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Mane A, Kasibhatla SM, Vidhate P, Saxena V, Patil S, Rao A, Nirmalkar A, Kulkarni-Kale U, Panda S. Phylogenetic Analysis of Spread of Hepatitis C Virus Identified during HIV Outbreak Investigation, Unnao, India. Emerg Infect Dis 2022; 28:725-733. [PMID: 35318918 PMCID: PMC8962895 DOI: 10.3201/eid2804.211845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
An HIV outbreak investigation during 2017–2018 in Unnao District, Uttar Pradesh, India, unearthed high prevalence of hepatitis C virus (HCV) antibodies among the study participants. We investigated these HCV infections by analyzing NS5B and core regions. We observed no correlation between HIV–HCV viral loads and clustering of HCV sequences, regardless of HIV serostatus. All HCV isolates belonged to genotype 3a. Monophyletic clustering of isolates in NS5B phylogeny indicates emergence of the outbreak from a single isolate or its closely related descendants. The nucleotide substitution rate for NS5B was 6 × 10−3 and for core was 2 × 10−3 substitutions/site/year. Estimated time to most recent common ancestor of these isolates was 2012, aligning with the timeline of this outbreak, which might be attributable to unsafe injection practices while seeking healthcare. HIV–HCV co-infection underlines the need for integrated testing, surveillance, strengthening of healthcare systems, community empowerment, and molecular analyses as pragmatic public health tools.
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Butt N, Anoshia, Khan MA, Akbar A. Effectiveness of Sofosbuvir and Daclatasvir in treatment of Hepatitis-C: An experience of tertiary care hospital in Karachi. Pak J Med Sci 2021; 37:2014-2019. [PMID: 34912436 PMCID: PMC8613042 DOI: 10.12669/pjms.37.7.4627] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: To assess the effectiveness of Sofosbuvir (SOF) and Daclatasvir (DCV) in patients with chronic hepatitis C (CHC), compensated cirrhosis (CC) and decompensated cirrhosis (DCLD) either treatment naïve or experienced. Methods: This was a prospective, observational study, conducted from January 2017 to December 2018 at Jinnah Postgraduate Medical Centre, Karachi. All patients above 12 years of age with detectable HCV RNA PCR were included. Patients were divided into three groups: CHC, CC and DCLD. SOF and DCV for 12 or 24 weeks were given. Ribavirin (RBV) was given to treatment experienced and cirrhotic patients. Primary outcome was End of Treatment Response (ETR) and secondary outcome was Sustained Virological Response (SVR) at post treatment week 12 or 24. Results: Total 300 patients with mean age of 40.49 ± 13.86 were enrolled. Majority were females 174 (58%). CHC were 200 (66.6%) while cirrhotic were 100 (33.4%). Treatment naïve patients were 267 (89%) and 33 (11%) patients were experienced. Most common genotype was 3 (83%). ETR was achieved in 292 (97.33%) and SVR in 265 (88.33%) patients respectively. Conclusion: SOF plus DCV with or without RBV is a highly effective treatment for chronic HCV and is still used in many centers of Pakistan. This regimen has excellent results for GT-3. The outcomes are mainly influenced by the presence or absence of cirrhosis.
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Affiliation(s)
- Nazish Butt
- Dr. Nazish Butt, MBBS, FCPS. Assistant Professor, Head Department of Gastroenterology, Department of Gastroenterology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Anoshia
- Dr. Anoshia, MBBS, FCPS. Consultant Gastroenterologist, Department of Gastroenterology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Muhammad Ali Khan
- Dr. Muhammad Ali Khan, MBBS. Department of Gastroenterology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Ali Akbar
- Dr. Ali Akbar, MBBS, FCPS. Consultant Gastroenterologist, Department of Gastroenterology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
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Chatterjee K, Kalita D, Omar BJ, Gupta R, Jha MK, Gupta P. Hepatitis C virus subtyping in Uttarakhand, India: a comparative study. Virusdisease 2021; 32:576-581. [PMID: 34631982 DOI: 10.1007/s13337-021-00729-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/15/2021] [Indexed: 11/24/2022] Open
Abstract
The objective of this study was to compare Reverse Hybridisation Assay with conventional sequencing for determination of Hepatitis C Virus Genotype and Subtypes. Anti-HCV antibody was determined followed by HCV RNA extraction which was used for (1) viral load determination (2) qualitative real-time PCR RHA for genotyping and (3) conventional sequencing. Compared to conventional sequencing, accuracy of RHA results was 96.55% for determination of genotype (κ = 0.93) and 89.66% for subtype (κ = 0.85). Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of the qualitative PCR were 82.29%, 100%, 44.44% and 100% respectively with an accuracy of 86.84%. RHA is a less time consuming and cheaper method for determination of HCV genotype and subtype yet results must be interpreted with caution and quality control monitoring should be strictly followed to ensure validity. Supplementary Information The online version contains supplementary material available at 10.1007/s13337-021-00729-9.
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Affiliation(s)
- Kuhu Chatterjee
- Department of Microbiology, All India Institute of Medical Sciences, Veerbhadra Marg, Dehradun, Rishikesh, 249203 Uttarakhand India
| | - Deepjyoti Kalita
- Department of Microbiology, All India Institute of Medical Sciences, Veerbhadra Marg, Dehradun, Rishikesh, 249203 Uttarakhand India
| | - Balram Ji Omar
- Department of Microbiology, All India Institute of Medical Sciences, Veerbhadra Marg, Dehradun, Rishikesh, 249203 Uttarakhand India
| | - Rohit Gupta
- Department of Gastroenterology, All India Institute of Medical Sciences, Rishikesh, India
| | - Mithilesh Kumar Jha
- Department of Microbiology, All India Institute of Medical Sciences, Veerbhadra Marg, Dehradun, Rishikesh, 249203 Uttarakhand India.,Department of Microbiology, All India Institute of Medical Sciences, Patna, India
| | - Pratima Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Veerbhadra Marg, Dehradun, Rishikesh, 249203 Uttarakhand India
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Chatterjee K, Gupta R, Omar BJ, Gupta P, Kalita D. Genotypic distribution of hepatitis C virus in Uttarakhand. Indian J Med Microbiol 2021; 39:479-483. [PMID: 34210508 DOI: 10.1016/j.ijmmb.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/26/2021] [Accepted: 06/11/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Hepatitis C virus is a major cause of chronic hepatitis with seven known genotypes. Uttarakhand is a north Indian state in the Sub-Himalayan region where the genotypic distribution of HCV is largely unknown. This study was undertaken in order to assess the pattern of genotype and subtype and understand the risk factors leading to transmission of Hepatitis C virus in this understudied region. METHODS Anti-HCV reactive cases were selected for determination of the circulating genotypes. Viral RNA was confirmed by real-time PCR. Strains were amplified and sequenced using Sanger's methods. Phylogenetic tree was constructed to determine the genotype. RESULTS Genotype 3 was found to be the predominant genotype majority being subtype 3a and 3b followed by genotype 1. Subtypes 3g and genotype 4a were also observed. Major risk factor found was parenteral injection therapy from unregistered medical practitioners for minor ailments. CONCLUSIONS Findings of our study will help in tailoring management and prevention protocols for HCV for the people of this region.
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Affiliation(s)
- Kuhu Chatterjee
- Dept. of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rohit Gupta
- Dept. of Gastroenterology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Balram Ji Omar
- Dept. of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pratima Gupta
- Dept. of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepjyoti Kalita
- Dept. of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
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Kalita D, Deka S, Chamuah K. Circulation of an atypical hepatitis C virus (HCV) strain at a dialysis unit in northeast India. Microbiologyopen 2020; 10:e1147. [PMID: 33369206 PMCID: PMC7884925 DOI: 10.1002/mbo3.1147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 01/02/2023] Open
Abstract
Patients undergoing hemodialysis are at an increased risk of hepatitis C virus (HCV) infection. The implementation of standard infection control measures can substantially decrease the risk of infections and other nosocomial infections. To study the HCV infection rates and genotypes in maintenance hemodialysis subjects in a dialysis unit. A total of 196 maintenance hemodialysis subjects were tested for HCV RNA for one year at a tertiary care teaching hospital in northeast India continuously. Genotyping was performed using direct sequencing (Sanger sequencing) of the 5′UTR‐core region. The HCV infection rate was 26.0%. On phylogenetic analysis, 29 sequences clustered around genotype 3 and subtype 3f were observed. High sequence similarities (75–100% homology) were observed among the isolated sequences. High molecular similarities in the isolates from the same dialysis unit with a high infection rate (26.0%) over a relatively short period of study (10 months) indicated an ongoing nosocomial transmission. Nosocomial transmission by subtype 3f is rare, and it has not been reported in dialysis cases previously. The strain is most likely evolving from common strains such as 3b or 3i and may spread due to migration or movement of people. Urgent implementation of adequate infection control measures is required.
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Affiliation(s)
- Deepjyoti Kalita
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India.,Department Microbiology, Gauhati Medical College, Guwahati, India
| | - Sangeeta Deka
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India
| | - Kailash Chamuah
- Department Microbiology, Gauhati Medical College, Guwahati, India
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HCV genotypes and their determinative role in hepatitis C treatment. Virusdisease 2020; 31:235-240. [PMID: 32904762 DOI: 10.1007/s13337-020-00592-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/24/2020] [Indexed: 02/05/2023] Open
Abstract
Nowadays, exposure to infectious diseases caused by pathogenic viruses has become one of the major human concerns in health fields. In the meantime, hepatitis viruses are associated with health problems, especially in liver tissue. So far, several types of these viruses have been known including: HAV, HBV, HCV, HDV, HEV, and HGV. Nevertheless, it seems that hepatitis C is the major viral infection among all of the hepatitis infections. The cirrhosis and hepatocellular carcinoma are known as the most important pathological complications of this virus, from which seven genotypes have been identified. However, among these genotypes, the incidence rate of genotypes 1 and 3 is more than others. In this review, we have investigated the relationship between all HCV genotypes and therapeutic responses against them. Regarding heterogeneity between hepatitis C genotypes, it is not possible to access an effective vaccine against this virus, and treatment is the only applicable strategy. Response to treatment is different among genotypes, and it has resulted that each genotype has a specific therapeutic regimen of itself. Therefore, it seems that determination of hepatitis C genotype, as a key tool, is essential in controlling therapeutic regimen, improving local control programs and eventually producing an effective vaccine.
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Rodgers MA, Gomathi S, Vallari A, Saravanan S, Lucas GM, Mehta S, Solomon SS, Cloherty GA. Diverse HCV Strains And HIV URFS Identified Amongst People Who Inject Drugs In India. Sci Rep 2020; 10:7214. [PMID: 32350342 PMCID: PMC7190742 DOI: 10.1038/s41598-020-64309-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/27/2020] [Indexed: 12/22/2022] Open
Abstract
Although the prevalences of HIV and HCV are significantly higher amongst PWID in India compared to the general population, the strains circulating within this group have not been well-characterized. Through subgenomic sequencing of viruses present in residual plasma from an HIV/HCV prevalence study conducted amongst PWID across five cities in India in 2016-2017, a total of N = 498 HCV and N = 755 HIV strains were classified from N = 975 study participants. Considerable HCV diversity was identified, with different strains predominating in each region of the country. Overall, the most common strain was genotype 3a (39.0%), with genotypes 1a (26.9%), 1b (3.0%), 1c (0.2%), 3b (20.7%), 3i (2.0%), 4a (0.2%), 4d (1.0%), 6 (1.8%), 6n (4.8%), 6 v (0.2%) and one unclassifiable recombinant specimen (0.2%) also identified. The majority of the HIV specimens were subtype C (96.7%), although subtype A (0.4%), CRF01_AE (0.4%) and unique recombinant forms (URFs, 2.5%) were also detected. Notably, the geographical restriction of HIV subtype A and CRF01_AE, and HCV genotypes 4 and 6 to specific sites suggests distinct novel introductions of HIV and HCV into PWID populations, potentially via drug trafficking routes from neighboring countries where these strains are common.
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Affiliation(s)
- Mary A Rodgers
- Abbott Diagnostics, Infectious Disease Research, Abbott Park, USA.
| | | | - Ana Vallari
- Abbott Diagnostics, Infectious Disease Research, Abbott Park, USA
| | | | | | - Shruti Mehta
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Sunil S Solomon
- YR Gaitonde Centre for AIDS Research and Education, Chennai, India
- Johns Hopkins University School of Medicine, Baltimore, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Gavin A Cloherty
- Abbott Diagnostics, Infectious Disease Research, Abbott Park, USA
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Ye D, Tang Y, Gu Y, Haleem H, Zhang L, Zhang Y, Xu C, Zhao J. Evaluation of the effectiveness of a pilot study of hospital-based hepatitis C epidemic surveillance. Medicine (Baltimore) 2019; 98:e18334. [PMID: 31860986 PMCID: PMC6940170 DOI: 10.1097/md.0000000000018334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to evaluate the effectiveness of hospital-based hepatitis C epidemic surveillance initiated by China's CDC STD/AIDS (National Center for AIDS/STD Control and Prevention of Chinese Center for Disease Control and Prevention) Prevention and Control Center in 2017.A total of 104,666 anti-hepatitis C virus (HCV) and 633 HCV-RNA detection records in our hospital from 2014 to 2017 were used to analyze the anti-HCV and HCV-RNA detection rates and positive rates in patients before and after implementation of epidemic surveillance.We found that the estimated HCV positive rate was 0.395% in all patients, and this rate increased to 0.533% after the pilot research. The positive rates of anti-HCV were significantly enhanced, although certain differences were observed among different departments. Significant increase of positive rate of HCV-RNA was only found in the inpatients from nonsurgical departments. Eighty-one cases were diagnosed after this pilot research, exceeding the 70 total cases in the previous 3 years. Most cases were diagnosed by nonsurgical departments; the upward trend of the cases diagnosed by surgical departments cannot be ignored.Our study indicates expanding anti-HCV and HCV-RNA detection in the target populations in hospitals is a useful strategy for finding more occult HCV infection. In addition, our results provide useful pilot data of the seroepidemiology of Hepatitis C for the special populations in hospitals, which will provide valuable information for public health research.
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Affiliation(s)
- Dongxian Ye
- Department of Prevention and Health Care, Beilun Branch of the First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Yuqing Tang
- Department of Preventative Medicine, Zhejiang Provincial Key Laboratory of Pathological and Physiological Technology, School of Medicine, Ningbo University, Ningbo, Zhejiang, P.R. China
| | - Yuanliang Gu
- Department of Prevention and Health Care, Beilun Branch of the First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Harris Haleem
- Department of Preventative Medicine, Zhejiang Provincial Key Laboratory of Pathological and Physiological Technology, School of Medicine, Ningbo University, Ningbo, Zhejiang, P.R. China
| | - Libo Zhang
- Department of Prevention and Health Care, Beilun Branch of the First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Youping Zhang
- Department of Prevention and Health Care, Beilun Branch of the First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Chunxia Xu
- Department of Prevention and Health Care, Beilun Branch of the First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Jinshun Zhao
- Department of Preventative Medicine, Zhejiang Provincial Key Laboratory of Pathological and Physiological Technology, School of Medicine, Ningbo University, Ningbo, Zhejiang, P.R. China
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