Molecular detection of HCV genotypes and viral loads in chronic HCV infected patients in Iraq

A cross sectional hospital based study was carried out in Kirkuk city from 10.09.2020 to 10.01.2021. The number of hepatitis patients understudy were 50 chronic hepatitis C patients whose ages between 20-75 years old. These patients admitted to Hepatology and Gastroenterology centers of Kirkuk. The control group, included 35 individuals who haven't any diseases who admitted to blood bank for blood donation. Five mL was collected for molecular detection of HCV load and genotype by real-time polymerase chain reaction (RT- PCR), detection of hepatitis C antibodies, by enzyme linked immunosorbent assay (ELISA) technique and biochemical to determine the level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and total serum bilirubin (TSB) and immunofluorescent estimation of level of alpha fetoprotein (AFP). The study showed that 86% of patients with chronic hepatitis C who had anti-HCV as detected by ELISA revealed positive result by PCR The result was significant (P<0.01). The study showed that 72.09% (31 of 43) of patients with chronic hepatitis C were infected by genotype 4 of HCV comparing with patients with genotype 1a (27.91%). The study showed that there was a highly significant difference in viral loads between patients with genotype 4 of chronic hepatitis C and who with genotype 1a (1901.3±105.6 v.s. 1693.4±108.4IU/mL), with a significant difference (P<0.01). In the current study, 41.94% of males with chronic hepatitis C had genotype 4 and 58.06 of females with chronic hepatitis C had genotype 4, 33.33 of males and 66.67 of females with chronic hepatitis C had genotype 1a. The present study showed that the highest mean of ALT, AST, ALP and TSB were found in patients with chronic hepatitis C (64.69 IU/mL, 54.8 IU/mL, 285.5 IU/mL and 4.33 mg/dL) as compared with the control group with highly significant relation among the groups. The present study showed positive correlation of viral load of HCV with ALT, AST, ALP and TSB levels in patients with chronic hepatitis C. The current study revealed that the viral load increased with the progression of the fibrosis. The lowest mean of viral load was found in patients without fibrosis (1235.5 IU/mL) followed by patients with first stage of fibrosis and highest mean of viral load was recorded in patients with cirrhosis (stage 4) (2088.1 IU/mL). The study showed that the highest mean of AFP level was found among patients with chronic hepatitis C (25.5 µg/L) as compared the control group (4.18 µg/L). Keywords: HCV, ELISA, Real Time PCR, HCV genotyping, Iraq