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Hepatitis C genotypes and subtypes in Saudi Arabia
O A Shobokshi1, F E Serebour, L Skakni
1Ministry of Health, Riyadh, Saudi Arabia. serebour@kfshrc.edu.sa
Insights
Hepatitis C virus (HCV) genotype 4 is dominant in Saudi chronic hepatitis patients. However, genotypes 1a and 1b are emerging in hemodialysis patients and intravenous drug users, respectively, indicating a link between viral genotype and infection source.
Area of Science:
- Hepatology
- Virology
- Epidemiology
Background:
- Hepatitis C virus (HCV) genotypes vary globally, impacting disease progression and treatment outcomes.
- Understanding genotype distribution is crucial for public health strategies and patient management.
Purpose of the Study:
- To investigate the distribution of HCV genotypes and subtypes in Saudi Arabian populations with chronic active hepatitis (CAH), haemodialysis, and intravenous drug use.
- To explore potential relationships between HCV genotypes and specific risk groups.
Main Methods:
- Reverse transcription-polymerase chain reaction (RT-PCR) was used for viral RNA amplification.
- HCV genotyping and subtyping were performed using a commercial reverse hybridization assay (Innolipa HCV 11).
Main Results:
- HCV genotype 4 was predominant (74%) in CAH patients, with subtypes 4c/4d, 4h, and 4e being most common.
- In haemodialysis patients, genotype 4 (49%) and genotype 1a (33%) were prevalent.
- Intravenous drug users showed a high prevalence of subtype 1b (39%) and genotype 4 (36%).
Conclusions:
- Genotype 4 is the dominant HCV genotype in Saudi CAH patients.
- Subtypes 1a and 1b are increasingly identified in haemodialysis patients and intravenous drug users, respectively.
- A significant association exists between HCV genotype distribution and the source of infection in high-risk Saudi populations.
Abstract:
Hepatitis C virus (HCV) genotypes are diverse geographically. Infectivity, pathogenicity, and sustained response to treatment may be influenced by HCV genotypes/subtypes. This study examined the relative distribution of hepatitis C genotypes and subtypes among isolates from 84 individuals with chronic active hepatitis (CAH), 39 haemodialysis patients, and 31 intravenous drug addicts, of Saudi Arabian origin. Reverse transcription-polymerase chain reaction (RT-PCR) using specific primers from the 5'-UTR was performed and amplified products were genotyped/subtyped using a commercial reverse phase hybridisation technique (Innolipa HCV 11, Innogenetics, Belgium). Seventy-four percent of the CAH patients were found to be genotype 4 (4c/4d: 33%; 4h: 14%; 4e: 7%; 4: 20%) but other subtypes such as 1b: 14%, 2b: 4%, 3a: 5%, 5a: 1%, and 6a: 1%, were also detected. A history of blood transfusion was disclosed in only 10% of the CAH group. The pattern among haemodialysis patients was as follows: genotype 4: 49% (4h: 13%; 4: 36% ); 1a: 33%, 1: 3%; 1b: 10%; and 5a: 5%. The intravenous drug addict group showed 39% subtype 1b, but other subtypes such as 9% for 1a; 3% for 2a; 36% for 4; 3% for 5a; and 9% for 3a were seen. It is concluded that genotype 4 is predominant among our HCV isolates from CAH patients but subtype 1a and 1b have emerged among our haemodialysis and intravenous drug addict cases, respectively. A significant relationship between the viral genotype and the source of infection has emerged among Saudi groups at high risk for hepatitis C virus.