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Hepatitis C virus (HCV) genotypes refer to the genetic variations that occurs in the hepatitis C virus. Hepatitis C is a contagious disease that primarily affects the liver, causing severe damage as the disease progresses.[1] It is caused by the Hepatitis C virus, a small, enveloped RNA virus. The transmission of hepatitis C is through the contact with the blood of the infected person, for example by sharing the needles or by using non-sterile medical equipment.[2] HCV is transmitted globally because of the high infection rate and is also associated with a high mortality rate.[3][4] The World Health Organization indicates the 3.3% of the world population is infected by the HCV virus.[5] Statistical records show that there are about 13 million HCV affected persons in Сhina, 3.5 million affected persons in the United States,[6] and about 10 million people are affected by HCV in Pakistan.[3] In all cases, the viral genotype of the HCV stays the same, occasionally mutations do occur making the treatment more complex by targeting the changes in the genotype.[7] Hepatitis C virus genotype is considered more common than the Hepatitis B virus infection contributing to more than a million cases annually[8] and is considered one of the major reason for liver transplantation in United States.[9] Some of the HCV genotypes may develop in people without symptoms leading to dangerous conditions like liver cirrhosis causing a permanent damage to liver and the unnoticed HCV conditions will affect brain, joints, blood vessels, bones, and kidneys.[10]
The complexity of the HCV genotypes made the treatment specific for the associated genotype. The treatment for the HCV genotype also depends on the presence or absence of cirrhosis.[11] There are six major genotypes of hepatitis C virus which includes many subtypes.[12] The genotype can affect treatment of HCV infections.[3] Recent studies show that HCV genotypes consist of 8 genotypes and 67 subtypes.[13] [14] All the genotypes and subtypes affect the liver to the same extent of damage irrespective of the HCV genotype[7] Among the common six genotypes, genotype 1 is the most prevalent form in the United States of America,[15] covering around 70-90% of total infections. It is usually difficult to treat the people with HCV genotype 1.[citation needed] Genotype 2 and genotype 3 are less common contributing to around 10-20%.[15] Genotypes 4 and 5 affect a large proportion of the population in undeveloped countries.[16] Genotype 4 is the most common type of infections in Middle East and Africa, around 80% of total infections.[17] About 15% of the people affected by HCV genotypes will get cured without medications, in which immune system plays a vital role in defeating the virus.[18] Until recently, there were no specific vaccines available for treating hepatitis C virus genotypes.[19]
People traveling around different subcontinents where several HCV genotypes are common will have the possibility of resulting in mixed infection.[7]
| HCV genotypes | Subsets | Geographical distribution[20] |
|---|---|---|
| Genotype 1 | 1a, 1b | North America, Central Africa, Europe |
| Genotype 2 | 2a, 2b, 2c, 2d | Western Africa |
| Genotype 3 | 3a, 3b, 3c, 3d, 3e, 3f | Southeast Asia |
| Genotype 4 | 4a, 4b, 4c, 4d, 4e, 4f, 4g, 4h, 4i, 4j | Central Africa |
| Genotype 5 | 5a | South Africa and Asia |
| Genotype 6 | 6a | Southeast Asia |
The Main techniques used to diagnose the HCV genotype are as follows:[17]
- HCV ELISA (Enzyme-linked immunosorbent assay)
- Quantitative HCV-RNA PCR (Hepatitis C virus-Ribonucleic acid Polymerase Chain reaction)
- Recombinant immunoblot assay
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