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Khedhiri M, Ghedira K, Rajhi M, Hammemi W, Sadraoui A, Touzi H, Tebibi K, Chouikha A, Triki H. Overview of the epidemic history of Hepatitis C uncommon subtypes 2i and 4d in Tunisia and in the world. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 105:105375. [PMID: 36241024 DOI: 10.1016/j.meegid.2022.105375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/06/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
The impressive improvements in qua therapy efficacy alone are not sufficient to substantially reduce the Hepatitis C Virus burden because of the usually very long asymptomatic phase of the infection. In turn, this renders prevention of infection of great importance. The value of learning how the virus has spread in the past is that this can provide clues as to what routes the virus likely spreads through today, which can feedback into prevention policy. In Tunisia, HCV subtypes 2i and 4d are minor circulating subtypes. Here, we applied a Bayesian Markov Chain Monte Carlo method for visualization of spatial and temporal spread of HCV-2i and 4d in Tunisia and some other countries in the world. Our analysis included sequences retrieved from Genbank and isolated from several countries in the world; 21 HCV-NS5B subtype 2i genome sequences obtained during the period 2002-2020 and 206 HCV-NS5B-4d sequences detected between 2000 and 2019. Phylogenetic analysis revealed that two geographical clusters could be identified in HCV-2i tree with two clearly distinguished clusters in HCV-4d Tree. The estimated time for the most recent common ancestor suggested that current HCV-2i strains emerged in 1963 [1930, 1995] and current HCV-4d strains emerged in 1992 [1988, 1996] in Tunisia and other countries from the world investigated in the present study.
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Affiliation(s)
- Marwa Khedhiri
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Faculty of Sciences of Tunis, University of Tunis El Manar, Campus Universitaire, El Manar, Tunis 2092, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia.
| | - Kais Ghedira
- Laboratory of Bioinformatics, Biomathematics and Biostatistics - LR16IPT09, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.
| | - Mouna Rajhi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia
| | - Walid Hammemi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia
| | - Amel Sadraoui
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia
| | - Henda Touzi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia
| | - Khadija Tebibi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Faculty of Sciences of Tunis, University of Tunis El Manar, Campus Universitaire, El Manar, Tunis 2092, Tunisia
| | - Anissa Chouikha
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia.
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia.
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Khedhiri M, Triki H, Triki H. Hepatitis C in Tunisia from 1991 to 2019: A systematic review. LA TUNISIE MEDICALE 2021; 99:189-200. [PMID: 33899186 PMCID: PMC8715794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease and liver cancer related deaths in Tunisia. AIM Perform a systematic review on viral hepatitis C in Tunisia between 1991 and 2019. METHODS A global search of HCV-specific documentation in Tunisia (1991-2019) in bibliographic data search sites. RESULTS Tunisia is a low endemic country for hepatitis C with a prevalence that not exceed 1% in the general population. Several studies have focused on populations at risk of HCV contamination such as hemodialysis and polytransfused patients. The prevalence of hepatitis C is higher in these groups. In relatively small series, a clear predominance of genotype 1 and subtype 1b has been reported in Tunisia with a lower co-circulation of the other genotypes. Several polymorphisms of cytokine and chemokine genes can influence the clearance or persistence of HCV infection. Tunisian studies have focused on the efficacy of conventional dual therapy (pegylated IFN + ribavirin) by analyzing the predictive factors linked to SVR and mutations associated with resistance to viral inhibitors. No publication has discussed the effectiveness of new direct-acting antivirals in Tunisia. CONCLUSION This review of the literature provides an update on the status of hepatitis C in Tunisia and reveals a lack of investigations on new direct-acting antivirals.
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Affiliation(s)
- Marwa Khedhiri
- 1- Faculté des Sciences de Tunis, Université de Tunis El Manar
| | - Hatem Triki
- 2- Faculté de médecine de Sfax, Université de Sfax
| | - Henda Triki
- 3- Faculté de médecine de Tunis, Université de Tunis el Manar
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Focus on hepatitis C virus genotype distribution in Tunisia prior to elimination: a 16-year retrospective study. Arch Virol 2021; 166:501-510. [PMID: 33394169 DOI: 10.1007/s00705-020-04918-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/30/2020] [Indexed: 12/12/2022]
Abstract
With the introduction of direct-acting antiviral treatment (DAA), Tunisia has committed to achieving the international goal of eliminating viral hepatitis. Because the specific DAA prescribed depends on viral genotype, viral genotyping remains of great importance. The aim of the present study was to outline the trends in the distribution of HCV genotypes from 2002 to 2017 in the Tunisian general population in order to guide authorities towards the most appropriate therapeutic strategies for preventing HCV infection. A total of 2532 blood samples were collected over a 16-year period and from all regions of Tunisia. Genotyping showed that genotype 1 (subtype 1b) was the most prevalent genotype in the country (n = 2012; 79.5%), followed by genotype 2 (n = 339; 13.3%). Genotypes 3, 4 and 5 were detected in 4.8%, 2.2% and 0.1% of the country's population, respectively. Mixed infections with different HCV genotypes were detected in 0.1% of the population (one case each of genotypes 1b + 4, 1b + 2 and 2 + 4). Interestingly, a significant increase in genotypes 2, 3 and 4 was observed over time (p = 0.03). Sixteen different subtypes were detected over the study period, most of which were subtypes of genotype 2, and some of these subtypes appeared to be new. Patients infected with genotypes 1a, 3 and 4 were significantly younger than those infected with genotypes 1b and 2 (p < 0.01). Furthermore, genotypes 1b and 2 were detected more often in women than men, while genotypes 1a and 3 were detected mostly in men (P < 0.01). Our study confirms a large predominance of genotype1/subtype1b in Tunisia and shows a significant increase in the prevalence of other genotypes over time. These findings reinforce the need for an additional HCV genotype survey to improve the design of treatment strategies in Tunisia.
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