title: Epidemiological Distribution and Genotype Characterization of the Hepatitis C Virus Among HIV Patients in Kashan, Iran.
abstract: BACKGROUND
  Parenteral transmission is a common route of transmission for both human immunodeficiency virus (HIV) and hepatitis C virus (HCV); therefore, hepatitis C viral infection is highly prevalent among people infected with HIV.
  
  
  OBJECTIVE
  This study was designed to examine the epidemiology and describe the clinical manifestation as well as the HCV genotypes in patients from the city of Kashan, Iran, who are coinfected with HIV and HCV.
  
  
  METHODS
  This descriptive study was conducted in 2014 in the city of Kashan. The population consisted of all the HIV-infected patients who were referred to the behavioral counseling center and jail in Kashan. Demographic information and HCV- and HIV-related risk behaviors were obtained through the use of an interviewer-assisted questionnaire. After the participants gave written informed consent to participate, 10 cc venous blood samples were collected. The serum samples were screened for HCV infection using an enzyme-linked immunosorbent assay (ELISA). In the event of a positive test for HCV, the RNA was then amplified by polymerase chain reaction (PCR) amplification. The HCV subtypes were determined via the direct sequencing of the amplicons. All data analysis was performed using SPSS version 16.0 for the descriptive statistics, and then the chi-square test and Pearson coefficient were performed for additional analysis.
  
  
  RESULTS
  The results of the analysis indicated that 54 (85%) of the 63 HIV-infected patients were males who were also HCV positive and who had less than a high school level education. There was a significant association between HCV infection and both occupation (P < 0.0001) and level of education (P < 0.05). All the HIV/HCV coinfected cases had a history of illicit drug use, while 92.6% had a history of imprisonment and 40.7% had high risk sexual contacts. Overall, genotype 1 was found in 75.9% of HCV patients, while genotype 3 was found in 24.1%. Some 94.4% of HCV patients had subtype A. There were no clinical symptoms of chronic hepatitis C.
  
  
  CONCLUSIONS
  The majority of HIV-infected persons in the city of Kashan were also HCV positive. Genotype 1 was the predominant type, alongside subtype A. Considering the high prevalence of HCV among the HIV-infected persons, as well as the impact of occupation, education, illicit drug use, and imprisonment on the incidence of both infections, health policy makers must introduce health programs and plans to reduce the prevalence of these infections.
authors.affiliation: Associate Professor, Department of Infectious Disease, School of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Hasan
authors.initials: H
authors.lastname: Afzali
authors.affiliation: Associate Professor, Department of Infectious Disease, Social Determinants of Health (SDH) Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mansooreh
authors.initials: M
authors.lastname: Momen-Heravi
authors.affiliation: Infectious Disease Specialist, Department of Infectious Disease, School of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Asefeh
authors.initials: A
authors.lastname: Farokhzad
keywords: Genotype; HIV; Hepatitis C Virus