Experience with HCV Detection and Molecular Genetic Characterization among Otherwise Healthy Pregnant Women and Their Partners in the Republic of Guinea

Abstract

According to recent data, there are currently 170 to 200 million people infected with HCV worldwide, and the number of new cases annually is approximately 40,000. Thus, the overall prevalence of the pathogen in the world is about 1.8–3%. The dynamic monitoring of circulating viral variants in specific groups that reflect the situation in the wider population, including potential pathogen spread, is of high importance for predicting the epidemiologic situation. Pregnant women are such a group. The Republic of Guinea is one of the poorest countries in the world, in which medicine receives little finance from the state. Among other conditions, HCV infection is not monitored in the country. This work used blood plasma from pregnant women living in the Republic of Guinea and their partners (1810 and 481). ELISA diagnostic kits were used to detect serologic markers, and PCR diagnostic kits were used to detect molecular biologic markers. Sanger sequencing, followed by phylogenetic analysis, was used for genotyping. The present study shows that HCV antibodies were detected in 3.2% of the pregnant women examined and in 3.33% of their male partners. HCV RNA was detected in 0.5% of cases in women and in all anti-HCV-positive male partners (3.33%). HCV RNA was more common in the men than in the pregnant women (χ2 = 25.6, df 1, p < 0.0001, RR = 6.69 with 95% CI: 2.97–15.04). The HCV viral load was determined for all the RNA-HCV-positive samples. The HCV viral load exceeded 1000 IU/mL in all nine women and only in two cases in men. The HCV genes NS5A and NS5B and the NS3 gene fragment were sequenced for 11 samples. Subtype 2q was determined for three isolates and 2j for another three isolates. Another five isolates could not be confidently assigned a subtype because different results were obtained with different methods of analyzing the three viral regions. It can be assumed that these isolates belong to new viral subtypes or to recombinant forms between genotype 2 subtypes. No drug resistance mutations were identified, but a large number of natural polymorphisms in the analyzed genomic regions of the HCV isolates were shown. These results may serve as baseline data for the future planning of a nationwide estimate of the prevalence of bloodborne infections among pregnant women.