Core Gene Expression and Association of Genotypes with Viral Load in Hepatitis C Virus (HCV) - Infected Patients in Punjab, Pakistan

Purpose: To determine genotypic distribution, ribonucleic acid (RNA) RNA viral load and express core gene from Hepatitis C Virus (HCV) infected patients in Punjab, Pakistan. Methods: A total of 1690 HCV RNA positive patients were included in the study. HCV genotyping was tested by type-specific genotyping assay, viral load, by real time polymerase chain reaction (PCR) and HCV core protein was expressed in E. coli. Antigenicity of core protein was confirmed by enzyme-linked immunosorbant assay (ELISA). Results: Out of total 1690 serum samples, type-specific PCR fragments were observed in 1482 (87.69 %) of the samples. In both genders, genotype 3a (55.44 %) was most prevalent followed by 3b (15.03 %), 1a (6.98 %) and 1b (3.14 %). Regionally, genotype 3a occurred most frequently in Jaranwala (59.72 %). Patients infected with genotype 3 had pre-treatment viral load values of 52.56, 15.79 and 31.65 %, while patients infected by other genotypes showed viral load values of 13.43, 35.27 and 51.3 % for low, intermediate and high categories of viral load, respectively. ELISA showed that core protein possessed greater antigenicity. Conclusion: HCV genotype 3a is the most prevalent genotype in Punjab, although the distribution of HCV genotypes in eight cities of Punjab was not uniform. HCV core protein used to develop local screening assays may be more effective than current commercial assays