Epidemic History of Hepatitis C Virus among Patients with Inherited Bleeding Disorders in Iran.
The high rate of hepatitis C virus (HCV) infection among transfusion related risk groups such as patients with inherited bleeding disorders highlighting the investigation on prevalent subtypes and their epidemic history among this group. In this study, 166 new HCV NS5B sequences isolated from patients with inherited bleeding disorders together with 29 sequences related to hemophiliacs obtained from a previous study on diversity of HCV in Iran were analyzed. The most prevalent subtype was 1a (65%), followed by 3a (18.7%),1b (14.5%),4(1.2%) and 2k (0.6%). Subtypes 1a and 3a showed exponential expansion during the 20th century. Whereas expansion of 3a started around 20 years earlier than 1a among the study patients, the epidemic growth of 1a revealed a delay of about 10 years compared with that found for this subtype in developed countries. Our results supported the view that the spread of 3a reached the plateau 10 years prior to the screening of blood donors for HCV. Rather, 1a reached the plateau when screening program was implemented. The differences observed in the epidemic behavior of HCV-1a and 3a may be associated with different transmission routes of two subtypes. Indeed, expansion of 1a was more commonly linked to blood transfusion, while 3a was more strongly associated to drug use and specially IDU after 1960. Our findings also showed HCV transmission through blood products has effectively been controlled from late 1990s. In conclusion, the implementation of strategies such as standard surveillance programs and subsiding antiviral treatments seems to be essential to both prevent new HCV infections and to decline the current and future HCV disease among Iranian patients with inherited bleeding disorders.
Department of Virology, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Katayoun
K
Samimi-Rad
Department of Nano medicine, School of Advanced Technologies in Medicine, TUMS, Tehran, Iran.
Ramin
R
Rahimnia
National Institute of Genetic Engineering and Biotechnology, Tehran, Iran.
Mahdi
M
Sadeghi
School of Mathematics, Statistics and Computer Science, College of Science, University of Tehran, Tehran, Iran.
Seyed Amir
SA
Malekpour
Department of Virology, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Mona
M
Marzban
Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
Maryam
M
Keshvari
Department of Virology, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Seyed Jalal
SJ
Kiani
Research Center for Gastroenterology and Liver Disease, Baqiatallah University of Medical Sciences, Tehran, Iran.
Seyed-Moayed
SM
Alavian
D000293:Adolescent; D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders / Q000453:epidemiology / Q000821:virology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000472:pathogenicity; D006526:Hepatitis C / Q000145:classification / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D058974:Phylogeography; D012367:RNA, Viral / Q000235:genetics; D017361:Viral Nonstructural Proteins / Q000235:genetics; D055815:Young Adult
D012367:RNA, Viral; D017361:Viral Nonstructural Proteins