Recurrence Rate of Hepatitis C Virus After Achieving a Sustained Virologic Response in Kurdistan Region, Iraq

Abstract

Background Infection with hepatitis C virus (HCV) is a public health problem that is associated with deleterious consequences such as liver cirrhosis and hepatocellular carcinoma (1). Recent estimates suggest that more than 150 million people are chronically infected with the virus and over 500 000 subjects die annually of the infection (2). With the approval of direct-acting antivirals for the treatment of HCV, outstanding progress has been made that made the elimination of the virus feasible (3). Successful treatment with the achievement of sustained virologic response (SVR) reduces the risk of complications such as cirrhosis and cancer. One of the challenges to treatment is the risk of late relapse after finishing the treatment. The prevalence of HCV in Iraq has been studied thoroughly and it has been reported to be low in all regions of the country (4-7). The most common HCV genotype in Iraq is genotype 1 followed by genotype 4 (8). Additionally, reports from our country showed a very high SVR rate in patients with hemoglobinopathy and end-stage kidney diseases (9,10). The aim of this study was to investigate the relapse rate of HCV 36 months after the completion of the treatment Materials and Methods Patients Annually, invitations were sent to patients who were previously infected with HCV and completed treatment course successfully as defined by negative RT-PCR results 12 weeks after the end of treatment in patients who received direct-acting antiviral therapy. This was performed for 3 years. HBsAg and HIV ELISA Commercial ELISA kit (DIA.PRO Diagnostic Bioprobes ELISA kit, Italy) was utilized to test HBsAg and HIV positivity. RNA Extraction HCV nucleic acid was extracted using QIAamp RNA Extraction Kit (Qiagen) following the manufacturer's instructions for automatic extraction in QIAcube extractor (Qiagen). Then, the purity and concentration of RNA were measured by NanoDrop. HCV Quantification and Genotyping Nucleic acid amplification was conducted using artus HCV RG-RT PCR Kit and was run on a Rotor-Gene

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