Evaluation of Multiplex Nested Polymerase Chain Reaction for Routine Hepatitis C Virus Genotyping in Egyptian Patients

Background: At least six HCV (hepatitis C virus) genotypes are unequally distributed worldwide. HCV genotyping guides the selection of treatment regimens and provides important epidemiological markers that enable the outbreak source to be traced and the spread of disease to be controlled. In Egypt, there is an increasing need for cost-effective, fast, and easily performable HCV genotyping assays.Recently, a multiplex PCR assay was developed to determine HCV genotypes. It employs genotype-specific primers, based on sequences of the entire core region and part of the 5’UTR of the genome.
Objectives: In this study, we compared a simple, new, modified multiplex PCR system for HCV genotyping with a commercially available line probe assay (INNO-LiPA) that is based on reverse hybridization.
Patients and Methods: Serum samples from chronic HCV Egyptian patients (n = 73) were genotyped using the modified multiplex PCR assay, and genotypes were verified using the INNO-LiPA HCV II assay.
Results: The modified multiplex PCR method was able to type HCV-4 in 65 of 70 typeable samples (92.86%) and had 100% concordance with the INNO-LiPA assay.
Conclusions: Genotype 4 was the most prevalent genotype in our study. Based on our results, the modified multiplex nested PCR assay is a sensitive and inexpensive alternative for HCV genotyping and can be used in routine diagnostic laboratories. INNO-LiPA may be useful as a second-line assay for genotyping samples that are indeterminate by multiplex PCR. This approach will effect better treatment optimization and a reduction of the spread of HCV.

• Implication for health policy/practice/research/medical education:
  Egypt has the highest prevalence of worldwide HCV (15%) and the highest prevalence of HCV-4, which is responsible for almost 90% of infections. There is increasing evidence that patients with different HCV genotypes have different clinical profiles, severity of liver disease and response to current combination therapy. HCV genotyping helps clinicians in their practice as it guides the selection of treatment regimens, and provides important epidemiological markers that enable outbreak source tracing and control of the spread of disease.

• Please cite this paper as:
  Shemis MA, El-Abd DM, Ramadan DI, El-Sayed MI, Guirgis BS, Saber MA, et al. Evaluation of Multiplex Nested Polymerase Chain Reaction for Routine Hepatitis C Virus Genotyping in Egyptian Patients. Hepat Mon. 2012;12(4): 265-270. DOI: 10.5812/hepatmon.830

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