Skip to main content
Top
Published in: BMC Infectious Diseases 1/2008

Open Access 01-12-2008 | Research article

Frequency distribution of hepatitis C virus genotypes in different geographical regions of Pakistan and their possible routes of transmission

Authors: Muhammad Idrees, Sheikh Riazuddin

Published in: BMC Infectious Diseases | Issue 1/2008

Login to get access

Abstract

Background

Information regarding hepatitis C virus genotypes and subtypes circulating in Pakistan and various risk factors for their transmission are not known well. The specific objective of this study was to find out the frequency of various HCV genotypes present in well-characterized Pakistani HCV isolates and their possible routes of transmission.

Methods

A total of 3351 serum samples were tested by type-specific genotyping assay. Out of 3351 HCV RNA positive patients, 2039 were males and 1312 were females. As regard as genotyped samples, 2165 belonged to Punjab region, 823 belonged to N.W.F.P., 239 to Sindh and 124 patients were from Balochistan.

Results

Out of the total 3351 tested serum samples, type-specific PCR fragments were observed in 3150 (94.00%) serum samples. The distribution of genotypes of the typeable samples as determined by this assay, was as follows: 1664 (49.05%) genotype 3a; 592 (17.66%) genotype 3b; 280 (8.35%) genotype 1a; 252 (7.52%) genotype 2a; 101 (3.01%) genotype 1b; 50 (1.49%) with genotype 4; 25 (0.75%) with 3c; 27 (0.80%) genotype 2b; 6 (0.18%) with subtype 5a; 5 (0.15%) genotype 1c; 4 (0.12%) with subtype 6a; 3 (0.09%) genotype 2c; and 161 (4.80%) patients were infected with mixed infection. Two hundred and one (5.99%) serum samples were found untypeable by the present genotyping system. More than 86% and 72% patients with genotypes 3a and 3b respectively had received multiple injections in past. For genotypes 1a and 1b the route of transmission was major/minor surgery along with unknown reasons. Majority of the cases with type 2a, 2b and indeterminate genotypes were sporadic. Mixed infections were common in thalassaemic patients.

Conclusion

The most common HCV genotype in Pakistan is type 3a. Regional difference in genotypes was observed only in Balochistan province of Pakistan. More than 70% of the cases were acquired in hospitals through reuse of needles/syringes and major/minor surgery that is very common in this country.
Appendix
Available only for authorised users
Literature
1.
go back to reference Leiveven J: Pegasys/RBV Improves Fibrosis in Responders, relapsers & Nonresponders with Advanced Fibrosis. 55th Annual Meeting of the American Association for the Study of Liver Disease:. 2004, October 29 – November 2: Boston, MA, USA Leiveven J: Pegasys/RBV Improves Fibrosis in Responders, relapsers & Nonresponders with Advanced Fibrosis. 55th Annual Meeting of the American Association for the Study of Liver Disease:. 2004, October 29 – November 2: Boston, MA, USA
2.
go back to reference Zein NN, Persing DH: Hepatitis C Genotypes: current trends and future implications. Mayo Clin Proc. 1996, 71: 458-462.CrossRefPubMed Zein NN, Persing DH: Hepatitis C Genotypes: current trends and future implications. Mayo Clin Proc. 1996, 71: 458-462.CrossRefPubMed
3.
go back to reference Liew M, Erali M, Page S, Hillyard D, Wittwer C: Hepatitis C Genotyping by Denaturing High-Performance Liquid Chromatography. J Clin Microbiol. 2004, 42 (1): 158-163. 10.1128/JCM.42.1.158-163.2004.CrossRefPubMedPubMedCentral Liew M, Erali M, Page S, Hillyard D, Wittwer C: Hepatitis C Genotyping by Denaturing High-Performance Liquid Chromatography. J Clin Microbiol. 2004, 42 (1): 158-163. 10.1128/JCM.42.1.158-163.2004.CrossRefPubMedPubMedCentral
4.
go back to reference Zein NN, Rakela J, Krawitt EL, Reddy KR, Tominaga T, Persing DH: Hepatitis C virus genotypes in the United States: epidemiology, pathogenicity, and response to interferon therapy. Ann Intern Med. 1996, 125: 634-639.CrossRefPubMed Zein NN, Rakela J, Krawitt EL, Reddy KR, Tominaga T, Persing DH: Hepatitis C virus genotypes in the United States: epidemiology, pathogenicity, and response to interferon therapy. Ann Intern Med. 1996, 125: 634-639.CrossRefPubMed
5.
go back to reference Trepo C: Seminar on hepatitis C. European Commission Public Health Unit. 1994 Trepo C: Seminar on hepatitis C. European Commission Public Health Unit. 1994
6.
go back to reference Dusheiko G, Schmilovitz H, Brown D, McOmish F, Yap PL, Simmonds P: Hepatitis C virus genotypes: an investigation of type-specific differences in geographic origin and disease. Hepatology. 1996, 19: 13-18.CrossRef Dusheiko G, Schmilovitz H, Brown D, McOmish F, Yap PL, Simmonds P: Hepatitis C virus genotypes: an investigation of type-specific differences in geographic origin and disease. Hepatology. 1996, 19: 13-18.CrossRef
7.
go back to reference McHutchison JG, Gordon SC, Schiff ER, Shiffman ML, Lee WM, Rustgi VK, Goodman ZD: Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. Hepatitis Interventional Therapy Group. N Engl J Med. 1998, 339: 1485-1492. 10.1056/NEJM199811193392101.CrossRefPubMed McHutchison JG, Gordon SC, Schiff ER, Shiffman ML, Lee WM, Rustgi VK, Goodman ZD: Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. Hepatitis Interventional Therapy Group. N Engl J Med. 1998, 339: 1485-1492. 10.1056/NEJM199811193392101.CrossRefPubMed
8.
go back to reference Poynard T, Marcellin P, Lee SS, Niederau C, Minuk GS, Ideo G, Bain V: Randomised trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus. Lancet. 1998, International Hepatitis Interventional Therapy Group (IHIT), 352: 1426-1432. 10.1016/S0140-6736(98)07124-4. Poynard T, Marcellin P, Lee SS, Niederau C, Minuk GS, Ideo G, Bain V: Randomised trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus. Lancet. 1998, International Hepatitis Interventional Therapy Group (IHIT), 352: 1426-1432. 10.1016/S0140-6736(98)07124-4.
9.
go back to reference McOmish F, Yap PIL, Dow BC, Follett EAC, Seed C, Keller AJ, Cobain TJ, Krusius T, Kolho E, Naukkarinen R, Lin C, Lai C, Leong S, Medgyesi GA, Heéjjas M, Kiyokawa H, Fukada K, Cuypers T, Saeed AA, Al-Rasheed AM, Lin M, Simmonds P: Geographic distribution of hepatitis C virus genotypes in blood donors: an international collaborative survey. J Clin Microbiol. 1994, 32: 884-92.PubMedPubMedCentral McOmish F, Yap PIL, Dow BC, Follett EAC, Seed C, Keller AJ, Cobain TJ, Krusius T, Kolho E, Naukkarinen R, Lin C, Lai C, Leong S, Medgyesi GA, Heéjjas M, Kiyokawa H, Fukada K, Cuypers T, Saeed AA, Al-Rasheed AM, Lin M, Simmonds P: Geographic distribution of hepatitis C virus genotypes in blood donors: an international collaborative survey. J Clin Microbiol. 1994, 32: 884-92.PubMedPubMedCentral
10.
go back to reference Dusheiko G, Main J, Thomas H: Ribavirin treatment for patients with chronic hepatitis C: results of a placebo-controlled study. J Hepatol. 1994, 25 (5): 591-8. 10.1016/S0168-8278(96)80225-X.CrossRef Dusheiko G, Main J, Thomas H: Ribavirin treatment for patients with chronic hepatitis C: results of a placebo-controlled study. J Hepatol. 1994, 25 (5): 591-8. 10.1016/S0168-8278(96)80225-X.CrossRef
11.
go back to reference Nousbaum JB, Pol S, Nalpas B, Landais P, Berthelot P, Brechot C, the Collaborative Study Group: Hepatitis C virus type 1b (II) infection in France and Italy. Ann Intern Med. 1995, 122: 161-168.CrossRefPubMed Nousbaum JB, Pol S, Nalpas B, Landais P, Berthelot P, Brechot C, the Collaborative Study Group: Hepatitis C virus type 1b (II) infection in France and Italy. Ann Intern Med. 1995, 122: 161-168.CrossRefPubMed
12.
go back to reference Takada NS, Takase S, Takada A, Date T: Differences in the hepatitis C virus genotypes in different countries. J Hepatol. 1993, 17: 277-283. 10.1016/S0168-8278(05)80205-3.CrossRefPubMed Takada NS, Takase S, Takada A, Date T: Differences in the hepatitis C virus genotypes in different countries. J Hepatol. 1993, 17: 277-283. 10.1016/S0168-8278(05)80205-3.CrossRefPubMed
13.
go back to reference Abdulkarim AS, Zein NN, Germer JJ, Kolbert CP, Kabbani L, Krajnik KL, Hola A, Agha MN, Tourogman M, Persing DH: Hepatitis C virus genotypes and hepatitis G virus in hemodialysis patients from Syria: identification of two novel hepatitis C virus subtypes. Am J Trop Med Hyg. 1998, 59: 571-576.PubMed Abdulkarim AS, Zein NN, Germer JJ, Kolbert CP, Kabbani L, Krajnik KL, Hola A, Agha MN, Tourogman M, Persing DH: Hepatitis C virus genotypes and hepatitis G virus in hemodialysis patients from Syria: identification of two novel hepatitis C virus subtypes. Am J Trop Med Hyg. 1998, 59: 571-576.PubMed
14.
go back to reference Chamberlain RW, Adams N, Saeed AA, Simmonds P, Elliot RM: Complete nucleotide sequence of a type 4 hepatitis C virus variant, the predominantgenotype in the Middle East. J Gen Virol. 1997, 78: 1341-1347.CrossRefPubMed Chamberlain RW, Adams N, Saeed AA, Simmonds P, Elliot RM: Complete nucleotide sequence of a type 4 hepatitis C virus variant, the predominantgenotype in the Middle East. J Gen Virol. 1997, 78: 1341-1347.CrossRefPubMed
15.
go back to reference Simmonds P, Holmes EC, Cha TA, Chan SW, McOmish F, Irvine B, Beall E, Yap PL, Kolberg J, Urdea MS: Classification of hepatitis C virus into six major genotypes and a series of subtypes by phylogenetic analysis of the NS-5 region. J Gen Virol. 1993, 74: 2391-9.CrossRefPubMed Simmonds P, Holmes EC, Cha TA, Chan SW, McOmish F, Irvine B, Beall E, Yap PL, Kolberg J, Urdea MS: Classification of hepatitis C virus into six major genotypes and a series of subtypes by phylogenetic analysis of the NS-5 region. J Gen Virol. 1993, 74: 2391-9.CrossRefPubMed
16.
go back to reference Cha TA, Kolberg J, Irvine B, Stempien M, Beall E, Yano M, Choo QL, Houghton M, Kuo G, Han JH, Urdea MS: Use of a signature nucleotide sequence of hepatitis C virus for detection of viral RNA in human serum and plasma. J Clin Microbiol. 1992, 29: 2528-2534. Cha TA, Kolberg J, Irvine B, Stempien M, Beall E, Yano M, Choo QL, Houghton M, Kuo G, Han JH, Urdea MS: Use of a signature nucleotide sequence of hepatitis C virus for detection of viral RNA in human serum and plasma. J Clin Microbiol. 1992, 29: 2528-2534.
17.
go back to reference Tokita H, Shrestha SM, Okamoto H, Sakamoto M, Horikita M, Iizuka H, Shrestha S, Miyakawa Y, Mayumi M: Hepatitis C virus variants from Nepal with novel genotypes and their classification into the third major group. J Gen Virol. 1994, 75: 931-936.CrossRefPubMed Tokita H, Shrestha SM, Okamoto H, Sakamoto M, Horikita M, Iizuka H, Shrestha S, Miyakawa Y, Mayumi M: Hepatitis C virus variants from Nepal with novel genotypes and their classification into the third major group. J Gen Virol. 1994, 75: 931-936.CrossRefPubMed
18.
go back to reference Tokita H, Okamoto H, Iizuka H, Kishimoto H, Tsuda F, Lesmana LA, Miyakawa Y, Mayumi M: Hepatitis C virus variants from Jakarta, Indonesia classifiable into novel genotypes in the second (2e and 2f), tenth (10a) and eleventh (11a) genetic groups. J Gen Virol. 1996, 77: 293-301.CrossRefPubMed Tokita H, Okamoto H, Iizuka H, Kishimoto H, Tsuda F, Lesmana LA, Miyakawa Y, Mayumi M: Hepatitis C virus variants from Jakarta, Indonesia classifiable into novel genotypes in the second (2e and 2f), tenth (10a) and eleventh (11a) genetic groups. J Gen Virol. 1996, 77: 293-301.CrossRefPubMed
19.
go back to reference deLamballerie X, Charrel RN, Attoui H, De Micco P: Classification of hepatitis C virus variants in six major types based on analysis of the envelope 1 and nonstructural 5B genome regions and complete polyprotein sequences. J Gen Virol. 1997, 78: 45-51.CrossRef deLamballerie X, Charrel RN, Attoui H, De Micco P: Classification of hepatitis C virus variants in six major types based on analysis of the envelope 1 and nonstructural 5B genome regions and complete polyprotein sequences. J Gen Virol. 1997, 78: 45-51.CrossRef
20.
go back to reference Tokita H, Okamoto H, Iizuka H, Kishimoto J, Tsuda F, Miyakawa Y, Mayumi M: The entire nucleotide sequences of three hepatitis C virus isolates in genetic groups 7–9 and comparison with those in the other eight genetic groups. J Gen Virol. 1998, 79: 1847-1857.CrossRefPubMed Tokita H, Okamoto H, Iizuka H, Kishimoto J, Tsuda F, Miyakawa Y, Mayumi M: The entire nucleotide sequences of three hepatitis C virus isolates in genetic groups 7–9 and comparison with those in the other eight genetic groups. J Gen Virol. 1998, 79: 1847-1857.CrossRefPubMed
21.
go back to reference Idrees M: Detection of Six Serotypes of HCV in anti-HCV Positive Patients and rate of ALT/AST abnormalities. Pak J Microbiol. 2001, 1 (2): 61-65. Idrees M: Detection of Six Serotypes of HCV in anti-HCV Positive Patients and rate of ALT/AST abnormalities. Pak J Microbiol. 2001, 1 (2): 61-65.
22.
go back to reference Shah HA, Jafri WS, Malik I, Prescott L, Simmonds P: Hepatitis C virus (HCV) genotypes and chronic liver disease in Pakistan. J Gastroenterol Hepatol. 1997, 12: 758-761. 10.1111/j.1440-1746.1997.tb00366.x.CrossRefPubMed Shah HA, Jafri WS, Malik I, Prescott L, Simmonds P: Hepatitis C virus (HCV) genotypes and chronic liver disease in Pakistan. J Gastroenterol Hepatol. 1997, 12: 758-761. 10.1111/j.1440-1746.1997.tb00366.x.CrossRefPubMed
23.
go back to reference Idrees M: Common genotypes of hepatitis C virus present in Pakistan. Pak J Med Res. 2001, 40 (2): 46-49. Idrees M: Common genotypes of hepatitis C virus present in Pakistan. Pak J Med Res. 2001, 40 (2): 46-49.
24.
go back to reference Idrees M: Development of an improved HCV Genotyping Assay for the Detection of Common Genotypes and subtypes in Pakistan. J Virol Meth. 2008, 150 (1): 50-56. 10.1016/j.jviromet.2008.03.001.CrossRef Idrees M: Development of an improved HCV Genotyping Assay for the Detection of Common Genotypes and subtypes in Pakistan. J Virol Meth. 2008, 150 (1): 50-56. 10.1016/j.jviromet.2008.03.001.CrossRef
25.
go back to reference Poynard T, Bedossa P, Chevallier M, Matturin P, Lemonnier C, Trepo C: A comparison of three Interferon alpha 2b regimens for long terms treatment of chronic non A, non B hepatitis. N Engl J Med. 1995, 332: 1457-62. 10.1056/NEJM199506013322201.CrossRefPubMed Poynard T, Bedossa P, Chevallier M, Matturin P, Lemonnier C, Trepo C: A comparison of three Interferon alpha 2b regimens for long terms treatment of chronic non A, non B hepatitis. N Engl J Med. 1995, 332: 1457-62. 10.1056/NEJM199506013322201.CrossRefPubMed
26.
go back to reference Davis GL, Esteban-Mur R, Rustgi V, Hoefs J, Gordon SC, Trepo C, Shiffman ML, Zeuzem S, Craxì A, Ling MH, Alvrecht J: Interferon alpha-2b alone or in combination with ribavirin for the treatment of relapse of chronic hepatitis C. N Engl J Med. 1998, 339: 1493-1499. 10.1056/NEJM199811193392102.CrossRefPubMed Davis GL, Esteban-Mur R, Rustgi V, Hoefs J, Gordon SC, Trepo C, Shiffman ML, Zeuzem S, Craxì A, Ling MH, Alvrecht J: Interferon alpha-2b alone or in combination with ribavirin for the treatment of relapse of chronic hepatitis C. N Engl J Med. 1998, 339: 1493-1499. 10.1056/NEJM199811193392102.CrossRefPubMed
27.
go back to reference McHutchison JG, Poynard T, Davis GL, Esteban-Mur R, Harvey J, Ling M, Cort S, Fraud JJ, Albrecht J, Dienstag J: Evaluation of hepatic HCV RNA before and after treatment with interferon alfa 2b or combined with ribavirin in chronic hepatitis. Hepatology. 1999, 30 (Suppl 2): 363A- McHutchison JG, Poynard T, Davis GL, Esteban-Mur R, Harvey J, Ling M, Cort S, Fraud JJ, Albrecht J, Dienstag J: Evaluation of hepatic HCV RNA before and after treatment with interferon alfa 2b or combined with ribavirin in chronic hepatitis. Hepatology. 1999, 30 (Suppl 2): 363A-
28.
go back to reference Nausbaum JB, Pol S, Nalpas B, Landras P, Berthelot P, Brechot C: Hepatitis C virus type 1b(II) infection in France and Italy. Ann Intern Med. 1995, 12: 161-8.CrossRef Nausbaum JB, Pol S, Nalpas B, Landras P, Berthelot P, Brechot C: Hepatitis C virus type 1b(II) infection in France and Italy. Ann Intern Med. 1995, 12: 161-8.CrossRef
29.
go back to reference McOmish F, Chan SW, Dow BC, Gillon J, Frame WD, Crawford RJ, Yap PL, Follett EAC, Simmonds P: Detection of three types of hepatitis C virus in blood donors: investigation of type specific differences in serologic reactivity and rate of alanine aminotransferase abnormalities. Transfusion. 1993, 33: 7-13. 10.1046/j.1537-2995.1993.33193142314.x.CrossRefPubMed McOmish F, Chan SW, Dow BC, Gillon J, Frame WD, Crawford RJ, Yap PL, Follett EAC, Simmonds P: Detection of three types of hepatitis C virus in blood donors: investigation of type specific differences in serologic reactivity and rate of alanine aminotransferase abnormalities. Transfusion. 1993, 33: 7-13. 10.1046/j.1537-2995.1993.33193142314.x.CrossRefPubMed
30.
go back to reference Jarvis LM, Ludlam CA, Ellender JA, Nemes L, Field SP, Song E, Chuansumrit A, Preston FE, Simmonds P: Investigation of the relative infectivity and pathogenicity of different hepatitis C virus genotypes in hemophiliacs. Blood. 1996, 87: 3007-11.PubMed Jarvis LM, Ludlam CA, Ellender JA, Nemes L, Field SP, Song E, Chuansumrit A, Preston FE, Simmonds P: Investigation of the relative infectivity and pathogenicity of different hepatitis C virus genotypes in hemophiliacs. Blood. 1996, 87: 3007-11.PubMed
31.
go back to reference Pár A, Gervain J, Gógl A: Hepatitis C virus infection: pathogenesis, diagnosis and treatment. Scand J Gastroenterol Suppl. 1998, 228: 107-14. 10.1080/003655298750026633.PubMed Pár A, Gervain J, Gógl A: Hepatitis C virus infection: pathogenesis, diagnosis and treatment. Scand J Gastroenterol Suppl. 1998, 228: 107-14. 10.1080/003655298750026633.PubMed
32.
go back to reference Chowdhury A, Santra A, Chaudhuri S, Dhali GK, Chaudhuri S, Maity SG, Naik TN, Bhattacharya SK, Mazumder DN: Hepatitis c virus infection in the general population: a community-based study in west bengal, india. Hepatology. 2003, 37 (4): 802-9. 10.1053/jhep.2003.50157.CrossRefPubMed Chowdhury A, Santra A, Chaudhuri S, Dhali GK, Chaudhuri S, Maity SG, Naik TN, Bhattacharya SK, Mazumder DN: Hepatitis c virus infection in the general population: a community-based study in west bengal, india. Hepatology. 2003, 37 (4): 802-9. 10.1053/jhep.2003.50157.CrossRefPubMed
33.
go back to reference Singh B, Verma M, Verma K: Markers for transfusion-associated hepatitis in north Indian blood donors: prevalence and trends. Jpn J Infect Dis. 2004, 57 (2): 49-51.PubMed Singh B, Verma M, Verma K: Markers for transfusion-associated hepatitis in north Indian blood donors: prevalence and trends. Jpn J Infect Dis. 2004, 57 (2): 49-51.PubMed
34.
go back to reference Shinji T, Kyaw Y, Gokan K, Tanaka Y, Ochi K: Analysis of HCV genotypes from blood donors shows three new HCV types 6 subgroups exist in Myanmar. Acta Med Okayama. 2004, 58 (3): 135-42.PubMed Shinji T, Kyaw Y, Gokan K, Tanaka Y, Ochi K: Analysis of HCV genotypes from blood donors shows three new HCV types 6 subgroups exist in Myanmar. Acta Med Okayama. 2004, 58 (3): 135-42.PubMed
35.
go back to reference Tokita H, Okamoto H, Luengrojanakul P, Vareesangthip K, Chainuvati T, Iizuka H, Tsuda F, Miyakawa Y, Mayumi M: Hepatitis C virus variants from Thailand classifiable into five novel genotypes in the sixth (6b), seventh (7c, 7d) and ninth (9b, 9c) major genetic groups. J Gen Virol. 1995, 76: 2329-2335.CrossRefPubMed Tokita H, Okamoto H, Luengrojanakul P, Vareesangthip K, Chainuvati T, Iizuka H, Tsuda F, Miyakawa Y, Mayumi M: Hepatitis C virus variants from Thailand classifiable into five novel genotypes in the sixth (6b), seventh (7c, 7d) and ninth (9b, 9c) major genetic groups. J Gen Virol. 1995, 76: 2329-2335.CrossRefPubMed
36.
go back to reference Flor PH, Loureiro , Carmen LLic: Replacement of hepatitis C virus genotype 1b by genotype 2 over a 10 year period in Venezuela. J Clin Gastroenterl. 2007, 41 (5): 518-520. 10.1097/01.mcg.0000248010.55149.ce.CrossRef Flor PH, Loureiro , Carmen LLic: Replacement of hepatitis C virus genotype 1b by genotype 2 over a 10 year period in Venezuela. J Clin Gastroenterl. 2007, 41 (5): 518-520. 10.1097/01.mcg.0000248010.55149.ce.CrossRef
37.
go back to reference el-Zayadi A, Simmonds P, Dabbous H: Response to interferon-alpha of Egyptian patients infected with hepatitis C virus genotype 4. J Viral Hepat. 1996, 3: 261-64. 10.1111/j.1365-2893.1996.tb00052.x.CrossRefPubMed el-Zayadi A, Simmonds P, Dabbous H: Response to interferon-alpha of Egyptian patients infected with hepatitis C virus genotype 4. J Viral Hepat. 1996, 3: 261-64. 10.1111/j.1365-2893.1996.tb00052.x.CrossRefPubMed
38.
go back to reference Xu LZ, Larzul D, Delaporte E: Hepatitis C virus genotype 4 is highly prevalent in central Africa (Gabon). J Gen Virol. 1994, 75: 2393-98.CrossRefPubMed Xu LZ, Larzul D, Delaporte E: Hepatitis C virus genotype 4 is highly prevalent in central Africa (Gabon). J Gen Virol. 1994, 75: 2393-98.CrossRefPubMed
39.
go back to reference Lyra Andre, Ramrakhiani Sunil, Bacon Bruce, Di Bisceglie Adrian: Infection with Hepatitis C virus Genotype 4 in the United States. J Clin Gastroenterol. 2004, 38 (1): 68-71. 10.1097/00004836-200401000-00014.CrossRefPubMed Lyra Andre, Ramrakhiani Sunil, Bacon Bruce, Di Bisceglie Adrian: Infection with Hepatitis C virus Genotype 4 in the United States. J Clin Gastroenterol. 2004, 38 (1): 68-71. 10.1097/00004836-200401000-00014.CrossRefPubMed
40.
go back to reference Kabir A, Alavian SM, Keyvani H: Distribution of hepatitis C virus in patients infected by different sources and its correlation with clinical and virological parameters: A preliminary study. Comparative Hepatology. 2006, 5: 4-10.1186/1476-5926-5-4. doi:10.1186/1476-5926-5-4CrossRefPubMedPubMedCentral Kabir A, Alavian SM, Keyvani H: Distribution of hepatitis C virus in patients infected by different sources and its correlation with clinical and virological parameters: A preliminary study. Comparative Hepatology. 2006, 5: 4-10.1186/1476-5926-5-4. doi:10.1186/1476-5926-5-4CrossRefPubMedPubMedCentral
41.
go back to reference Benani A, El-Turk J, Benjelloun S, Sekkat S, Nadifi S, Hda N, Benslimane A: HCV genotypes in Morocco. J Med Virol. 1997, 52 (4): 396-8. 10.1002/(SICI)1096-9071(199708)52:4<396::AID-JMV9>3.0.CO;2-X.CrossRefPubMed Benani A, El-Turk J, Benjelloun S, Sekkat S, Nadifi S, Hda N, Benslimane A: HCV genotypes in Morocco. J Med Virol. 1997, 52 (4): 396-8. 10.1002/(SICI)1096-9071(199708)52:4<396::AID-JMV9>3.0.CO;2-X.CrossRefPubMed
42.
go back to reference Pawlotsky JM, Dussaix E, Simmonds P, Prescott L, Pellet C, Lau-rent-Puig P, Labonne C, Remire J, Darthuy F, Duval J, Buffet C, Etienne JP, Dhumeaux D: Hepatitis C virus (HCV) genotype determination: genotyping versus serotyping. Hepatology. 1995, 22: 359A-10.1016/0270-9139(95)95098-2.CrossRef Pawlotsky JM, Dussaix E, Simmonds P, Prescott L, Pellet C, Lau-rent-Puig P, Labonne C, Remire J, Darthuy F, Duval J, Buffet C, Etienne JP, Dhumeaux D: Hepatitis C virus (HCV) genotype determination: genotyping versus serotyping. Hepatology. 1995, 22: 359A-10.1016/0270-9139(95)95098-2.CrossRef
43.
go back to reference Pawlotsky JM, Bastie A, Pellet C: Significance of indeterminate third-generation hepatitis C virus recombinant Immunoblot assay. J Clin Microbiol. 1996, 34: 80-83.PubMedPubMedCentral Pawlotsky JM, Bastie A, Pellet C: Significance of indeterminate third-generation hepatitis C virus recombinant Immunoblot assay. J Clin Microbiol. 1996, 34: 80-83.PubMedPubMedCentral
44.
go back to reference Khan AJ: Unsafe injections and the transmission of hepatitis B and C in a Periurban community in Pakistan. Bull World Health Organ. 2000, 78: 956-963.PubMedPubMedCentral Khan AJ: Unsafe injections and the transmission of hepatitis B and C in a Periurban community in Pakistan. Bull World Health Organ. 2000, 78: 956-963.PubMedPubMedCentral
45.
go back to reference Jafri W, Jafri N, Yakoob J, Islam M, Tirmizi SFA, Jafar T: Hepatitis B and C: prevalence and risk factors associated with seropositivity among children in Karachi, Pakistan. BMC Infect Dis. 2006, 6: 101-10.1186/1471-2334-6-101.CrossRefPubMedPubMedCentral Jafri W, Jafri N, Yakoob J, Islam M, Tirmizi SFA, Jafar T: Hepatitis B and C: prevalence and risk factors associated with seropositivity among children in Karachi, Pakistan. BMC Infect Dis. 2006, 6: 101-10.1186/1471-2334-6-101.CrossRefPubMedPubMedCentral
46.
go back to reference Ministry of Health, Annual report, Director General Health, 2001–2002. Government of Pakistan. 2002 Ministry of Health, Annual report, Director General Health, 2001–2002. Government of Pakistan. 2002
Metadata
Title
Frequency distribution of hepatitis C virus genotypes in different geographical regions of Pakistan and their possible routes of transmission
Authors
Muhammad Idrees
Sheikh Riazuddin
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2008
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-8-69

Other articles of this Issue 1/2008

BMC Infectious Diseases 1/2008 Go to the issue