title: Determination of hepatitis C virus genotypes circulating in different districts of Punjab (Pakistan).
abstract: BACKGROUND
  Hepatitis C virus (HCV) is a principal cause of severe liver diseases worldwide and a possible source of significant morbidity and fatality in the long term. Information on the genotype is more significant because it has prognostic value in the response to antiviral therapy.
  
  
  OBJECTIVE
  This study aimed to determine the frequency of various HCV genotypes circulating in the different districts of Punjab and to show the pattern distribution of HCV genotypes in different age groups and sexes.
  
  
  METHODS
  A total of 542 HCV-positive patients were selected from various districts of the province and were subjected to an HCV genotype-specific assay. Among 542 positive patients, 300 (55.35%) were men and 242 (44.65%) were women. There were 245 (45.20%), 61 (11.25%), 56 (10.33%), 56 (10.33%), 53 (9.77%), 27 (5%), 20 (3.69%), 16 (3%), and eight (1.47%) HCV-positive patients from Lahore, Sargodha, Multan, Toba Tek Singh, Faisalabad, Rawalpindi, Mandi Bahauddin Gujranwala, and Sahiwal districts, respectively.
  
  
  RESULTS
  Of a total of 542 serum samples analyzed, 476 (88%) were successfully genotyped whereas 66 (12%) samples were undetermined genotypes. Among the typable genotypes, 1a was found in 37 (7%), 1b in 18 (3%), 3a in 386 (71%), and genotype 3b in five (1%) patients. Thirty patients (6%) were identified to be infected with mixed HCV genotypes. Genotypes 3a (P=0.0001), 1a (P=0.001), and untypable genotypes (P=0.03) were circulating significantly in all the studied districts. All the genotypes were distributed evenly in male and female patients. The most affected age range of patients was 21-40 years as compared with teenage and older age groups.
  
  
  CONCLUSIONS
  The study found a significantly high prevalence of HCV among the patients of Punjab. In addition, genotype 1a was found to be a significantly and rapidly increasing genotype in the study area. It appears that HCV-3a (the most prevalent genotype) may be replaced by genotype 1a. If this occurs, it will make the present scenario more complex in terms of response to therapy and economic burden on the health sector of Pakistan. HCV infection is more common in the age group of 21-40 years. All the genotypes were distributed at the same frequency in men and women.
authors.affiliation: Departments of aMicrobiology bGenetics, Hazara University (Garden Campus), Mansehra cDepartment of Medicine, Khyber Medical University, Peshawar dDepartment of Biotechnology, University of Malakand, Khyber Pakhtunkhwa eDepartment of Medicine, Mardan Complex Hospital, Mardan fNational Centre of Excellence in Molecular Biology, Division of Molecular Virology and Molecular Diagnostics, University of the Punjab gGenome Center for Molecular Diagnosis & Research, Lahore, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Waqar
authors.forename: Asad U
authors.initials: AU
authors.lastname: Khan
authors.forename: Habib U
authors.initials: HU
authors.lastname: Rehman
authors.forename: Muhammad
authors.initials: M
authors.lastname: Idrees
authors.forename: Muhammad
authors.initials: M
authors.lastname: Wasim
authors.forename: Amjad
authors.initials: A
authors.lastname: Ali
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Niaz
authors.forename: Zobia
authors.initials: Z
authors.lastname: Ismail
authors.forename: Mujaddad U
authors.initials: MU
authors.lastname: Rehman
authors.forename: Muhammad
authors.initials: M
authors.lastname: Tariq
authors.forename: Muqarrab
authors.initials: M
authors.lastname: Shah
authors.forename: Bibi N
authors.initials: BN
authors.lastname: Murtaza
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002648:Child; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D017678:Sex Distribution; D012737:Sex Factors; D055815:Young Adult