title: HCV genotype-specific correlation with serum markers: higher predictability for genotype 4a.
abstract: BACKGROUND
  Several factors have been proposed to assess the clinical outcome of HCV infection. The correlation of HCV genotypes to possible serum markers in clinical prediction is still controversial. The main objective of this study was to determine the existence of any correlation between HCV genotypes to viral load and different clinical serum markers.
  
  
  METHODS
  We performed a prospective cross-sectional and observational study. About 3160 serum HCV RNA positive patients were chosen from 4020 randomly selected anti-HCV positive patients. Statistical analysis was performed using the SPSS 16 software package. ROC (receiver operating characteristics) curves were used to compare diagnostic values of serum markers to predict genotypes.
  
  
  RESULTS
  The most prevalent genotype was 3a (73.9%) followed by 1a (10.7%), 4a (6.4%) and 3b (6.1%) in Pakistani population. No correlation was found between viral load and serum markers for genotype 3a in a large no. of sample (n = 2336). While significant correlation was observed between viral load and AST in genotype 3b, ALP with viral load and ALT for genotype 1a. Patients with genotype 4a showed a significant inverse correlation with viral load and Hb level and AST with ALP. For genotype 4a, AUC (area under the curve) of ALT, ALP, AST, bilirubin, Hb level and viral load was 0.790, 0.763, 0.454, 0.664, 0.458 and 0.872 respectively.
  
  
  CONCLUSIONS
  In conclusion, there was a significant variable response of HCV genotypes with serum markers. Severity of disease is independent of serum marker level in genotype 3a, while the liver damage in genotype 4a may associate with viral cytopathic effect as well as the immune-mediated process. An index using six serum markers may correctly predict genotype 4a in patients with ≥ 75% accuracy.
authors.affiliation: Applied and Functional Genomics Lab, Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan.
authors.forename: Waqar
authors.initials: W
authors.lastname: Ahmad
authors.forename: Bushra
authors.initials: B
authors.lastname: Ijaz
authors.forename: Fouzia T
authors.initials: FT
authors.lastname: Javed
authors.forename: Humera
authors.initials: H
authors.lastname: Kausar
authors.forename: Muhammad T
authors.initials: MT
authors.lastname: Sarwar
authors.forename: Sana
authors.initials: S
authors.lastname: Gull
authors.forename: Sultan
authors.initials: S
authors.lastname: Asad
authors.forename: Imran
authors.initials: I
authors.lastname: Shahid
authors.forename: Sajida
authors.initials: S
authors.lastname: Hassan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity*; D006526:Hepatitis C / Q000175:diagnosis* / Q000473:pathology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D015415:Biomarkers