ABSTRACT
Hepatitis C viral [HCV] infection, is a major health problem all over the world. HCV genotypes have been implicated in many: clinical aspects including the severity of liver disease, response to antiviral therapy and geographical distribution. A number of previous studies highlighted the magnitude of HCV infection in Egypt. In the current study we assessed the distribution of HCV genotypes, and the prevalence of HCV viremia among 204 Egyptian subjects classified into four high-risk groups as follows: HCV-associated chronic liver disease [n=144]. healthy blood donors [n=18], hemodialysis patients [n=14], and family contacts of index patients [n=28]. And for comparison HCV genotypes were also determined among 115 American patients chronically infected with HCV. HCV antibodies were assessed using 2nd generation [EIA]. HCV RNA was detected by nested RT-PCR. using primers specific to the 5 UTR region of the HCV genome. HCV genotypes were analyzed using restriction fragment length polymorphism [RFLP] and HCV viral quantitation was carried out using branched DNA assay [bDNA]. HCV viremia was demonstrated in 53% of the overall population, 42% were negative for HCV RNA while 5% showed indeterminate results. HCV genotype distribution revealed that the majority [72%] of our population was infected with type 4a. while type la and Ib were demonstrated in 4% and 15% respectively. HCV risk factors were given by 74% of the patients while 26% were unaware of any exposure to risk factors. More that 60% of the population were unaware of the duration, of their infection. Liver transaminases were significantly higher in HCV viremic patients compared to non-viremic ones. Both HCV viremia and HCV genotypes were statistically unrelated to the examined predictor variables i.e. age, gender, risk factors including schistosomiasis, duration of infection or liver histology. In the American population HCV genotype 1 was the most common genotype. The majority of patients reported duration of 10-20 years for their HCV illness. A tendency towards higher ALT and bDNA [levels was encountered in the American, patients comvared to the Egyptians