Estimation of HCV viral load and liver enzymes among different patients groups of District Gujrat, Pakistan

Hepatitis C has a 3% of the global disease burden that remains endemic in many regions of the world. According to a general statistical survey it has approximately 5.3% seroprevalence in Pakistan. HCV is a persistent and silent disease thus making the primary diagnosis complicated. Occasionally HCV positive population could not be diagnosed by routine HCV antibody testing therefore requires molecular diagnosis. This study is aimed to determine the prevalence of HCV and to estimate the HCV viral load by quantitative analysis among different patient groups of District Gujrat, Pakistan. A total of 597 samples were collected from clinically diagnosed liver patients that were categorized into three age groups: 1) up to 25 years; 2) 26 - 50 years 3) above 50 years. All samples were subjected to real time PCR for determination and quantification of HCV RNA. Activity of liver aminotransferases was measured. The overall prevalence of HCV-RNA was 73.87%. Females had slightly higher HCV prevalence which is 74.06% while 73.45% in males. Highest prevalence of active HCV infection was found in age group 26 - 50. In addition, liver function tests showed that 28.12% HCV-positive patients do not have elevated ALT level whereas 32.65% did not show elevated AST levels. It may be assumed that there is not a significant relationship between increased viral load and liver amino transferases. The study concluded a significantly higher rate of HCV infection in young population. Moreover screening with antibody and liver function tests alone does not exclude the possibility of HCV infection.