acute myeloid leukemia (AML) patients in Egypt

There is an interest in the use of IL-12 as a possible anti-cancer drug to induce immune responses and anti-IL-13 formulations to treat the undesirable effects of IL-13. Thus, the present study aimed at analyzing IL-12 and IL-13 profiles, viral hepatitis serology and blood cultures in acute myeloid leukemia (AML) patients. Forty individuals (20 without septicemia - Group A, and 20 with septicemia - Group B) and 20 healthy controls were evaluated. Hepatitis B virus antigens (HBsAg) and hepatitis C virus antibodies (HCV Ab) were quantified using commercial ELISA kits. IL-12 and IL-13 levels were estimated in culture supernatant of mitogen-stimulated peripheral blood mononuclear cells by ELISA. Significantly low IL-12 values were observed among AML patients compared to controls whereas the opposite was observed regarding IL-13. IL-12 levels were found to be elevated in the follow-up cases. M4 and M5 subtypes of AML presented higher IL-12 levels than M1 and M2 subtypes. The isolated organisms from AML with septicemia were Staphylococcus aureus (35 percent), Esherichia coli (25 percent), coagulase-negative staphylococci (25 percent), and Candida (15 percent). Fungemia cases showed higher IL-12 values than bacteremia cases. In conclusion, IL-12 and IL-13 should be further tested in large-scale studies to provide future immunotherapy against AML.(AU)

Levels of interleukins 12 (IL-12) and 13 (IL-13), hepatitis B and C serology, and blood cultures among acute myeloid leukemia (AML) patients in Egypt

There is an interest in the use of IL-12 as a possible anti-cancer drug to induce immune responses and anti-IL-13 formulations to treat the undesirable effects of IL-13. Thus, the present study aimed at analyzing IL-12 and IL-13 profiles, viral hepatitis serology and blood cultures in acute myeloid leukemia (AML) patients. Forty individuals (20 without septicemia - Group A, and 20 with septicemia - Group B) and 20 healthy controls were evaluated. Hepatitis B virus antigens (HBsAg) and hepatitis C virus antibodies (HCV Ab) were quantified using commercial ELISA kits. IL-12 and IL-13 levels were estimated in culture supernatant of mitogen-stimulated peripheral blood mononuclear cells by ELISA. Significantly low IL-12 values were observed among AML patients compared to controls whereas the opposite was observed regarding IL-13. IL-12 levels were found to be elevated in the follow-up cases. M4 and M5 subtypes of AML presented higher IL-12 levels than M1 and M2 subtypes. The isolated organisms from AML with septicemia were Staphylococcus aureus (35 percent), Esherichia coli (25 percent), coagulase-negative staphylococci (25 percent), and Candida (15 percent). Fungemia cases showed higher IL-12 values than bacteremia cases. In conclusion, IL-12 and IL-13 should be further tested in large-scale studies to provide future immunotherapy against AML.(AU)

HCV genotypes distribution in patients from Botucatu, Bauru and Assis, São Paulo State, Brazil / Distribuição dos genótipos do HCV em pacientes das regiões de Botucatu, Bauru e Assis, SP, Brasil

Hepatitis C is an infectious disease with variable clinical evolution, generally slow and progressive, caused by a RNA virus termed HCV (hepatitis C virus). This virus presents a structure composed by an external envelop, protein core, and a single strand RNA with approximately 9,5 Kb. RNA virus usually present a high mutation level resulting in diverse genomic sequences , and owing to these various genotypes and subtypes are evolved. HCV genotypes 1, 2 and 3 have been worldwide disseminated, being types 4 and 5 specially in Africa, and type 6 has been found in Asia. In Brazil the mostly frequent genotypes are 1, 2, and 3. The present study evaluated 1.018 plasma samples anti-HCV positive on ELISA assay, and HCV RNA positive by means of RT-PCR (Roche®). These plasma samples were sent from following cities of São Paulo state: Botucatu (N=508), Bauru (N= 415), and Assis (N= 95). Genotyping was performed by means of LiPA (Line probe assay - Bayer) which allows to analyze six HCV genotypes, and the most common subtypes. HCV genotypes regional distribution was 62.9% of genotype 1 ,and 34.5% of genotype 3 . Genotype 2 was found in Botucatu and Bauru regions only in a frequency of 2.1%, and genotype 5 was shown in Botucatu (0.2%) only . HCV subtypes distribution was as follow: in Botucatu region subtype 1a (25%), 1b (29.3%), 1a/1b (3.5%), 2b (0.6%), 3a (35.0%), 5a (0.2%); in Bauru r

Com objetivo de avaliar a distribuição dos genótipos do HCV em pacientes de Botucatu, Bauru, Assis e regiões, foram analisadas 1.018 amostras assim distribuídas: Botucatu (508), Bauru (415) e Assis (95) com sorologia anti-HCV reagente pela técnica ELISA (Enzyme - linked immunosorbent assay) e detectadas por Biologia Molecular RT-PCR (reverse transcription Polymerase Chain Reaction - Roche®). Genótipos foram determinados pela tecnologia LiPA (Line probe assay - Bayer) que permite detecção de 6 genótipos e subtipos mais comuns. Distribuição dos genótipos na região: genótipo 1 (62,9%) , genótipo 3 (34,5%), genótipo 2 presente nas regiões de Botucatu e Bauru (2,1%), genótipo 5 em Botucatu (0,2%). Distribuição dos subtipos: Região de Botucatu - subtipos: 1a (25,0%), 1b (29,3%), 1a/1b (3,5%), 2b (0,6%), 3ª (35,0%), 5a (0,2%). Região de Bauru - subtipos: 1a (31,1%), 1b (27,2%),1a /1b (2,4%), 2 b (1,9%), 2 a/ 2c (0,2%), 3a (32,3%). Região de Assis - subtipos: 1a (26,3%), 1b (26,3%), 1a /1b (2,1%), 3a (41,1%). A técnica utilizada não permitiu a diferenciação dos subtipos em 5,1% das amostras. A distribuição dos genótipos nestas regiões foi similar às outras regiões do Brasil e do mundo ocidental (Europa Ocidental e Américas) apresentando algumas diferenças regionais relativas aos subtipos, como presença de genótipo africano (5) na região de Botucatu.

Anti HCV activity and expression inhibition of HCC markers by protein extract from Iberis gibraltarica / Atividade anti-HCV e inibição da expressão de marcadores HCC por extrato de proteína de Iberis gibraltarica

Hepatitis C virus infection (HCV) is the foremost reason of progressive hepatic fibrosis and cirrhosis, with an elevated risk of hepatocellular carcinoma (HCC) development. Medicinal plants have been used for human health benefits for several years, but their therapeutic potential needs to be explored. The main objective of this study was to figure out the in vitro antiviral and anticancer characteristics of total crude protein of Iberis gibraltarica against HCV and HCC. Total crude protein of Iberis gibraltarica was isolated and quantified. The level of cytotoxicity was measured against the HepG2 cell line and it shows no significant cytotoxicity at the concentration of 504µg/ml. The anti-HCV effect was determined by absolute quantification via real time RT-PCR method and viral titer was reduced up to 66% in a dose dependent manner against the total protein of Iberis gibraltarica. The anticancer potential of Iberis gibraltarica was also examined through mRNA expression studies of AFP and GPC3 genes against the total protein of Iberis gibraltarica-treated HepG2 cells. The results show up to 90% of the down-regulation expression of AFP and GPC3. The obtained results indicate the therapeutic potential of total protein of Iberis gibraltarica against HCV and hepatocellular carcinoma in vitro.

A infecção pelo vírus da hepatite C (HCV) é a principal causa de fibrose hepática progressiva e cirrose, com risco elevado de desenvolvimento de carcinoma hepatocelular (HCC). As plantas medicinais vêm sendo utilizadas para benefícios à saúde humana há vários anos, mas seu potencial terapêutico precisa ser explorado. O principal objetivo deste estudo foi descobrir as características antivirais e anticancerígenas in vitro da proteína bruta total de Iberis gibraltarica contra HCV e HCC. A proteína bruta total de Iberis gibraltarica foi isolada e quantificada. O nível de citotoxicidade foi medido contra a linha celular HepG2 e não apresenta citotoxicidade significativa na concentração de 504µg/ml. O efeito anti-HCV foi determinado por quantificação absoluta através do método RT-PCR em tempo real e o título viral foi reduzido em até 66% de forma dose-dependente contra a proteína total de Iberis gibraltarica. O potencial anticancerígeno de Iberis gibraltarica também foi examinado através de estudos de expressão de mRNA dos genes AFP e GPC3 contra a proteína total de células HepG2 tratadas com Iberis gibraltarica. Os resultados mostram até 90% da expressão de regulação negativa de AFP e GPC3. Os resultados obtidos indicam o potencial terapêutico da proteína total de Iberis gibraltarica contra HCV e carcinoma hepatocelular in vitro.

Hepatitis C virus associated ALT, AST, GGT, Bili T, HB, HBA1C, CREAT, PT, aPPT, AFP, CEA, CA 125, CA 19-9, iPTH biomarkers, computed tomography and HCV burden of disease during pre COVID-19 era (2018-2019) and post COVID-19 era (2020-2022) in Pakistan / ALT, AST, GGT, Bili T, HB, HBA1C, CREAT, PT, aPPT, AFP, CEA, CA 125, CA 125, CA 19-9: biomarcadores iPTH associados ao vírus da hepatite C, tomografia computadorizada e carga de doença do VHC durante a era pré-COVID-19 (2018-2019) e era pós-COVID-19 (2020-2022) no Paquistão

The national burden of HCV has significantly mounted over the period of last few decades placing Pakistan at the worst placement of second largest burden of HCV globally. Herein for the first time from Pakistan, we examined clinical correlation of potential biomarkers with HCV. Nation-wide study was conducted on 13,348 suspected HCV patients during 2018-2022. During pre-COVID-19 era of 2018-2019, prevalence of HCV remained 30%. During 2018, among HCV positive patients, 91% of ALT, 63% of AST, 67% of GGT, 28% of Bili T, 62% of HB, 15% of HBA1C, 25% of CREAT, 15% of PT, 15% of aPTT and 64% of AFP were abnormal. During 2019, among HCV infected 74.47% of ALT, 63.54% of AST, 70.24% of GGT, 24.71% of Bili T, 8.77% of HB and 75% of AFP were raised. CT/CAT scan revealed 4.65% liver complications (mild 13.04%, moderate 30.43% and severe 56.52%). During 2020, HCV prevalence remained 25%. 65.17% of ALT, 64.20% of AST, 68.75% of GGT, 31.25% of Bili T, 20.97% of HB, 4.65% of CREAT and 73.68% of AFP levels were raised. CAT analysis revealed liver complications among 4.41% (14.81% mild, 40.74% moderate, and 44.44% sever). 85.71% of participants diabetes was out of control. During 2021, HCV prevalence remained 27.1%. ALT (73.86%), AST (50.6%), GGT (67.95%), Bili T (28.21%), HB (20%), CREAT (5.8%) and AFP (82.14%) levels were abnormal. During 2022, the levels of ALT (56.06%), AST (56.36%), GGT (56.6%), Bili T (19.23%), HB (43.48%), HBA1C (14.81), CREAT (18.92%), AFP (93.75%) were abnormal. CAT analysis revealed 7.46% liver complications (25% mild, 30.36% moderate, and 42.86% sever). During 2021-2022, 83.33% of subject's diabetes was not controlled.

A carga nacional de HCV aumentou significativamente ao longo das últimas décadas, colocando o Paquistão na pior colocação da segunda maior carga de HCV globalmente. Pela primeira vez no Paquistão, examinamos a correlação clínica de potenciais biomarcadores com HCV. Um estudo nacional foi realizado com 13.348 pacientes suspeitos de HCV de 2018 a 2022. Durante a era pré-COVID-19 de 2018 a 2019, a prevalência do HCV permaneceu em 30%. Durante 2018, entre pacientes positivos para HCV, 91% de ALT, 63% de AST, 67% de GGT, 28% de Bili T, 62% de HB, 15% de HBA1C, 25% de CREAT, 15% de PT, 15% de aPTT e 64% de AFP eram anormais. Durante 2019, entre os infectados pelo HCV, 74,47% de ALT, 63,54% de AST, 70,24% de GGT, 24,71% de Bili T, 8,77% de HB e 75% de AFP foram elevados. A TC/TAC revelou 4,65% de complicações hepáticas (leve 13,04%, moderada 30,43% e grave 56,52%). Durante 2020, a prevalência do HCV permaneceu em 25%. 65,17% de ALT, 64,20% de AST, 68,75% de GGT, 31,25% de Bili T, 20,97% de HB, 4,65% de CREAT e 73,68% de AFP estavam elevados. A análise de TAC revelou complicações hepáticas em 4,41% (14,81% leves, 40,74% moderadas e 44,44% graves). 85,71% dos participantes o diabetes estava fora de controle. Durante 2021, a prevalência de HCV permaneceu em 27,1%. Os níveis de ALT (73,86%), AST (50,6%), GGT (67,95%), Bili T (28,21%), HB (20%), CREAT (5,8%) e AFP (82,14%) estavam anormais. Durante 2022, os níveis de ALT (56,06%), AST (56,36%), GGT (56,6%), Bili T (19,23%), HB (43,48%), HBA1C (14,81), CREAT (18,92%), AFP (93,75%) eram anormais. A análise de TAC revelou 7,46% de complicações hepáticas (25% leves, 30,36% moderadas e 42,86% severas). Durante 2021 e 2022, 83,33% do diabetes do sujeito não foi controlado.