This document discusses the prevalence of hepatitis C virus (HCV) genotypes in Punjab, Pakistan. It finds that genotype 3a is the most prevalent, accounting for 87% of cases. The second most common is genotype 3b at 1%. Mixed infections and untypeable genotypes accounted for 1% and 7% of cases, respectively. A review of previous studies on HCV genotype distribution across Pakistan found that genotype 3a is dominant nationwide, ranging from 49-79% of cases in different provinces, while genotype 1a and 3b are also relatively common. Determining HCV genotypes is important for treatment and reducing the disease burden.

1. Aleena Haqqi March 10th , 2019
PREVALENCE OF HCV
GENOTYPES IN PUNJAB,
PAKISTAN
Presented by:
- Aleena Haqqi
BS Biotechnology

2. Enveloped &
Positive
stranded RNA
virus
Mainly Affects
Hepatocytes
Single stranded
RNA 9.6 Kb
Hepatitis C Virus
1

3. Inflammation of the liver.
What Is Hepatitis ?
Self-limiting or can progress to fibrosis cirrhosis or liver cancer.
2

4. Risk Factors 3

5. HCV infection are the main
Global public health problems
Liver related complications
Hepatitis C affects 1.76 million
people all over the world [1].
7.2 million people in Pakistan are
living with HCV
Hepatitis C Virus
HCV genotype prevalence varies
in different parts of the world
4

6. Hepatitis C, A Global Health Problem
Figure: Global Prevalence of HCV (Organization, 2017)
5

7. HCV is a global
health problem
It causes both
acute and
chronic
infection in
liver.
Also consist
of seven
nonstructural
proteins NS
(NS2, NS3, NS4A,
NS4B, NS5A
,NS5B and pore
forming p7 )
HCV is a
hepatotrophic
and
lymphotrophic
virus.
HCV is single
stranded RNA
virus with the
genome of
9600 bp.
It consist of
three structural
proteins (E1, E2
and core
protein)
1 2 3 4 5
Hepatitis C virus 6

8. Structure of HCV
Core Protein
Envelope
Envelope
GlycoProtein
+SSRNA
7

9. HCV Genome Organization
8
Figure: Structure of HCV Polyprotein (M. Shazzad Hosain, 2016)

10. viral genome
sequence
variability and
heterogeneity
Genotypes of HCV
Error prone
nature of HCV
RdRp
10-3 Per
nucleotide per
generation
7 Genotypes
67 subtypes
5’ UTR, core, E1,
NS5 regions of
the viral HCV
genome
9
Figure: Evolutionary Tree of HCV Genotypes
(Echeverría et al., 2015)

11. Hepatitis C , worldwide Genotype Distribution 10
Figure: Worldwide Distribution of HCV Genotypes (Gower et al., 2014)

12. Treatment Options Of Hepatitis C 11

13. Objectives
The study was designed to
check the epidemiology of
HCV genotypes in Pakistan.
Therefore precise genotyping
is crucial in order to lower the
disease burden
Genotype is the most crucial
factor influencing diesease
pathogenesis, severity and
SVR.
12

14. 02
03
04
05
Methodology
01 Patients Enrollment
Blood Sampling
Serum Separation
PCR Reaction
Gel Documentation
13

15. 07
09
Methodology
06 1st Round of PCR
1b, 2a, 2b, and 3b
2nd Round of PCR
3a, 4, 5a, 1a, and 6a
Gel Documentation
14

16. Results
Figure: Genotype distribution of HCV infected individuals residing in Punjab
15

17. Prevalence of HCV Variants in Punjab (2015 - 2018)
1a
4%
3a
87%
3b
1%
Mixed
1%
Untypeable
7%
16
Figure: Prevalence of HCV Genotypes in Punjab, Pakistan

18. Review of HCV
Genotype
Distribution in
Pakistan
Review HCV Genotypes in Pakistan (2009 – 2018) 17

19. Review of HCV Genotype Distribution in Pakistan

20. Review of HCV Genotype Distribution in Pakistan

21. Prevalence HCV Genotypes in Pakistan and it’s Provinces (2009-2018)
Figure 2: HCV Genotype Distribution in Pakistan Figure 3: HCV Genotype Distribution in Punjab
1a
6.12%
1b
2.07%
2a
7.25%
2b
0.95%
3a
57.70%
3b
8.53%
4a
1.37%
4b
0.06%
5a
0.10%
6a
0.07%
M
3.49%
UT
12.29%
1a
7%
1b
1%
2a
1%
3a
79%
3b
4%
4a
3%
Mixed
2%
UT
3%
* UT denotes; Untypeable Genotype and M denotes Mixed Genotype Infection
20

22. Prevalence HCV Genotypes in Pakistan and it’s Provinces (2009-2018)
Figure 4: HCV Genotype Distribution in Sindh Figure 5: HCV Genotype Distribution in KPK
1a
4%
1b
2%
2a
2%
3a
61%
3b
9%
Mixed
1%
UT
21%
1a
7%
1b
2%
2a
12%
2b
1%
3a
49%
3b
9%
4a
1%
Mixed
5%
UT
14%
21

23. Prevalence HCV Genotypes in Pakistan and it’s Provinces (2009-2018)
Figure 6: HCV Genotype Distribution in Baluchistan Figure 7: HCV Genotype Distribution in AJK
1a
7%
3a
50%3b
11%
UT
32%
1a
7% 1b
7%
2a
4%
3a
59%
3b
19%
UT
4%
22

24. ● 1. Organization, W.H., Progress report on access to
hepatitis C treatment. 2018.
● Organization, W. H. (2017). Global hepatitis report 2017:
World Health Organization.
● Gower, E., Estes, C., Blach, S., Razavi-Shearer, K., & Razavi,
H. (2014). Global epidemiology and genotype distribution
of the hepatitis C virus infection. Journal of hepatology,
61(1), S45-S57.
● Mauss, S., Berg, T., Jurger, R., & Wedemeyer, H. (2014).
Hepatology: Flying Publisher.
● Tang, H., & Grisé, H. (2009). Cellular and molecular biology
of HCV infection and hepatitis. Clinical Science, 117(2), 49-
65.
References 24

25. Aleena Haqqi March 11, 2019
- Aleena Haqqi
BS Biotechnology
Thank You
for
Your Patience