Determination of Hepatitis C Virus Genotypes in Gaza Strip

Abstract

Hepatitis C virus is a heterogeneous virus with 6 major genotypes and more than 50 subtypes. The present work aims to determine the commonest HCV genotypes in chronic patients ofGazastrip,Palestine. This study highlights the prognostic potential of determining the HCV genotype for patients as an integral part of their diagnostic and therapeutic regimen, and thus may be helpful in tailoring the therapy for HCV patients based on their virus genotype. If taken in conjunction with other factors important in therapy HCV genotyping will reduce the expenses of treatment when the duration of therapy is accordingly optimized, and thus allowing a larger number of patients to be considered for the therapy. Genotyping of HCV may also be useful for identifying some important origins of transmission and risk factors of the virus inGazastrip. The chronic HCV patients participating in the study were interviewed, and a questionnaire was completed and serum samples were obtained from each of them. The samples were analyzed to justify the presence of HCV RNA by reverse transcriptase polymerase chain reaction (RT/PCR), and the PCR products of 92 positive samples were purified and submitted for sequencing and genotype determination. ALT level was determined for each sample. The results of this study showed that genotype 1 and 4 and their subtypes 1a, 1b, 4a and 4c/d are the major common HCV genotypes in Gaza strip. Genotype 4 and its subtypes are the predominant ones. Genotype 1 and its subtypes collectively contributed to 28.3% of the cases, while genotype 4 and its subtypes collectively contributed to 64.1% of the cases. Mixed infection with the two genotypes was also seen among 7.6% of the cases. Travelling, surgery and blood transfusion in an endemic HCV area are the major roots of HCV transmission inGazastrip although other routs exist. The results also show that genotype 1 infections are more serious than genotype 4 infections and associated with significantly higher ALT levels in patients' blood. The education level, infection date and hemodialysis don’t show any significant relation to the HCV genotype and subtypes. The results of this study contribute to the identification of sources of outbreaks, risk factors and control strategy of HCV. The results will also help tailor treatment schedules as well as to monitor response to antiviral treatment.