Clinical and epidemiological profile of HCV genotype 3 patients in southern Brazil

Introduction: Despite the emergence of new treatments for HCV genotype 3 (HCV G3), there is still a lack of data about this particular subgroup in Brazil. Our objective was to describe clinical and sociodemographic variables and treatment profile of HCV G3 Brazilian patients. Methods: This was a descriptive, retrospective study, performed in a specialized center for HCV treatment in the South Region of Brazil. Medical records of patients diagnosed with HCV G3 were reviewed to collect clinical, sociodemographic, and treatment information. Results: Participants included total of 564 patients, with a mean age of 59.3 years (SD = 10.5). Cirrhosis was present in 54.4% of patients. The most common coexisting conditions were systemic arterial hypertension (36.6%) and diabetes mellitus (30%). Regarding treatment, 25.2% of the patients were treatment-naïve and 74.8% were currently under treatment (11.6%) or had received a previous treatment (87%). The most frequent ongoing treatment was sofosbuvir + daclatasvir (± ribavirin) (87.8%). Of the 388 patients who had at least one previous treatment, 67% achieved sustained virologic response in the last treatment. Caucasian / white, non-obese, transplanted patients, those with longer time since diagnosis and with cirrhosis were more likely to receive treatment, according to multivariate analysis. Patients with hepatocellular carcinoma were 64.1% less likely to be on treatment during the study period than those without this condition; patients with chronic kidney disease were 2.91-fold more likely to have an interruption of treatment than those without this condition. Conclusion: This study describes a large sample of Brazilian patients with HCV G3. Treatment patterns were mainly influenced by the presence of HCV complications and comorbidities.(AU)

Molecular characterization of Hepatitis C virus 3a in Peshawar.

BACKGROUND: The purpose of this study was to explore molecular epidemiology of HCV genotype 3a in Peshawar based on sequencing and phylogenetic analysis of Core region of HCV genome. METHODS: Chronically infected Hepatitis C virus infected patients enrolled under the Prime Minister Hepatitis C control program at three Tertiary care units of Peshawar [Khyber Teaching Hospital Peshawar, Lady Reading Hospital Peshawar, Hayat Abad Medical Complex Peshawar] were included in this cross sectional observational study. Qualitative detection of HCV and HCV genotyping was carried out by a modified reverse transcription-polymerase chain reaction (RT-PCR) and type specific genotyping assay. The Core gene of HCV genotype 3a was amplified, cloned and sequenced. The sequences obtained were used for phylogenetic analysis using MEGA 6 software. RESULTS: Among the 422 (82.75 %) PCR positive samples, 192 (45.5 %) were identified as having HCV genotype 3a infection. HCV Core gene sequencing was carried out randomly for the characterization of HCV 3a. Nucleotide sequence analysis of the obtained viral genomic sequences based on partial HCV 3a Core gene sequences with reference sequences from different countries showed that our sequences clustered with some local and regional sequences with high bootstrap values. CONCLUSION: HCV 3a is highly prevalent in Peshawar, Pakistan and its phylogenetics based on Core gene sequences indicate the prevalence of different lineages of HCV 3a in Peshawar which may have consequences for disease management strategies causing more economic pressure on the impoverished population due to possible antiviral resistance.

Do differences exist between chronic hepatitis C genotypes 2 and 3?

Introduction Six genotypes of the hepatitis C virus (HCV) have been identified thus far, and their distribution is well defined. Genotype 1, which is the most prevalent worldwide, is always compared to genotypes 2 and 3, particularly in terms of treatment response. However, little is known about the differences between genotypes 2 and 3 because these genotypes are analyzed together in most studies. Therefore, the aim of this study was to evaluate differences in the clinical, epidemiological, laboratory, and histological parameters between HCV-2 and HCV-3. Methods Patients with chronic hepatitis C infected with genotypes 2 and 3 were studied retrospectively and compared according to clinical, laboratory, and histological aspects. Hepatitis C virus-ribonucleic acid (HCV-RNA) was analyzed quantitatively by TaqMan® real-time PCR, and the HCV genotype was determined by sequencing the 5′-untranslated region. Results A total of 306 patients with chronic HCV-2 (n=50) and HCV-3 (n = 256) were studied. Subtype 2b (n=17/50) and subtype 3a (n=244/256) were the most prevalent among patients infected with HCV-2 and HCV-3, respectively. The mean age was 47 ± 10 years, and there was a predominance of men in the group studied (61%). Comparative analysis between HCV-2 and HCV-3 showed a younger age (p=0.002), less prevalence of arterial hypertension (p=0.03), higher serum albumin levels (p=0.01), more advanced stage of liver fibrosis (p=0.03), and higher frequency of steatosis in patients with HCV-3 (p=0.001). After multivariate regression analysis, all the variables, except serum albumin, remained as variables associated with HCV-3 in the final model. Conclusions Clinical and histological differences exist between HCV-2 and HVC-3, which suggests the need for separate analyses of these genotypes. .

Genotypes of Hepatitis C Virus Amplified from Sera Non-Reactive to Anti-HCV Enzyme Immunoassay / 대한임상병리학회지

BACKGROUND: Despite sensitive antibody-based blood-donor screening, a residual risk of transfusion-transmitted viral infections exists. For hepatitis C virus (HCV), window-period donations account for the major risk. In the previous studies, however, estimates of the risk of post-transfusion hepatitis C was much higher than that calculated from the risk of donation in the seroconversion window. Therefore, we reevaluated the rate of HCV RNA positive/ anti-HCV negative samples using the two domestic anti-HCV EIA kits. All the samples showing HCV RNA positive/ anti-HCV negative were genotyped. METHODS: A total of 909 patients' samples showing HCV RNA positivity using the Amplicor HCV TEST (Roche Diagnostic Systems) was retested for antibody presence with the LG HCD 3.0 (LG Chemicals) and DONG-A HCV 3.0 (DONG-A Pharmaceuticals) EIA kit. Samples that were non-reactive to the EIA kits were genotyped by INNO-LiPA HCV kit (INNOGENETICS, Belgium). RESULTS: Among 909 tested samples, 5 samples showed nonreactivity to both anti-HCV EIA kits, while 1 sample was nonreactive only to DONG-A HCV 3.0. When RT-PCR for HCV was performed using stored or follow-up samples, 4 samples showed negative results. Medical records were also reviewed and found to be false positive for HCV RT-PCR in 3 of those 4 patients. In the case of one remaining patient, the follow-up RT-PCR was negative. Finally, 2 samples (0.2%) showed HCV RNA positive/ anti-HCV negative. The 2 samples were genotyped as 1b type. CONCLUSIONS: More than 99.8% of HCV RNA positive samples showed reactivity to anti-HCV EIA kits. There were two samples that were non-reactive to anti-HCV kits and were genotyped as 1b type, which is the most common subtype in Korea. Our study suggests that false negativity of anti-HCV in Korea would very rarely be caused by uncommon HCV genotypes.

Positive Rate of HCV RNA in Anti-HCV Immunoblot Indeterminate Samples from Blood Donors and Analysis of Reactivity of Enzyme Immunoassay Kits to Indeterminate Samples / 대한수혈학회지

BACKGROUND: Positive rate of HCV RNA in anti-HCV immunoblot indeterminate samples from Korean blood donors was investigated in this study. Futhermore, reactivity of enzyme immunoassay kits was evaluated according to patterns of band reactivity and RNA positivity of indeterminate samples. METHODS: HCV RNA was tested from a total of 180 samples that had been repeatedly reactive to LG HCD 3.0 or DONG-A HCV 3.0 and further confirmed to be indeterminate by LG HCD CONFIRM at 14 Korean Red Cross Blood Centers in 1997. Correlation between HCV RNA and reactivity to each recombinant antigens was analysed. Three kinds of EIA kits such as HCD 3.0, DONG-A HCV 3.0 and Cobas Core Anti-HCV EIA kits were tested of their reactivity to 56 samples that had shown single band positivity on LG HCD CONFIRM. RESLUTS: HCV RNA was detected in 11 (6.1%) of 180 samples. Positivity of 897 band showed positive correlation with HCV RNA positivity (p<0.001), while Core518 showed negative correlation (p<0.001). DONG-A HCV 3.0 showed negative reaction to two samples with anti-897 specificity and HCV RNA, while LG HCD 3.0 and Cobas Core HCV showed negative reaction to one sample with anti-EIE2NS4 and HCV RNA. CONCLUSION: Positive rate of anti-HCV immunoblot indeterminate samples from Korean blood donors was 6.1%. In case of indeterminate results by LG HCD CONFIRM, positive reaction to 897 band highly suggests the presence of HCV RNA, while Core518 the absence of HCV RNA. It is highly recommended that specificity of Core518 antigen be increased in LG HCD 3.0 or LG HCD CONFIRM and sensitivity of recombinant antigen from the 3rd non-structural region of HCV genome be increased in DONG-A HCV 3.0.