Qanita Fahim, Irfan Ali Mirza, Ayesha Khalid, Anum Imtiaz, Asad Ahmad.
The hepatitis C untype-able genotypes, an emergence of quasi-species in HCV infected patients.
Pak Armed Forces Med J Jan ;71(Sup-1):S106-12.

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, Pakistan from Sep 2017 to Mar 2018. Methodology: Six hundred forty seven anti HCV antibodies positive serum samples by Enzyme Linked Immuno Sorbant 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 predominant genotype 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 untypeables were seen in 61-70 age group. Conclusion: Need of the hour is proper sequencing of untypeable 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.

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