ABB  Vol.4 No.9 , September 2013
Estimation of HCV viral load and liver enzymes among different patients groups of District Gujrat, Pakistan
ABSTRACT

Hepatitis C has a 3% of the global disease burden that remains endemic in many regions of the world. According to a general statistical survey it has approximately 5.3% seroprevalence in Pakistan. HCV is a persistent and silent disease thus making the primary diagnosis complicated. Occasionally HCV positive population could not be diagnosed by routine HCV antibody testing therefore requires molecular diagnosis. This study is aimed to determine the prevalence of HCV and to estimate the HCV viral load by quantitative analysis among different patient groups of District Gujrat, Pakistan. A total of 597 samples were collected from clinically diagnosed liver patients that were categorized into three age groups: 1) up to 25 years; 2) 26-50 years 3) above 50 years. All samples were subjected to real time PCR for determination and quantification of HCV RNA. Activity of liver aminotransferases was measured. The overall prevalence of HCV-RNA was 73.87%. Females had slightly higher HCV prevalence which is 74.06% while 73.45% in males. Highest prevalence of active HCV infection was found in age group 26-50. In addition, liver function tests showed that 28.12% HCV-positive patients do not have elevated ALT level whereas 32.65% did not show elevated AST levels. It may be assumed that there is not a significant relationship between increased viral load and liver amino transferases. The study concluded a significantly higher rate of HCV infection in young population. Moreover screening with antibody and liver function tests alone does not exclude the possibility of HCV infection.


Cite this paper
Mushtaq, A. , Tariq, M. , Rashid, U. , Afroz, A. , Zeeshan, N. , Asif, A. and Zahur, M. (2013) Estimation of HCV viral load and liver enzymes among different patients groups of District Gujrat, Pakistan. Advances in Bioscience and Biotechnology, 4, 866-871. doi: 10.4236/abb.2013.49115.
References
[1]   Alter, H.J. and Seeff, L.B. (2000) Recovery, persistence. and sequelae in hepatitis C virus infection: A perspective on long-term outcome. Seminars in Liver Disease, 20, 17-35. doi:10.1055/s-2000-9505

[2]   Freeman, A.J., Dore, G.J., Law, M.G., Thorpe, M., Von Overbeck, J., Lloyd, A.R., Marinos, G. and Kaldor, J.M. (2001) Estimating progression to cirrhosisin chronic hepatitis C virus infection. Hepatology, 34, 809-816. doi:10.1053/jhep.2001.27831

[3]   Smith, D.B., Mellor, J., Jarvis, L.M., et al. (1995) Variation of the hepatitis C virus 5’ non-coding region: Implications for secondary structure, virus detection and typing: The International HCV Collaborative Study Group. Journal of General Virology, 76, 1749-1761. doi:10.1099/0022-1317-76-7-1749

[4]   Global Burden of Disease (GBD) for Hepatitis (2004) The Global Burden of Hepatitis C Working Group. Pharmacology, 44, 20-29.

[5]   El-Zanaty, F. and Way, A. (2009) Egypt demographic and health survey 2008. Ministry of Health, El-Zanaty and Associates, and Macro International, Cairo.

[6]   Williams, I. (1999) Epidemiology of hepatitis C in the United States. American Journal of Medicine, 107, 2S-9S. doi:10.1016/S0002-9343(99)00373-3

[7]   Waheed, Y., Shafi, T., Safi, S.Z. and Qadri, I. (2009) Hepatitis C virus in Pakistan: A systematic review of prevalence, genotypes and risk factors. World Journal of Gastroenterology, 15, 5647-5653. doi:10.3748/wjg.15.5647

[8]   Caritter, R.L. and Emerson, S.S. (1997) Therapy of hepatitis—Meta analysis of interferon alpha 2b trials. Hepatology, 26, 835-885.

[9]   Fox, R.K. and Wright, T.L. (2003) Viral hepatitis: Current diagnosis and treatment. Gastroenterology, 2, 446-562.

[10]   Sherman, M., Shafran, S., Burak, K., Doucette, K., Wong, W., Girgrah, N., Yoshida, E., Renner, E., Wong, P. and Deschênes, M. (2007) Management of chronicnhepatitis C: Consensus guidelines. Canadian Journal of Gastroenterology, 21, 25C-34C.

[11]   Yoshioka, K., Kakumu, S. and Wakita, T. (1992) Detection of hepatitis C virus bypolymerase chain reaction and response to interferon-a therapy: Relationship to genotypes of hepatitis C virus. Hepatology, 16, 293-299. doi:10.1002/hep.1840160203

[12]   Ahmad, W., Ijaz, B., Javed, T.F., Jahan, S., Shahid, I., Khan, F.M. and Hassan, S. (2010) HCV genotype distribution and possible transmission risks in Lahore, Pakistan. World Journal of Gastroenterology, 16, 4321-4328. doi:10.3748/wjg.v16.i34.4321

[13]   Lee, Y.S., Yoon, S.K., Chung, E.S., Bae, S.H., Choi, J.Y., Han, J.Y., Chung, K.W., Sun, H.S., Kim, B.S. and Kim, B.K. (2001) The relationship of histologic activity to serum ALT, HCV genotype and HCV RNA titers in chronic hepatitis C. Journal of Korean Medical Science, 16, 585-591.

[14]   Dienstag, J.L. and Alter, H.J. (1986) Non-A, non-B hepatitis: Evolving epidemiologic and clinical perspective. Seminars in Liver Disease, 6, 67-81. doi:10.1055/s-2008-1040795

[15]   Tassopoulos, N.C. (1999) Treatment of patients with chronic hepatitis C and normal ALT levels. Journal of Hepatology, 31, 193-196. doi:10.1016/S0168-8278(99)80400-0

[16]   Carreno, V. (2006)Occult hepatitis C virus infection: A new form of hepatitis C. World Journal of Gastroenterology, 12, 6922-6925.

[17]   Franciscus, A. (2012) Hepatitis C basics. Hepatitis C Support Project Vesion.

[18]   Franciscus, A. and Highleyman, L. (2012) HCSP fact sheet: HCV diagnostic tools (Version 4).

[19]   Raza, S.A., Clifford, G.M. and Franceschi, S. (2007) Worldwide variation in the relative importance of hepatitis B and hepatitis C viruses in hepato cellular carcinoma: A systematic review. British Journal of Cancer, 96, 1127-1134. doi:10.1038/sj.bjc.6603649

[20]   Khan, S., Rai, M.A., Khan, A., Farooq, A., Kazmi, S.U. and Ali, S.H. (2008) Prevalence of HCV and HIV infections in 2005-Earthquak areas of Pakistan. BMC Infectious Diseases, 8, 147. doi:10.1186/1471-2334-8-147

[21]   Anonymous (1999) Global surveillance and control of hepatitis C. Journal of Viral Hepatitis, 6, 35-47. doi:10.1046/j.1365-2893.1999.6120139.x

[22]   Waheed, Y., Shafi, T., Safi, S.Z. and Qadri, I. (2009) Hepatitis C virus in Pakistan: A systematic review of prevalence, genotypes and risk factors. World Journal of Gastroenterology, 15, 5647-5653. doi:10.3748/wjg.15.5647

[23]   Ali, S.A., Donahue, R.M.J., Qureshi, H. and Vermund, S.H. (2010) Hepatitis B and hepatitis C in Pakistan prevalence and risk factors. International Journal of Infectious Diseases, 13, 9-19. doi:10.1016/j.ijid.2008.06.019

[24]   Umar, M., Bushra, H., Ahmad, M., Khurram, M., Usman, S., Arif, M., Adam, T., Minhas, Z., Arif, A., Naeem, A., Ejaz, K., Butt, Z. and Bilal, M. (2010) Hepatitis C in Pakistan: A review of available data. Hepatitis Monthly, 10, 205-214.

[25]   Ali, A., Ahmad, H., Ali, I., Khan, S., Zaidi, G. and Idrees, M. (2010) Prevalence of active hepatitis c virus infection in district mansehra Pakistan. Virology Journal, 7, 334. doi:10.1186/1743-422X-7-334

[26]   Zechini, B., Pasquazzi, C. and Aceti, A. (2004) Correlation of serum aminotransferase with HCV RNA levels and histological findings in patients with chronic hepatitis C: The role of serum aspartate transaminase in the evaluation of disease progression. European Journal of Gastroenterology & Hepatology, 16, 891-896.

[27]   Lee, Y.S., Yoon, S.K., Chung, E.S., et al. (2001) The Relationship of histologic activity to serum ALT, HCV genotype and HCV RNA titers in chronic hepatitis C. Journal of Korean Medical Science, 16, 585-591.

[28]   Jensen, M.D., Morgan, T.R., Mercellin, P., Pockros, T.J., Reddy, K.R., Hadziyannis, S.J., Ferenci, P., et al. (2006) Early identification of HCV genotype 1 patients responding to 24 weeks peginterferon-2a (40 kd)/ribavirin therapy. Hepatology, 43, 954-960. doi:10.1002/hep.21159

[29]   Bell, H., Hellum, K. and Harthug, S. (1997) Genotype, viral load and age as independent predictors of treatment outcome of interferon-a 2a treatment in patients with chronic hepatitis C. Scandinavian Journal of Infectious Diseases, 29, 17-22. doi:10.3109/00365549709008658

[30]   Jimenez-Mendez, R., Uribe-Salas, F., López-Guillen, P., Cisneros-Garza, L. and Castaneda-Hernandez, G. (2010) Distribution of HCV genotypes and HCV RNA viral load in different geographical regions of Mexico. Annals of Hepatology, 9, 33-39.

 
 
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