HCV Genotypes in Correlation to Histopathological Grading and Staging in Interior Sindh

Abstract

Background: Hepatitis C virus is inherently unstable, giving rise to multiple genotypes and more than 50 subtypes have been identified on the basis of molecular relatedness. This study was conducted to correlate genotype of HCV infection with grading and staging of chronic hepatitis induced in interior Sindh.

Material & Methods: It was a prospective cross-sectional, observational study carried out from August 2006 to June 2008, at Research Medical Center LUMHS Jamshoro, Departments of pathology, Nawabshah Medical College, Nawabshah and Biotechnology Department, University of Karachi. A total of 344 HCV-PCR positive patients with different genotypes were evaluated, 239 men and 105 women, ages between 18–55 years were included in the study. All patients had HCV antibodies by ELISA and also determination of HCV RNA and genotypes. Liver biopsy was performed in chronic hepatitis patients and submitted to histopathological procedures.

Results: Out of 242 cases of genotype 3a, 122 presented with grade A2, 62 with A3, 36 with A1 and 22 with grade A4. Stage F1 was seen in 91, F2 in 81, F3 in 43 cases, 14 with stage F0 and 13 with F4. Genotype 3b presented with grade A2 in 9 cases, A3 in 7, A1 in 2 and A4 in 1 case. Stage F2 in 7 cases, F3 in 6, F1 in 3 and F4 in 3. Out of 10 cases of genotype 1a, 6 cases presented with grade A3, 3 with A4 and 1 with A2. Stage F3, 2 cases, F4 and 1 each with F1 and F2. Five patients of genotype 1b presented with grade A3 in 3 and A4 in 2, and stage F3. While genotype-2 patients presented with grade A2 in 2 cases and A3 in 2, stage F1 in 2 cases and F2 in 2 cases. All the 3 cases of genotype 5 were in grade A2 and stage F2. Nine patients with genotype mixed type revealed grade A3 in 4, A4 in 4 and A2 in one case, 4 cases with stage F4, 3 with F2 and 1 each with F4 and F1. Out of 52 untypable genotype 33 cases presented with grade A3, 13 with A2 and 6 with A4, 24 cases presented with stage F2, 16 with F3, 8 with F4, and 4 with F1.

Conclusion: There is no correlation of genotype with grading and staging of the disease in chronic hepatitis C.