Global Distribution And Prevalence Of Hepatitis C Virus Genotypes
Corresponding Author
Spatial Epidemiology and Ecology Group, Department of Zoology, University of Oxford, Oxford, UK
Division of Infectious Diseases, St Mary’s Campus, Imperial College, London, UK
These authors contributed equally.
Department of Zoology, University of Oxford, Oxford, UK
These authors contributed equally.
Peter Medawar Building for Pathogen Research, University of Oxford, and Oxford NHIR BRC, Oxford, UK
These authors contributed equally.
Corresponding Author
Spatial Epidemiology and Ecology Group, Department of Zoology, University of Oxford, Oxford, UK
Division of Infectious Diseases, St Mary’s Campus, Imperial College, London, UK
These authors contributed equally.
Department of Zoology, University of Oxford, Oxford, UK
These authors contributed equally.
Peter Medawar Building for Pathogen Research, University of Oxford, and Oxford NHIR BRC, Oxford, UK
These authors contributed equally.
Potential conflict of interest: Dr. Cooke consults for Gilead, Janssen, and Boehringer Ingelheim.
J.M. received support from the EU-funded IDAMS consortium . E.B. is funded by the MRC as an MRC Senior Clinical Fellow, as well as the Oxford Martin School and Oxford NIHR BRC. G.C. is supported in part by Imperial College Biomedical Research Centre. E.B. and G.C. are part of the STOP-HCV consortium.
What Are The Signs And Symptoms Of Hepatitis C
There are two types of Hepatitis C acute and chronic . Individuals with acute Hepatitis C usually do not manifest symptoms and the small percentage that do will experience symptoms similar to the other cases of acute hepatitis, including flu-like symptoms, joint aches or mild skin rash. Individuals that are particularly likely to experience a severe course of Hepatitis C are those individuals that already have Hepatitis B and become infected with acute Hepatitis C.
Other symptoms which may be experienced by individuals with acute Hepatitis C are:
- Loss of appetite
- Grey colored stool
- Jaundice
As is the case for acute Hepatitis C, most people who have chronic Hepatitis C do not experience symptoms in the early stages or even in the advanced stages of the disease. Therefore, it is not uncommon to find out, by surprise, that one has the virus when donating blood or during a routine blood examination. It is possible to have Hepatitis C for many years and not know it which is the reason why the disease has been referred to as a silent killer.
If symptoms do occur, they will most likely exhibit as:
- Pain and tenderness in the area of the liver
- Fever
- Jaundice
- Fatigue
In those persons who do develop symptoms, the average time period from exposure to symptom onset is 412 weeks .
Hcv Infection Among Saudi Population: High Prevalence Of Genotype 4 And Increased Viral Clearance Rate
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Affiliations College of Medicine, Taif University, Al-Taif, Saudi Arabia, Virology Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
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Affiliation Al-Hada Armed Forces Hospital, Department of Molecular Pathology, Al-Taif, Saudi Arabia
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Affiliations College of Medicine, Taif University, Al-Taif, Saudi Arabia, Biochemistry Department, Faculty of Agriculture, Cairo University, Giza, Egypt
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Affiliations College of Medicine, Taif University, Al-Taif, Saudi Arabia, Zoology Department, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
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Affiliations Postgraduate Training and Research Center, Armed Forces Hospitals, Al-Taif, Saudi Arabia, Public Health and Community Medicine Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt
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Treatments For Different Genotypes
DAAs are the most common treatment that directly targets the hepatitis C virus. A person may also need to take other medications, depending on the genotype of the virus and any complications of the infection.
The best treatment option tends to depend on whether or not the person has cirrhosis. The options below apply to people who have not previously received treatment for hepatitis C.
The following medications are recommended for genotypes 1a and 1b:
- elbasvir and grazoprevir
- ledipasvir and sofosbuvir
- glecaprevir and pibrentasvir
- sofosbuvir and velpatasvir
If a person has genotype 2 or 3, a healthcare provider may choose to prescribe glecaprevir and pibrentasvir or sofosbuvir and velpatasvir.
For people who have genotype 4, they may prescribe glecaprevir and pibrentasvir, sofosbuvir and velpatasvir, elbasvir and grazoprevir, or ledipasvir and sofosbuvir.
For people with genotypes 5 or 6, they may describe a combination of these medications. As one study paper concludes, developing more effective treatments and a better understanding of the prevalence of the condition will require more research.
The right treatment varies from person to person. When recommending a course of action, a healthcare provider will take into consideration previous treatments, medical history, overall health, and any complications of hepatitis C.
Sampling Procedure And Recruitment
To achieve a national representative sample, the two-stage cluster sampling method was used. Selection of the primary sampling units was performed by randomly selecting one township, which was considered to have an average level of viral hepatitis B when considering all states and regions of Myanmar. Selection of secondary sampling unit was achieved by selecting 10 wards and villages from each selected PSU township, based on the probability to population size. Systemic random sampling was then used to select 30 households from each selected SSU . The sampling frame for the current study included the list of households available to the Basic Health staff. One eligible participant in the selected household, aged between 15 to 80years, was recruited by random sampling. Informed consent of the participant was obtained by the in-field investigators who explained the purpose and procedure of the study, and it was signed on-site before blood samples were drawn. Hepatitis B virus screening was carried out with the rapid assay SD Bioline HBsAg WB , and results were shared with the participants individually, in a closed envelope. Counseling for consequences of HB infection, and treatment options and health education was imparted to all positive patients, and a second informed consent form was obtained for genotyping study. All positive patients from sampling sites in Myanmar were invited for a genotyping study without sampling bias .
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What Is Hepatitis C Symptoms Causes Diagnosis Treatment And Prevention
Hepatitis is an inflammation of the liver, and hepatitis C is liver inflammation caused by the hepatitis C virus .
Journal of Clinical MicrobiologyJournal of Infectious Diseases
Though these genotypes appear to affect people similarly, they respond differently to treatments, and it’s possible to be infected with more than one HCV genotype at the same time.
Whatever the genotype, hepatitis C is considered either acute or chronic .
What Is The Long Term Prognosis For Hepatitis C
The future looks promising for those with Hepatitis C. Fortunately, scientific advances and intense research and development have led to the development of many oral antiviral drugs. In addition, research shows that combining specific supplements such as milk thistle shows promise in assisting the liver of patients with Hepatitis C.
The odds of living well with Hepatitis C rather than dying from Hepatitis C are very good. By maintaining a positive attitude, working closely with ones physician after diagnosis, getting support from as many areas as possible , and making positive lifestyle changes, Hepatitis C doesnt have to be the death sentence it was once believed to be.
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A Patients Triumph Over Hepatitis C
Connie Welch knows the angst of being diagnosed with Hepatitis C, and she also knows what it is like to triumph over the disease.
Welch told Healthline, I contacted Hep C in an unusual way. In 1992 I had foot surgery, and two years later I was contacted and told that a convicted drug felon, who worked at the center at the time as a scrub tech, would take a vial of medicine and shoot up with the syringe with the patients IV bag, put normal saline back into that same syringe and put it back on the tray.
Welch, who has two children, was in complete shock to learn this news. It was horrific. It was very scary learning about Hep C and that there was not a cure. The doctor sat me and my husband down for an hour and a half and explained everything about Hep C.
After being tested three times, Welch learned that her Hepatitis C was active and doing damage. She has had two liver biopsies and three treatments in a course of 20 years. I was tested for my genotype and Im genotype 1.
Following a three-drug combination treatment, which included the drug Incivek for the first four weeks of the treatment, Welch went nondetected. The treatment lasted 24 weeks. I am now two years post treatment and Im still nondetected. I just received a new diagnosis and they said I am Hep C resolved, which means cured. In 2012, I did my last treatment. I was able to receive a cure. That was pretty phenomenal, said Welch.
Hepatitis C And Health
How can health-care personnel avoid exposure to HCV?
Avoiding occupational exposure to blood is the primary way to prevent transmission of bloodborne illnesses among health-care personnel. To promote blood safety in the workplace, health-care personnel should consult infectious-disease control guidance from the National Institute for Occupational Safety and Health and from CDC. Depending on the medical procedure involved, Standard Precautions may include the appropriate use of personal protective equipment .
What is the risk of acquiring hepatitis C after being accidentally exposed to HCV-contaminated blood or body fluids in the workplace?
Although sharps injuries have decreased in recent decades due to improved prevention measures, they continue to occur, placing health-care personnel at risk for several bloodborne pathogens like hepatitis C. A recent analysis of several studies revealed an overall 0.2% risk for infection among those exposed to HCV-antibody-positive blood through needlestick or sharps injuries . Updated guidelines for management and treatment of hepatitis Cexternal icon are available to provide guidance for health-care personnel who become infected via exposure to contaminated blood at the workplace.
Other than needlesticks, do other exposures place health-care personnel at risk for hepatitis C?
Should HCV-infected health-care personnel be restricted in their work?
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Retreatment Of Persons With Prior Peginterferon And Ribavirin Failure
The latest version of the AASLD-IDSA HCV Guidance no longer provides specific recommendations for retreatment of persons with a history of peginterferon plus ribavirin therapy, with or without an earlier generation direct-acting antiviral agent . The AASLD-IDSA HCV Guidance notes that these individuals respond to retreatment similar to treatment-naïve persons, thus implying the treatment approach should be the same as with treatment-naïve individuals. Although the pool of persons with a history of failure with a peginterferon-based regimen who need retreatment is small and diminishing, there are some individuals with this treatment history who need retreatment and may require special consideration that differs from that of treatment-naïve individuals. The following outlines a few of these key considerations based on available data and previous guidance that should be noted when retreating an individual with a history of prior treatment failure with peginterferon plus ribavirin, with or without an earlier generation DAA . Note that except for the 8-week option of glecaprevir-pibrentasvir , when retreating these individuals with first-line DAA combinations that have pangenotypic activity , the treatment will be the same as their treatment-naïve counterparts.
Favorite Hep C Online Magazine And Blogs
Hep Mag publishes current articles about people living with hep C, plus it offers a forum for people to ask questions and share stories and information with other readers. The online magazine also features a blog on funding, cures, liver disease, and related matters.
Feedspot, a feed compiling news from online sources, lists 20 top blogs and websites to explore concerning hepatitis C. Readers can connect with one another and find out about the latest drug research developments.
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What Tests Are Needed For Knowing My Genotype
When screening for HCV, a patient takes several tests to make a diagnosis .
Once a patient has been diagnosed with HCV, the doctor will run viral load level and genotype tests before starting treatment. Knowing a patients genotype determines the best treatment regimen.
Genotype tests use blood taken from fingersticks or simple blood draws. A patient might need to return to the doctors office to confirm whether the infection is chronic or to confirm whether they have been cured of the virus.
Genotypes 1a and 1b may require a patient to take additional blood tests to determine whether the virus has any resistance .
HCV treatment is now simpler, safer, and more effective, and diagnostics, including HCV genotyping, need to become simpler and less expensive.
The medications are available depending on the payer or what is available in a country or region.
Distribution Of Hbv Genotypes Among The Study Population
All 353 HBsAg positive serum samples also tested positive by HBV ELISA. Of the confirmed 353 HBsAg positive samples, 153 were PCR positive , and were further included for genotype analysis . Three major genotypes were found in this study population. The HBV genotype C was found to be the predominant circulating genotype , followed by genotypes D and B .
Fig. 1
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Are There Alternative Therapies For The Treatment Of Hepatitis C
Many people who have Hepatitis C choose to follow an alternative method of treatment due to the side effects and costs of current medical therapy. Complementary and Alternative Medicine is chosen as a means of treatment most commonly to boost the immune system, slow disease progression and improve quality of life.
The best CAM route in the treatment of Hepatitis C appears to be the approach that focuses on protecting and supporting the liver and keeping the immune system healthy however, none of these therapies are cures.
Some of the preferred alternative therapies for Hepatitis C include:
For those interested in learning more about liver supporting natural supplements, visit NaturalWellness.com.
Which Treatment Works For Each Genotype
- All Genotypes: see Epclusa fact sheet
- Genotypes 1 through 4: see Sovaldi, Viekira XR and Technivie, Harvoni, Olysio fact sheets
- Genotypes 1 or 4: see Zepatier fact sheet
- Genotypes 2 or 3: see Sovaldi, Daklinza fact sheets
- Genotype 6: see Harvoni fact sheets
Ribavirin causes birth defects and miscarriage. HCV treatment regimens that include RBV should not be used by pregnant women or by male partners of pregnant women. RBV stays in a persons body for months, so women and their male partners should avoid pregnancy until six months after stopping it .
This fact sheet is current as of December 2016. It is recommended to be read alongside the Adherence and HCV Diagnostics fact sheets. Always check for updated information.
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Models Of Care For Hcv
Despite one of the highest HCV diagnosis rates in the world, treatment uptake in Australia has been low . Upscaling treatment rates to the desired level to reduce population burdens of HCV and secondary liver disease 1 will require the development of new models of care for HCV treatment. These should include traditional tertiary centre-led models of care, particularly for people with cirrhosis or special populations , as well as community-based models of care involving GPs, specialist nurses and nurse practitioners. Specific models of care are needed for people who inject drugs, opioid substitution treatment centres, the prison system, rural and regional settings, Aboriginal and Torres Strait Islander people and migrants from high-prevalence regions .
The PBS listing allows the new HCV medicines to be prescribed by gastroenterologists, hepatologists or infectious diseases physicians who are experienced in treating chronic HCV infection, as well as by GPs in consultation with one of these specialists. The new HCV medicines will be available through the PBS General Schedule , meaning approved pharmacists in the community can dispense the new HCV medications, as well as through the Section 100 Highly Specialised Drugs Program, which makes provision for treatment of prisoners.
Distribution Of Hepatitis C Virus Genotypes Among Azerbaijani Patients In Capital City Of Iran
Seyed Moayed Alavian2, 3, Sherko Nasseri5
1Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran
2Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatollah University of Medical Sciences, Tehran, IR Iran
3Middle East Liver Disease Center, Tehran, IR Iran
4Faculty of Engineering Deaprtment, Islamic Azad University, Shahre Qods Branch, Tehran, IR Iran
5Department of Virology, Tehran University of Medical Sciences, Tehran, IR Iran
How to Cite: Bokharaei-SalimF, KeyvaniH, MonavariS H, AlavianS M, FakhimS, et al. Distribution of Hepatitis C Virus Genotypes among Azerbaijani Patients in Capital City of Iran-Tehran,Hepat Mon.2013 13:e13699. doi: 10.5812/hepatmon.13699.
ARTICLE INFORMATION
Hepatitis Monthly:Article Type:
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Hcv Rna Extraction And Reverse Transcription
The extraction of HCV RNA was done using COBAS AMPLICOR Hepatitis C Virus Test, v2.0 during 20072015 and using QIAamp MinElute Virus Spin Kit during 20162018. The technical details of the procedures that were followed are described in .
One-step HCV reverse transcription was done using COBAS AMPLICOR Hepatitis C Virus Test during 20072015 and HCV RNA Real Time Qualitative 2.0 during 20162018 following the manufacturers instructions in order to proceed to HCV genotyping.
Which Genotype Do You Have
In the U.S., genotype 1 is the most common. It makes up about 75% of all U.S. cases. The other 25% are mostly genotypes 2 or 3. A few Americans may have genotypes 4, 5, or 6. Genotype 4 is most common in Africa, while genotype 6 is most common in Southeast Asia.
Your doctor can test your blood to find out whether you have hepatitis C and which genotype it is. Most people have one. But some have more than one. Your doctor might call this âmixed infection.â
Youâre more likely to have a mixed infection if you:
- Got blood products like platelets, plasma, red cells, or whole blood many years ago
- Received blood products in a place that doesnât check blood for hep C
- Are on kidney dialysis
- Inject drugs with shared or unsterilized needles
Keep in mind that you might carry the hep C virus even if you donât have symptoms of hepatitis. Once you know your status and genotype, you and your doctor can decide on a treatment plan.
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