PHYLOGENETIC STUDY OF HEPATITIS C VIRUS IN HEPATITIS PATIENTS IN WASIT PROVINCE, IRAQ

Background and aims: Viral hepatitis represents a health problem that affects millions of people worldwide and is associated with high mortality, except for hepatitis A virus (HAV), all hepatotropic viruses, including hepatitis B, C, D, and E viruses (HBV, HCV, HDV and HEV), can produce chronic infections, whereas HAV causes acute self-limiting hepatitis that normally resolves spontaneously Hepatitis C virus (HCV) is one of the major globally cause of death and morbidity, and recent estimates showed an increase in its seroprevalence over the last decade to 2.8%. The whole extent of RNA genome is about 9.6 kb with one open reading frame (ORF) and 5′ and 3′ untranslated regions (UTRs) at both edges, 5′UTR is a more preserved portion of HCV genome, which aided in evolutionary studies and genotyping, the open reading frame encodes a polyprotein, which is comprised of 10 viral proteins named as Core (C), E1, E2, P7, NS2, NS3, NS4A, NS4B, NS5A and NS5B. Materials and methods: This study was conducted on 85 samples from HCV whom were confirmed to be infected with as they were diagnosed by a through ELISA screen test, RT-PCR and conventional PCR for selected genes. Their ages ranged from (5 - 75) years old during July and September 2022. Results: The work has been carried out on anti-HCV 85 (100%); sero-positive patients of the two sexes gathered comprising according to presumptive cause of infection 22.4% unknown patients; 35.3% hemodialysis patients; 35.2%; thalassemic patients; and finally, 7% other patients. Real-Time PCR was used to confirmed the serological diagnosis and for measurement of the viral loads (concentrations) in the 85 (100%) of seropositive HCV Ab HCV patients only 54(100%). The results revealed that all thalassemic patients was positive by ELISA technique, while 35.2% were gave positive results; 33.3% hemodialysis patients; 27.7% unknown patients; and finally, 3.8% other patients with HBV and HCV gave positive results. This study showed that 54 samples which were tested by Real time PCR for HCV viral load, then extraction HCV – RNA and amplification of Nonstructural protein 5A (NS5A) gene by using specific primers. Eight samples were positive amplification of NS5A gene, while the remaining was negative. A phylogenetic tree of HCV-NS5A gene revealed samples are related to genotype (4a). Conclution: The results of this study concluded that dialysis patients have a high degree of risk factors for infection with the virus, through frequent blood transfusion as well as the dialysis machine or through the nursing staff. Also, thalassemia patients were observed to have a high infection rate.