Hepatitis C virus genotypes in Myanmar

Abstract

Myanmar is adjacent to India, Bangladesh, Thailand, Laos and China. In Myanmar, the prevalence of hepatitis C virus (HCV) infection is 2%, and HCV infection accounts for 25% of hepatocellular carcinoma. In this study, we reviewed the prevalence of HCV genotypes in Myanmar. HCV genotypes 1, 3 and 6 were observed in volunteer blood donors in and around the Myanmar city of Yangon. Although there are several reports of HCV genotype 6 and its variants in Myanmar, the distribution of the HCV genotypes has not been well documented in areas other than Yangon. Previous studies showed that treatment with peginterferon and a weight-based dose of ribavirin for 24 or 48 wk could lead to an 80%-100% sustained virological response (SVR) rates in Myanmar. Current interferon-free treatments could lead to higher SVR rates (90%-95%) in patients infected with almost all HCV genotypes other than HCV genotype 3. In an era of heavy reliance on direct-acting antivirals against HCV, there is an increasing need to measure HCV genotypes, and this need will also increase specifically in Myanmar. Current available information of HCV genotypes were mostly from Yangon and other countries than Myanmar. The prevalence of HCV genotypes in Myanmar should be determined.

Safety and efficacy of sofosbuvir‐based direct‐acting antiviral regimens for hepatitis C virus genotypes 1‐4 and 6 in Myanmar: Real‐world experience

“…In particular, Myanmar is a resource‐constrained country with approximately 1‐2% of its population chronically infected with HCV . Genotypes 3 (33%‐80%), 6 (16%‐60%) and 1 (9%‐25%) account for the majority of HCV infection, with varying frequencies across different regions . Thus, the heterogeneity in genotype adds to the complexity of treating HCV in Myanmar.…”

“…6,7 Genotypes 3 (33%-80%), 6 (16%-60%) and 1 (9%-25%) account for the majority of HCV infection, with varying frequencies across different regions. 7 Thus, the heterogeneity in genotype adds to the complexity of treating HCV in Myanmar. Genotype 3 HCV infection is particularly concerning because it directly interacts with lipid metabolism and increases cellular triglyceride accumulation; patients commonly exhibit increased levels of steatosis, fibrosis and higher HCC incidence as well as a lower SVR rates.…”

Identification of a New HCV Subtype 6xg Among Injection Drug Users in Kachin, Myanmar

“…The subtype 6n was prevalent in China, Myanmar and other Southeast Asian countries (e.g., Thailand, Malaysia), while the subtype 6a was mainly circulating among IDUs in the south part of China, including Yunnan (Zhang et al, 2011, 2013; Chen et al, 2015; Qi et al, 2016; Wan et al, 2016), and the subtype 6m was mainly found in blood donors of Myanmar and Thailand (Shinji et al, 2004; Jutavijittum et al, 2009; Wasitthankasem et al, 2015). Interestingly, the prevalence of subtypes 6xa and 6xg were restricted to the China–Myanmar border region (Lwin et al, 2007; Zhang et al, 2013; Chen et al, 2015; Win et al, 2016). As a newly identified subtype, 6xg accounted for 12.0% (3/25) of all strains sampled in Kachin, and 6.0% (15/249) in Dehong prefecture, indicating that 6xg has become the main genotype 6 strains circulating in the China–Myanmar border region after the subtypes 6n and 6xa (Figure 1).…”

Systematic review: epidemiology and response to direct‐acting antiviral therapy in genotype 6 chronic hepatitis C virus infection

“…However, sample size of the studies is relatively small, in which additional epidemiology studies would have offered more accurate conclusions . Other endemic countries for GT6 are Vietnam, Thailand and Myanmar, although the most prevalent genotypes in Thailand, Myanmar and Vietnam are 3a, 3b and 1a, respectively . Interestingly, a recent study from Thailand reported the decline in prevalence of HCV by half in the past decades but opposed to other genotypes, GT6 turned out to have an increasing trend (9%‐34%) .…”