Fahmida Nasrin

ID No: 1030883070
MS in Biotechnology
Dept. of Biochemistry &
Microbiology
North South University

Hepatitis C Virus

At least 50% of patients develop chronic liver disease.

Cirrhosis develops in about 20-30% within 5-30years.
15% develops hepatocellular carcinoma.
Assess baseline viral load prior to initiation therapy
Determine therapeutic success during and after therapy.
Assessment of prognosis and disease progression.

70%
60%

60%

50%
Route of transmission

Percentage

Injection Drug use

60%

Sexual

15%

Transfussion

10%

Occupation

4%

Other

1%

Unknown

10%

40%
30%
20%
10%

15%

10%

10%
4%

0%

Percentage

1%

Serologic Pattern of Acute HCV Infection

with Recovery

Serologic Pattern of Acute HCV Infection with

Progression to Chronic Infection

Epidemiology of Hepatitis C

This study was carried out :

1. to correlate serological marker of HCV and liver function
tests as an alternative to HCV RNA estimation.
2. to evaluate the state of infection among Anti-HCV positive
patients.
3. to decide the indication of therapy
4. to find out discordance of seromarkers with HCV RNA.

Place of the study

The study was conducted inDNA Solution Ltd.
Bangladesh Institute of Research and Rehabilitation in
Diabetes, Endocrine and Metabolic Disorders
(BIRDEM), Dhaka.
Study period
This study was done during the period of April 2011 to
November 2011.
Study design
Cross sectional study.

Subjects
-Inclusion criteria
Subjects with age ranging from 15-80 years.
120 patients diagnosed as a case.
-Exclusion criteria
Patients with serious co-morbid disease (severe
infection, stroke, myocardial onfarction, major
surgery, mal-absorption etc).

Anti-HCV: Enzyme Linked Immunosorbent Assay

(ELISA), Fortress Diagnostic-USA.
Serum ALT, AST: enzymatic assay, Randox-Germany.
HCV RNA: Real-time Reverse Transcription PCR,
Roboscreen-Germany.
HCV genotyping: Real-time Reverse Transcription PCR,
Sacace-Italy.
Statistical Analysis
All data were analyzed by using Statistical Package for
Social Science (SPSS) for Windows version 12.0. p value
<0.05 was taken as level of significance.

Results

Age (years)

No. of subjects (%)

<20

8 (6.66)

21-40

68 (56.66)

41-60

42 (35)

61-75

2 (1.66)

Sex
Male
Female

60.00%

No. of subjects (%)

86 (71.66)
34 (28.33)

80.00%

50.00%

70.00%
60.00%

40.00%

50.00%
30.00%

40.00%
% of subjects

20.00%

% of subjects

30.00%
20.00%

10.00%

10.00%

0.00%

0.00%
<20

21-40

Age (years)

41-60

61-75

Male

Female

Prevalence of HCV infection in different age groups in male

Age group
0-10
11-20
21-30
31-40
41-60
61-75

No. of male subjects

0
6
35
17
26
2

40
35
30
25
20

No. of male subjects

15
10
5
0
0-10

11 to 20

21 to 30

31 to 40

41 to 60

61 to 75

Prevalence of HCV infection in different age groups in female

Age group
0-10
11-20
21-30
31-40
41-60
61-75

No. of female subjects

0
2
18
10
3
1

20
18
16
14
12

10
No. of female subjects

8
6
4
2
0
0-10

11 to 20

21 to 30

31 to 40

41 to 60

61 to 75

Prevalence of HCV infection in different age groups in male & female

Age group
0 -10
11-20
21-30
31- 40
41- 60
61-75

No. of male
subjects
0
6
35
17
26
2

No. of female
subjects
0
2
18
10
3
1

40
35
30
25
20
15

No. of male subjects

10

No. of female subjects

5
0
0-10

11 to 20

21 to 30

31 to 40

41 to 60

61 to 75

Correlation between Anti-HCV & HCV RNA

100.00
100.00

p=0.692

90.00
80.00

Positive
Negative
Anti-HCV Anti-HCV,
n=119 (%) n=01 (%)

68.91

70.00
60.00

50.00

Positive
HCV RNA

82 (68.91)

1 (100.0)

Negative
HCV RNA

37 (31.09)

0 (0.0)

40.00

31.09

30.00
20.00
10.00

0.00

0.00
Positive HCV RNA
Positive Anti-HCV

Negative HCV RNA

Negative Anti-HCV

Correlation between Anti-HCV and ALT

100.00

p=0.492

100.00
90.00

80.00

Positive
Anti-HCV,
n=119 (%)
Raised ALT

58 (48.47)

Negative
Anti-HCV,
n=01 (%)
1 (100.0)

70.00
60.00

48.74

51.26

50.00
40.00
30.00

Normal ALT

61 (51.26)

0 (0.0)

20.00
10.00

0.00

0.00
Raised ALT
Positive Anti-HCV

Normal ALT
Negative Anti-HCV

Correlation between Anti-HCV and AST

100.00

p=0.433

100.00
90.00

Raised AST

Positive
Anti-HCV,
n=119 (%)

Negative
Anti-HCV,
n=01 (%)

80.00

51 (42.86)

1 (100.0)

50.00

70.00

57.14

60.00
42.86

40.00

Normal AST

68 (57.14)

0 (0.0)

30.00
20.00

10.00

0.00

0.00
Raised AST
Positive Anti-HCV

Normal AST
Negative Anti-HCV

Correlation between HCV RNA and ALT

p=0.549
56.00

54.05

54.00

Positive
HCV RNA,
n=83 (%)

Negative
HCV RNA,
n=37 (%)

52.00
50.00

50.60
49.40

48.00

Raised ALT

41 (49.40)

45.95

17 (45.95)
46.00

Normal ALT 42 (50.60)

20 (54.05)

44.00
42.00
40.00
Raised ALT
Positive HCV RNA

Normal ALT
Negative HCV RNA

Correlation between HCV RNA and AST

p=0.425
57.83

60.00

Positive
HCV RNA,
n=83 (%)

Negative
HCV RNA,
n=37 (%)

Raised
AST

35 (42.17)

17 (45.96)

Normal
AST

48 (57.83)

20 (54.05)

54.05
45.96

50.00
42.17
40.00

30.00

20.00

10.00

0.00
Raised AST
Positive HCV RNA

Normal AST
Negative HCV RNA

Frequencies of liver transaminases with HCV RNA & Anti-HCV

HCV RNA
Positive (n=83)

Raised

Negative (n=37)

ALT+AST

ALT

AST

ALT+AST

ALT

AST

33 (39.76%)

8 (9.64%)

2 (2.41%)

15 (40.54%)

3 (8.11%)

2 (5.41%)

Normal

40 (48.19%)

17 (45.95%)

Anti-HCV

Positive (n=119)

Raised
Normal

Negative (n=01)

ALT+AST

ALT

AST

ALT+AST

ALT

AST

47 (39.50%)

11(9.24%)

4 (3.36%)

1 (100.0%)

0 (0.0%)

0 (0.0%)

57 (47.90%)

0 (0.0%)

Correlation between Viral load and ALT

Viral Load

1-10^3

10^4

10^5

10^6

10^7

10^8

7 (48.18)

4 (40.00)

Raised ALT 19 (51.35) 5 (62.50)

7 (70.00) 10 (47.62) 9 (52.94)

Normal ALT 18 (48.65) 3 (37.50)

3 (30.00) 11 (52.38) 8 (47.06) 10 (58.82) 6 (60.00)

p=0.792

70.00
70.00
60.00

62.50
52.38
47.62

51.35
48.65

50.00

52.94
47.06

37.50

40.00

58.82
41.18

60.00

40.00

30.00

30.00
20.00

10.00
0.00
0

1-10^3

10^4
Raised ALT

10^5

10^6

Normal ALT

10^7

10^8

Correlation between Viral load and AST

Viral Load
Raised AST

1-10^3

10^4

20 (54.05) 5 (62.50)

10^5

10^6

10^7

10^8

8 (80.00) 11 (52.38) 10 (58.82) 10 (58.82) 4 (40.00)

Normal AST 17 (45.95) 3 (37.50)

2 (20.00) 10 (47.62) 7 (41.18)

7 (41.18)

6 (60.00)

p=0.706

80.00
80.00
62.50

70.00
60.00

58.82

54.05

41.18

37.50

40.00

60.00

52.38
47.62

45.95

50.00

58.82

30.00

41.18

40.00

20.00

20.00
10.00
0.00
0

1-10^3

10^4
Raised AST

10^5

10^6

Normal AST

10^7

10^8

Prevalence of HCV genotype

Genotype

No. of subjects (%)

1a

4 (3.33)

1b

3 (2.5)

1 (0.83)

103 (85.83)

1 (0.83)

5 or 6

8 (0.67)
85.83

90
80
70
60
50
40
30
20
10

3.33

2.5

0.83

0.83

6.67

1a

1b

No. of subjects (%)

5 or 6

1.There is no significant correlation between AntiHCV to HCV RNA (P=0.692).

As a result since Anti-HCV negativity may

be detected in viremic patients molecular
methods should be applied specially for
suspected cases.