Bulut Mehmet Emin, Topalca Ummuhan Su, Murat Ali, Teke Leyla, Canalp Hazan Zengin, Ocal Murat, Bayraktar Banu
Department of Medical Microbiology, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul Turkey.
Department of Medical Microbiology, Necip Fazıl City Hospital, Kahramanmaras, Turkey.
Sisli Etfal Hastan Tıp Bul. 2021 Mar 17;55(1):86-92. doi: 10.14744/SEMB.2020.66990. eCollection 2021.
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.
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.
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.
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.
丙型肝炎病毒（HCV）是慢性肝炎的常见病因，对公共卫生构成严重威胁，且尚无保护性疫苗。HCV基因组不同区域的核苷酸和氨基酸序列存在差异，据此HCV至少有七种主要基因型和许多亚型。在土耳其，1型基因型的流行率在51.7%至97.1%之间，是所有基因型中最高的，而1b亚型是比率最高的基因型。可靠检测混合基因型感染很重要，因为它会导致治疗失败。本研究旨在揭示多年来伊斯坦布尔我院HCV基因型的分布情况，并为土耳其的流行病学数据提供参考。
为此，回顾性评估了2016年1月至2019年6月间送往锡斯利哈米迪耶埃法尔培训和研究医院临床微生物实验室进行HCV基因型测定的385份患者样本。通过酶免疫测定法筛查抗HCV，并通过线性免疫测定法进行确认。使用针对高度保守的5'UTR和最可变区域NS5B区域的HCV基因分型检测方法。
最常见的基因型是1型（81.3%），共313例，1a和1b亚型的检出率分别为10.9%和67.8%。此外，3型、2型、4型、5型基因型的检出率分别为8.8%、3.4%、2.9%、0.8%，2.9%的病例为混合基因型。5型基因型虽在南非可见，但在中东地区也有发现，不过比率较低。在我们的研究中，观察到5型基因型在不同年份从叙利亚裔患者中检出。
在本研究中，1型基因型是最常见的基因型，比率为81.3%，1b亚型为67.8%，与文献一致。然而，3型、2型、4型和5型基因型的比率也较低。监测这些罕见基因型很重要，因为其中一些在周边国家占主导地位。此外，检测到2.9%的HCV混合基因型，在HCV感染管理中应予以考虑。
