ABSTRACT
Objectives: Our study sought to determine the distribution of hepatitis C virus [HCV]- genotypes among patients attending two tertiary care hospitals in Benghazi and Tripoli, Libya, and correlate this with patient's characteristics, viral load, and degree of fibrosis
Methods: We conducted a retrospective study of 286 HCV-RNA positive Libyan patients referred from different health care facilities in east and west Libya for specific HCV treatment. HCV genotyping was carried out by gene amplification. Liver histology was graded by Metavir score according to the stage of fibrosis
Results: HCV genotypes 1, 2, 3, and 4 were found in 24.1%, 10.8%, 3.4%, and 61.5% of the patients, respectively. Genotype 4 was detected more frequently in patients from east Libya [Benghazi] compared to west Libya [Tripoli] [75.9% vs. 41.6%, p = 0.245]. Genotype 1 was more frequent in patients from west Libya compared to east Libya [34.1% vs. 16.8%, p = 0.657]. There was a significant correlation between HCV genotype distribution and viral load. Patients with genotype 4 exhibited a higher degree of liver fibrosis [p < 0.001]
Conclusions: HCV genotype 4 is the predominant genotype in Libya followed by genotype 1. However, as we go from the east to the west of the country, genotype 1 increases. Genotype 4 was associated with higher level of viremia and higher stage of liver fibrosis. It is important to note that both genotypes 1 and 4 are associated with a poor response to pegylated interferon and ribavirin combination therapy. The findings emphasize the need to develop improved strategies in Libya for the successful treatment of HCV infection with novel newly available antiviral drugs
ABSTRACT
Background and study aims: globally, More than 350 million individuals are chronically infected with hepatitis B virus [HBV], and >20 million of them are co-infected with hepatitis D virus [HDV]. The aim of this study was to determine the pattern of HDV infection in patients with chronic hepatitis B in three main tertiary hospitals in Tripoli and Benghazi, Libya
Patients and methods: this cross sectional and descriptive study was conducted on 162 patients with chronic hepatitis B positive for more than six months] who were followed up at hepatitis clinics of the three main tertiary hospitals in Tripoli city [88 patients from Tripoli Medical Centre and Tripoli Central Hospital] and Benghazi city [74 patients from Aljomhoria Hospital] during the period from January 2010 to June 2012. HBV and HDV markers were detected by enzyme linked fluorescent assay [ELFA] or enzyme-linked immunosorbent assay and HBV-DNA was quantified by real-time PCR techniques
Results: the mean age of patients was 36, 92 +/- 15,35. One hundred and three [63.6%] of them were males and 59 [36, 4%] were females. Four patients [2, 5%] were tested positive for anti-HD antibodies; all of them have had clinical and/or histological diagnosis of cirrhosis. In multivariable regression analysis, age [p = .04], elevation of serum ALT [p = .03], elevation of serum AST [p = .04], and presence of cirrhosis [p = .003] were significantly related to HDV seropositivity
Conclusion: although the study demonstrated that Libya has low to moderate prevalence of HDV [2,5%], it is important for policy makers and health care providers to continue the preventive measures for HDV spread, and HBV prevention program including utilization of HBV vaccine. Furthermore, it is imperative to screen chronic HBV patients for HDV for close observation for early diagnosis of subsequent development of liver cirrhosis. Moreover, further epidemiologic and genetic studies are needed to explore the trend for HDV infection in Libya