Genotypes of Hepatitis C Virus in United Arab Emirates: Their Relationship with Age, Gender and Nationality
Seham Abdelwahed Hafez Koura, AlAin University of Science and Technology, Abu Dhabi, United Arab Emirates.
Abdulghani Mohamed Alsamarai, Aalborg Academy College of Medicine, Denmark. Tikrit University College of Medicine, Tikrit, Iraq [TUCOM].
Salim Awadh, Consultant physician, Gastroenterologist and Hepatologist, United Arab Emirates.
Corresponding author: Seham Abdelwahed Hafez Koura, AlAin University of Science and Technology, Abu Dhabi, United Arab of Emirates.
Journal Title:Aalborg Academy Journal of Medical Sciences
Background: Hepatitis C virus (HCV) is a major global public health problem with estimate of 3% chronicity. The prevalence of HCV in Eastern Mediterranean Region was variable with a range of 1% to 14.9%. HCV infection was found to be endemic in Arab World as different studies confirmed such endemicity. Arabian Peninsula region HCV prevalence was reported as low (1-1.9%) in Oman, Saudi Arabia, Kuwait, and Bahrain, while it was moderate in Yemen (2.0-2.9%), high in UAE (3.0-3.9%), and very high in Qatar (>4%). Aim: To study sero-molecular epidemiology of HCV in UAE genotypes among the patients who have HCV positive antibodies and differentiate them according to their nationality in United Arab Emirates. Patients and methods: The study was conducted from June 2013 to December 2017 at the Medical as well as Infectious Diseases clinics at Khalifa Hospital Abu Dhabi, UAE. The patients with positive screening test for HCV antibodies referred from other clinics and peripheral health centers were included in the study. The study was designed to include patient's demographics, clinical information including the various risk factors for the transmission of HCV and laboratory data which included serum HCV RNA levels, HCV Genotypes and Liver function test (LFTs). A blood sample of each patient was collected and the confirmation of HCV was done by Western blot. The confirmed cases were further tested for HCV RNA levels by polymerase chain reaction and subsequently HCV-RNA positive patients were genotyped by selective hybridization of amplicons to HCV genotype-specific oligonucleotides. Results: A total of 193 patients included in the study with a mean age of 44.23 years and 76.68% of them were male, with M/F ratio of 3/1. The highest frequency was in Egyptian (60.10%), followed by UAE (18.13%) and 21.76% in others. The predominant genotype was 4 (67.93%), type 1 form 16.85%, and type 3 form 15.22%. Gender with significant influence on HCV genotype (P=0.001). HCV type 1 was higher in female (40.48%) than in male (9.86%), while type 3 was higher in male IJMS May 2019;2(2):25-44; ISSNe 2522-7837 26 (17.61%) than in female (7.14%), also type 4 was more frequent in male (72.54%) than in female (52.28%). HCV genotype 4 was the predominant types in Egyptian (97.35%), while type 1 in UAE citizen (68.57%), and type 3 in others (63.89%). Age was not with significant influence on genotype frequency, however, gender, nationality, and disease severity was with significant association between HCV genotype and age, gender and nationality (X 2 =179.01; P=0.001). Female gender was with negative association with type 3 genotype and female with relative risk to infection with type 4 genotype11 times to infection with type 3 genotype. There is no observed Egyptian with type 3 genotype infection in our study cohort. Conclusion: HCV more predominant in Egyptian than in UAE. However, Egyptian has a significant negative correlation [OR=0.085, P=0.006] with type 1, while UAE are with significant positive correlation with genotype 1 after excluding the effect of gender. Furthermore, Egyptian is 11 times susceptible for genotype4 than for genotype1, while the Emirati are 10 times susceptible for genotype1 than for genotype4. However, the genotype frequency distribution indicated that HCV infection in Emirati was with significant association with type 1 (OR=10.246; p=0.003), while OR was 0.085 in Egyptian and thus the hypothesis that presumed the increase in prevalence of HCV in Emirati was excluded. In addition, type 3 genotype was with 0% frequency in Egyptian, while it forms 63.89% as a cause of HCV infection in other nationality and thus this finding is strong evidence that exclude Egyptian a cause for increase of hepatitis C in Emirati. Key words: Hepatitis, HCV, Genotype, Nationality, United Arab Emirates, Egyptian.