Genotypic characterization of hepatitis C virus and its significance in patients with chronic liver disease from Northern India

The characterization of hepatitis C virus (HCV) strains has important prognostic, therapeutic, and epidemiologic implications. The present study was intended to determine the HCV genotypes from Northern India in chronic liver disease (CLD) patients. The response to therapy in various subtypes was also evaluated in patients with chronic hepatitis. Furthermore, the genotypes were correlated with the biochemical and histopathologic parameters to assess the severity of liver disease. Five milliliter of blood sample was collected aseptically from 98 patients with CLD due to hepatitis C. Genotyping was performed by restriction fragment length polymorphism and type-specific polymerase chain reaction, followed by direct sequencing. The HCV genotypes depicted were 1a (6.12%), 1b (8.16%), 1c (8.16%), 3a (17.34%), 3b (6.12%), 3a + 3b (40.81%), 3a + 1b (7.14%), and an unclassified type of 6.12%. The present study revealed that HCV genotype 3 is the predominant one, with 40.81% (40/98) being a mixed type of 3a with 3b and identification of newer subtype 1c. HCV subtypes 1a, 3a, and 3b are responding to therapy, whereas 1b (40%, 2/5), 1c (66.67%, 2/3), 3g (33.3%, 1/3), 3a + 3b (41.6%, 5/12), and mixed type 3a + 1b (66.67%, 4/6) are poor responders to therapy. The biochemical profiles were higher in mixed type followed by types 3 and 1, whereas the histologic parameters revealed that the severity of liver disease was more in mixed type followed by types 1 and 3, which also showed poor response to therapy.