Buruk Celal Kurtuluş, Bayramoğlu Gülçin, Reis Ahu, Kaklıkkaya Neşe, Tosun Ilknur, Aydın Faruk
Karadeniz Technical University Faculty of Medicine, Department of Medical Microbiology, Trabzon, Turkey.
Mikrobiyol Bul. 2013 Oct;47(4):650-7. doi: 10.5578/mb.5796.
Hepatitis C virus (HCV), the major cause of transfusion-associated hepatitis, is an important public health problem in the world as well as in Turkey. HCV is grouped as six distinct genotypes and a large number of closely-related subtypes. Genotyping of HCV is an important tool for providing epidemiological data, prediction of prognosis, and optimization of antiviral therapy. This study was carried out to determine the distribution of HCV genotypes in hepatitis C patients residing in different provinces of the Eastern Black Sea Region, Turkey. A total of 304 HCV-RNA positive cases (151 male, 153 female; age range: 11-93 years, mean age: 55.2 ± 13.3 years) who were admitted to the Molecular Microbiology Unit of Department of Medical Microbiology, Karadeniz Technical University Faculty of Medicine, between January 2009 to December 2012, were included in the study. HCV genotypes were detected in plasma samples of the patients by using commercial assays [INNO-LiPA HCV II (Innogenetics, Belgium) or Abbott RealTime HCV Genotype II (Abbott Molecular Inc, USA)]. Due to the ambiguous genotyping results in some samples with these methods, an in-house multiplex polymerase chain reaction (PCR) assay with genotype-specific primers was also used in the study. Similar to the previous reports from Turkey, our results showed that four HCV genotypes (1, 2, 3, and 4) prevailed in the Eastern Black Sea Region and the predominant genotype and subtype were genotype 1 (92.8%) and 1b (87.5%), respectively. Distribution of genotypes were observed to vary according to the province. Prevalences of subtype 1a, genotype 2, 3, and 4 were noted as 5.3%, 1.6%, 4.9%, and 0.7%, respectively. Furthermore, the samples from Giresun, Gumushane and Bayburt provinces, which are relatively less immigrated, had higher genotype 1, and the prevalence rates in the region was affected by the presence of non-citizen residents. This study is the first report on distribution of HCV genotypes in chronic hepatitis C patients living in the provinces of Eastern Black Sea Region. Moreover, genotype-specific multiplex PCR assay could be useful in resolving certain methodological problems such as "ghost bands" encountered in line probe assay (LiPA) and multiple genotypes (including genotype 4) observed in real-time PCR during the characterization of HCV genotypes seen in Turkey.
丙型肝炎病毒(HCV)是输血相关肝炎的主要病因,在世界范围内以及土耳其都是一个重要的公共卫生问题。HCV可分为六种不同的基因型和大量密切相关的亚型。HCV基因分型是提供流行病学数据、预测预后以及优化抗病毒治疗的重要工具。本研究旨在确定居住在土耳其黑海东部地区不同省份的丙型肝炎患者中HCV基因型的分布情况。
2009年1月至2012年12月期间,共有304例HCV - RNA阳性病例(男性151例,女性153例;年龄范围:11 - 93岁,平均年龄:55.2±13.3岁)被纳入研究,这些病例均入住了特拉布宗技术大学医学院医学微生物学系分子微生物学单元。通过使用商业检测方法[INNO - LiPA HCV II(比利时Innogenetics公司)或雅培实时HCV基因型II(美国雅培分子公司)]在患者的血浆样本中检测HCV基因型。由于使用这些方法在一些样本中基因分型结果不明确,本研究还使用了一种内部多重聚合酶链反应(PCR)检测方法,该方法使用了基因型特异性引物。
与土耳其之前的报告相似,我们的结果显示,四种HCV基因型(1、2、3和4)在黑海东部地区占主导地位,主要的基因型和亚型分别是基因型1(92.8%)和1b(87.5%)。观察到基因型的分布因省份而异。亚型1a、基因型2、3和4的流行率分别为5.3%、1.6%、4.9%和0.7%。此外,来自相对较少移民的吉雷松省、居穆什哈内省和巴伊布尔特省的样本中,基因型1的比例较高,该地区的流行率受到非公民居民存在情况的影响。
本研究是关于居住在黑海东部地区省份的慢性丙型肝炎患者中HCV基因型分布的首次报告。此外,基因型特异性多重PCR检测方法可能有助于解决某些方法学问题,如在土耳其观察到的HCV基因型特征分析过程中,在线性探针检测(LiPA)中遇到的“幽灵带”以及实时PCR中观察到的多种基因型(包括基因型4)等问题。