title: Geographic distribution of hepatitis C virus genotypes in pakistan.
abstract: BACKGROUND
  Distribution of Hepatitis C Virus (HCV) genotypes may be changed over time. Epidemiological Studies on distribution patterns of HCV genotypes in Pakistani population might assist for better treatment options and preventive strategies.
  
  
  OBJECTIVE
  This study was conducted to determine distribution patterns of HCV genotypes in different geographical regions of Pakistan.
  
  
  METHODS
  In this cross-sectional study, 1818 randomly selected patients from different geographical regions of Pakistan, diagnosed with HCV infection by the third generation Enzyme Linked Immunosorbent Assay (ELISA), were included between April 2011 and December 2013. HCV RNA was detected in serum samples of patients by Reverse Transcription Polymerase Chain Reaction (RT- PCR) of the core region. Qualitative PCR was performed to determine viral load. HCV genotyping was performed by RT-nested PCR using type-specific primers of the core region. Frequency of different genotypes among patients was assessed according to gender, age and geographical region at the time of sampling.
  
  
  RESULTS
  Of 1818 HCV RNA positive samples, HCV genotypes PCR fragments were detected in 1552 (85.5%) samples. HCV genotype 3a was the predominant genotype (39.4%) followed by genotype 2a (24.93%). HCV genotype 3 was the predominant genotype in Punjab and Sindh regions, while genotype 2 was the most predominant genotype in Khyber Pakhtunkhwa region and the second predominant genotype after genotype 3 in Sindh region. The incidence of genotype 2a is increasing in our country with decrease in the incidence of genotype 3a. A higher incidence of HCV various genotypes were observed among male patients and those younger than 45 years.
  
  
  CONCLUSIONS
  This study may facilitate treatment options and preventive strategies in Pakistan.
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Nasar
authors.initials: N
authors.lastname: Khan
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Akmal
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Hayat
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Umar
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Atta
authors.initials: A
authors.lastname: Ullah
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Iqbal
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Kashif
authors.initials: K
authors.lastname: Rahim
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Sadar
authors.initials: S
authors.lastname: Ali
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Sulaiman
authors.initials: S
authors.lastname: Bahadar
authors.affiliation: Department of Microbiology, Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa Kohat, Pakistan.
authors.forename: Shamim
authors.initials: S
authors.lastname: Saleha
keywords: Distribution Patterns; Geographical Regions; HCV Genotypes; Pakistan