HCV Genotype Distribution of Patients with Chronic Hepatitis C in Istanbul

Mehmet Emin Bulut; Ummuhan Su Topalca; Ali Murat; Leyla Teke; Hazan Zengin Canalp; Murat Ocal; Banu Bayraktar

doi:10.14744/SEMB.2020.66990

HCV Genotype Distribution of Patients with Chronic Hepatitis C in Istanbul

Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):86-92. doi: 10.14744/SEMB.2020.66990. eCollection 2021.

Authors

Mehmet Emin Bulut¹, Ummuhan Su Topalca², Ali Murat¹, Leyla Teke¹, Hazan Zengin Canalp¹, Murat Ocal¹, Banu Bayraktar¹

Affiliations

¹ Department of Medical Microbiology, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul Turkey.
² Department of Medical Microbiology, Necip Fazıl City Hospital, Kahramanmaras, Turkey.

Abstract

Objectives: Hepatitis C virus (HCV), which has no protective vaccine, is a common cause of chronic hepatitis, which is a severe public health threat. There are differences in nucleotide and amino acid sequences in different regions of the HCV genome. As a result of these differences, HCV has been shown to have at least seven major genotypes and many subtypes. In Turkey, the prevalence of genotype 1 is between 51.7% and 97.1%, the highest rate among all genotypes, while subtype 1b is the genotype with the highest rate. It is important to detect mixed genotype infection reliably as it causes treatment failure. This study aims to reveal the distribution of the HCV genotypes in our hospital in Istanbul over the years and to contribute to the epidemiological data of Turkey.

Methods: For this purpose, 385 patient samples sent to Sisli Hamidiye Etfal Training and Research Hospital, Clinical Microbiology Laboratory for HCV genotype determination between January 2016 and June 2019 were evaluated retrospectively. Anti-HCV was screened by enzyme immunoassay and confirmation was performed by Line immunoassay. HCV genotyping assays targeting highly conserved 5'UTR and most variable region NS5B regions were used.

Results: The most common genotype was genotype 1 (81.3%) with 313 cases and subtypes 1a and 1b were detected at the rates of 10.9% and 67.8%, respectively. In addition, genotype 3, 2, 4, 5 were detected at the rates of 8.8%, 3.4%, 2.9%, 0.8%, respectively and mixed genotype was found in 2.9% of cases. Although genotype 5 is seen in South Africa, it is found in the Middle East region, albeit at a low rate. In our study, it was observed that genotype 5 was detected in different years from patients of Syrian origin.

Conclusion: In this study, genotype 1 was the most common genotype with a rate of 81.3% and subtype 1b was 67.8%, in accordance with the literature. However, genotypes 3, 2, 4 and 5 were also present at low rates. It is important to monitor these rare genotypes since some of them are dominant in surrounding countries. In addition, 2.9% of HCV mixed genotype was detected and this should be considered concerning management of HCV infection.

Keywords: Epidemiology; HCV genotype; HCV subtype; hepatitis C virus; mixed genotype.