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HEPATITIS C VIRUS INFECTION AMONG PATIENTS AT HOSPITAL TENGKU AMPUAN AFZAN, KUANTAN: GENOTYPES DISTRIBUTION AND RNA

SEQUENCE VARIATIONSiti Nurul Fazlin Abdul Rahman1, Hairul Aini Hamzah1, Mohammed Imad Mustafa1, Mohamed

Hadzri Hasmoni2

Basic Medical Sciences Department (Microbiology)1, Internal Medicine department2,Kulliyyah of Medicine, International Islamic University Malaysia

Phone: 017-9306178, E-mail: fazlin89@yahoo.com

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Introduction • Hepatitis C is the leading cause of liver disease worldwide. • The causative agent is hepatitis C virus (HCV); a positive sense single

stranded RNA virus in the Flaviviridae family. There are six major types of HCV (genotype 1 until 6), which is determined based on their nucleotide sequence.

• The 5’ untranslated region (5’UTR) of HCV is the most of highly conserved region of the virus genome.

• The non-structural (NS) 5B region of the viral genome is heterogeneously enough to genotype HCV.

• HCV genotyping is very important for the clinical management of HCV-infected patients.

ObjectivesGeneral Objective:•To determine the common HCV genotypes among patients attending Gastroenterology clinic in Hospital Tengku Ampuan Afzan (HTAA).

Specific Objectives:•To detect the presence of HCV RNA in samples of HCV-infected patients.•To identify any sequence variances in 5’UTR and NS5B regions between common HCV genotypes.

MethodologyResearch Design:Observational and cross-sectional study

Consent:Study was approved by Medical Research Ethic Committee (MREC) and Clinical Research Centre, HTAA

Sample size & Duration of sample collection:40 samples were collected starting from January to July 2014

Result1. Detection of HCV in blood samples:

5’UTR-based assays (200 bp) NS5B-based assays (400 bp)

2. HCV Genotypes Distribution:

3. Sequence variation found in study isolates:

ConclusionIn conclusion, 5’UTR-based assay is an effective molecular tool for detection of HCV RNA as compared to NS5B-based assay. For HCV genotyping, the genotypes found in this study were 1 and 3. Based on the sequence analysis of these genotypes, there is less variation found in 5’UTR sequences compared to NS5B sequences.

AcknowledgementThe author acknowledge the Ministry of Higher Education Malaysia for funding this work through Fundamental Research Grant Scheme and State Department of Ministry of Health for consent and special thanks to all nurses in Gastroenterology Clinic, HTAA for their involvement in this study.

References1. Zein, N. N. (2000). Clinical Significance of Hepatitis C Virus Genotypes. Clinical Microbiology

Reviews, 13(2), 223–235.2. Germer, J. J., Rys, P. N., Thorvilson, J. N., & Persing, D. H. (1999). Determination of

Hepatitis C Virus Genotype by Direct Sequence Analysis of Products Generated with the  Amplicor HCV Test. Journal of Clinical Microbiology, 37(8), 2625–2630.

3. Shier, M. K., El-Wetidy, M. S., Ali, H. H., & Al-Qattan, M. M. (2014). Characterization of Hepatitis C Virus Genotypes by Direct Sequencing of HCV 5′UTR Region of Isolates from Saudi Arabia. PLoS ONE, 9(8), e103160. doi:10.1371/journal.pone.0103160