THE HEPATITIS C UNTYPE-ABLE GENOTYPES, AN EMERGENCE OF QUASI-SPECIES IN HCV INFECTED PATIENTS

Objective: To determine the frequency of Type-able and untype-able genotypes in hepatitis C infected patients,and to observe their association with gender, age, Alanine Aminotranferease and viral load. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Microbiology, Combined Military Hospital, and Lahore, Pakistanfrom Sep 2017 to Mar 2018. Methodology: Six hundred forty seven anti HCV antibodies positive serum samples by Enzyme Linked ImmunoSorbant Assay were received from a total of 6791 serum samples. The positive sera were subjected to qualitative PCR and quantitative real time (RT) PCR to determine pre-treatment viral load. Quantitative PCR positive sera with viral load >500IU/ml were further subjected to molecular genotyping by using Ohno et al method. Result: Out of 647 positive serum samples, type-specific PCR fragments were seen in 424 sera, while 13 (3.1%) of serum samples were of untype-able genotype. In all age groups genotype 3a had emerged as a predominantgenotype 397 (93.6%), followed by 1b 8 (1.9%), 3b 4 (0.9%), 1a 2 (0.5%), while no sample detected to have 2a, 2b,5a, 6a and mixed genotypes. The highest prevalence of untype-ables were seen in 61-70 age group. Conclusion: Need of the hour is proper sequencing of untype-able genotypes via upgrading existing methodologies. It will not only help the clinicians in achieving sustained virological response but also help in identifying new genotypes/subtypes.