Prevalence of Hepatitis C Virus Genotypes in Pakistan: Current Scenario and Review of Literature

Abstract

Hepatitis C virus (HCV) is a major public health concern globally, resulting in liver-related complications. Approximately 6% population of Pakistan is infected with HCV. HCV is error prone, due to which it is classified into 7 genotypes and 67 subtypes. HCV genotype determination is critical for treatment and therapy response. In this study, 3,539 samples were collected from 2015 to 2019 from all over Punjab. RNA was extracted from samples using QIA Amp Viral RNA MINI kit (Qiagen, Germany) and viral genotyping was performed. Furthermore, a systemized literature search (2009-2018) was done to analyze the HCV genotype distribution pattern in Pakistan. In Punjab, genotype 3a (86.46%) is most prevalent, followed by untypable (7.17%) and genotype 1a (3.84%) and 3b (1.04%). Mixed genotype constitutes only 0.67% of total infections. Genotype 2a, 2b, 3c, and 4 were found to be rare. Data available from literature review when compiled showed that HCV genotype 3a (58.16%) was predominant in Pakistan, followed by genotypes 3b (9.05%), 2a (6.70%), 1a (6.22%), and 1b (2.39%). The frequency of mixed genotypes was found to be 4% and 12% of untypable HCV variants. This study highlights the HCV genotype distribution pattern in different regions of Pakistan. Therapy response and disease management depend on genotype, so HCV genotype determination is crucial. In Pakistan, the most prevalent genotype is 3a, followed by untypable genotype. Both interferon and sofosbuvir are effective against genotype 3a, but treatment with sofosbuvir has comparatively high sustained virological response, less adverse effects, and more tolerability.

Comparative Analysis of PCR and LIPA Method for HCV Genotypes Screening

“…The results of the current study showed that HCV genotype 3a is the most prevalent viral genotype in the studied population. Similarly, previous studies from other cities of Punjab, Pakistan showed that 3a is the most frequent genotype [18]. In the current study, 3a was found to be the most common in age group 26-55 with the prevalence rate of 68.72%, followed by genotype 1 with 5.24% prevalence rate.…”

“…In 2018, out of a total of 59 HCV serum samples 23 (38.9%) were collected from males and 36 (61%) were collected from females. In 2019, out of 100 infected patients 40 (40%) were male and 60 (60%) were female [18]. In the current report, 3a was found to be the most prevalent genotype in Punjab followed by untypable genotypes and genotype 1a, respectively.…”

“…In a previous study, the highest prevalence rate of 91.5% was found for genotype 3a, which was followed by 8.47% prevalence rate for genotype 1a in age group 29-57 [22]. Similarly, in another report genotype 3a was found to be the most prevalent with 75% prevalence rate, followed by genotype 1a with 3% prevalent rate in age group 27-55 [18].…”

Induction of Profibrotic Microenvironment via TLR4 MyD88-Dependent and -Independent Inflammatory Signaling in Chronic Hepatitis C Virus Infection

“…In Pakistan, an estimated of around 9.4 million people (about 5.4% of the population) are infected by HCV (3,20,25,24). The immune-based therapy for viral elimination is effective in about 50% cases of genotype 1, 4, 5, and 6 and about 80% cases of genotype 2 and 3 (43,46,48,54), but still viral relapse is very frequent (55,56) and the therapy itself has serious side effects that range from flu-like symptoms to thrombocytopenia and suicidal tendencies (7,12,27,33).…”

Prevalence and Associated Risk Factors Analysis of Hepatitis B & C Infections in the Low Socioeconomic Communities; A Cross-Sectional Study from Pakistan

“…Every year, 1.4 million people die due to viral hepatitis, of whom 90% of deaths are due to hepatitis B or C [3,4]. Pakistan is bearing 2nd highest burden of global hepatitis C prevalence with 7.44% population carrying HCV [5]. Around 1.98% of the Pakistani population is having HBV antigen in their blood [6].…”