1887

Abstract

Outbreaks of hepatitis C virus (HCV) infection are associated with unsafe injection practices, intravenous drug abuse and other exposure to blood and body fluids. We report here three outbreaks of HCV infection from Jammu and Kashmir (J&K) State, India, which occurred over a period of 3 years and in which molecular epidemiological investigations identified a presumptive common source of infection, most likely a single healthcare venue. Representative blood samples collected from cases of hepatitis C were sent to the National Centre for Disease Control (NCDC) for molecular characterization. These samples were positive by HCV ELISA. Subsequently, specimens were also tested for the presence of HCV RNA by RT-PCR. Sequencing was carried out for all positive samples. A total of 812 cases were laboratory confirmed by HCV ELISA; a total of 115 samples were sent to the NCDC for RT-PCR, and 77 were positive. Subtype 3a of HCV was found in all samples from Anantnag (February 2013); and for subtype 3b, in all samples from Srinagar (May 2015). Subtypes 3a and 3g were identified from two samples from the Kulgam outbreak (July 2014). A detailed epidemiological investigation should be conducted whenever a cluster of HCV cases is revealed, as this potentially allows for the identification of larger outbreaks. Epidemiological investigations of outbreaks should be further supported by inclusion of molecular tests. Efforts to limit therapeutic injections to only those cases having strong medical/surgical indications and to restrict the use of non-sterile needles are essential to prevent transmission of HCV.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000284
2016-08-01
2024-12-13
Loading full text...

Full text loading...

/deliver/fulltext/jmm/65/8/804.html?itemId=/content/journal/jmm/10.1099/jmm.0.000284&mimeType=html&fmt=ahah

References

  1. Al Olaby R. R., Azzazy H. M. 2011; Hepatitis C virus RNA assays: current and emerging technologies and their clinical applications. Expert Rev Mol Diagn 11:53–64 [View Article][PubMed]
    [Google Scholar]
  2. Alexopoulou A., Dourakis S. P. 2005; Genetic heterogeneity of hepatitis viruses and its clinical significance. Curr Drug Targets Inflamm Allergy 4:47–55 [View Article][PubMed]
    [Google Scholar]
  3. Ashfaq U. A., Javed T., Rehman S., Nawaz Z., Riazuddin S. 2011; An overview of HCV molecular biology, replication and immune responses. Virol J 8:161 [View Article]
    [Google Scholar]
  4. Blackard J. T., Shata M. T., Shire N. J., Sherman K. E. 2008; Acute hepatitis C virus infection: a chronic problem. Hepatology 47:321–331 [View Article][PubMed]
    [Google Scholar]
  5. Bréchot C. 1996; Hepatitis C virus: molecular biology and genetic variability. Dig Dis Sci 41:6S–21S[PubMed] [CrossRef]
    [Google Scholar]
  6. Chakravarti A., Dogra G., Verma V., Srivastava A. P. 2011; Distribution pattern of HCV genotypes & its association with viral load. Indian J Med Res 133:326–331[PubMed]
    [Google Scholar]
  7. Chakravarti A., Ashraf A., Malik S. 2013; A study of changing trends of prevalence and genotypic distribution of hepatitis C virus among high risk groups in North India. Indian J Med Microbiol 31:354–359 [View Article][PubMed]
    [Google Scholar]
  8. Chen S. L., Morgan T. R. 2006; The natural history of hepatitis C virus (HCV) infection. Int J Med Sc 3:47–52 [View Article]
    [Google Scholar]
  9. Chevaliez S., Pawlotsky J. M. 2005; Use of virologic assays in the diagnosis and management of hepatitis C virus infection. Clin Liver Dis 9:371–382 [View Article][PubMed]
    [Google Scholar]
  10. Choo Q. L., Kuo G., Weiner A. J., Overby L. R., Bradley D. W., Houghton M. 1989; Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 244:359–362 [View Article][PubMed]
    [Google Scholar]
  11. Comstock R. D., Mallonee S., Fox J. L., Moolenaar R. L., Vogt T. M., Perz J. F., Bell B. P., Crutcher J. M. 2004; A large nosocomial outbreak of hepatitis C and hepatitis B among patients receiving pain remediation treatments. Infect Control Hosp Epidemiol 25:576–583 [View Article][PubMed]
    [Google Scholar]
  12. Davis G. L., Alter M. J., El-Serag H., Poynard T., Jennings L. W. 2010; Aging of hepatitis C virus (HCV) infected persons in the United States: a multiple cohort model of HCV prevalence and disease progression. Gastroenterol 138:513–521 [View Article]
    [Google Scholar]
  13. Friebe P., Lohmann V., Krieger N., Bartenschlager R. 2001; Sequences in the 5' nontranslated region of hepatitis C virus required for RNA replication. J Virol 75:12047–12057 [View Article][PubMed]
    [Google Scholar]
  14. Fukushi S., Katayama K., Kurihara C., Ishiyama N., Hoshino F. B., Ando T., Oya A. 1994; Complete 5' noncoding region is necessary for the efficient internal initiation of hepatitis C virus RNA. Biochem Biophys Res Commun 199:425–432 [View Article][PubMed]
    [Google Scholar]
  15. Ghany M. G., Strader D. B., Thomas D. L., Seeff L. B. American Association for the Study of Liver Diseases 2009; Diagnosis, management, and treatment of hepatitis C: an update. Hepatology 49:1335–1374 [View Article][PubMed]
    [Google Scholar]
  16. Hall T. A. 1999; BioEdit: a user-friendly biological sequence alignment editor and analysis program for Windows 95/98/NT. Nucl Acids Symp Ser 41:95–98
    [Google Scholar]
  17. Honda M., Ping L. H., Rijnbrand R. C., Amphlett E., Clarke B., Rowlands D., Lemon S. M. 1996; Structural requirements for initiation of translation by internal ribosome entry within genome-length hepatitis C virus RNA. Virology 222:31–42 [View Article][PubMed]
    [Google Scholar]
  18. Hoofnagle J. H. 2002; Course and outcome of hepatitis C. Hepatology 36:S21–S29 [CrossRef]
    [Google Scholar]
  19. Kato N., Hijikata M., Ootsuyama Y., Nakagawa M., Ohkoshi S., Sugimura T., Shimotohno K. 1990; Molecular cloning of the human hepatitis C virus genome from Japanese patients with non-A, non-B hepatitis. Proc Natl Acad Sci U S A 87:9524–9528 [View Article][PubMed]
    [Google Scholar]
  20. Kumar T., Shrivastava A., Kumar A., Laserson K. F., Narain J. P., Venkatesh S., Chauhan L. S., Averhoff F. 2015; Viral hepatitis surveillance—India, 20112013. MMWR Morb Mortal Wkly Rep 64:758–762 [View Article][PubMed]
    [Google Scholar]
  21. Leone N., Rizzetto M. 2005; Natural history of hepatitis C virus infection: from chronic hepatitis to cirrhosis, to hepatocellular carcinoma. Minerva Gastroenterol Dietol 51:31–46[PubMed]
    [Google Scholar]
  22. Li Y. P., Ramirez S., Gottwein J. M., Bukh J. 2011; Non-genotype-specific role of the hepatitis C virus 5' untranslated region in virus production and in inhibition by interferon. Virology 421:222–234 [View Article][PubMed]
    [Google Scholar]
  23. Lu L., Li C., Yuan J., Lu T., Okamoto H., Murphy D. G. 2013; Full-length genome sequences of five hepatitis C virus isolates representing subtypes 3g, 3h, 3i and 3k, and a unique genotype 3 variant. J Gen Virol 94:543–548 [View Article][PubMed]
    [Google Scholar]
  24. Luby S. P., Qamruddin K., Shah A. A., Omair A., Pahsa O., Khan A. J., McCormick J. B., Hoodbhouy F., Fisher-Hoch S. 1997; The relationship between therapeutic injections and high prevalence of hepatitis C infection in Hafizabad, Pakistan. Epidemiol Infect 119:349–356 [View Article][PubMed]
    [Google Scholar]
  25. Ma W., Feng B., Tao Q. 2001; Murine antibody against E2 can capture hepatitis C virus in vitro. Chin Med J 114:860–863[PubMed]
    [Google Scholar]
  26. Masante C., Mahias K., Lourenço S., Dumas E., Cahour A., Trimoulet P., Fleury H., Astier-Gin T., Ventura M. 2008; Seven nucleotide changes characteristic of the hepatitis C virus genotype 3 5' untranslated region: correlation with reduced in vitro replication. J Gen Virol 89:212–221 [View Article][PubMed]
    [Google Scholar]
  27. Missiha S. B., Ostrowski M., Heathcote E. J. 2008; Disease progression in chronic hepatitis C: modifiable and nonmodifiable factors. Gastroenterology 134:1699–1714 [View Article]
    [Google Scholar]
  28. Mohanraj U., Chavan Y. G., Pawar S. R., Raut A. D. 2015; Identification of hepatitis C virus genotypes and subtypes in patients from Maharashtra based on 5’UTR sequencing and analysis: a retrospective study. Int J Bioassays 4:4601–4607
    [Google Scholar]
  29. Nasu A., Marusawa H., Ueda Y., Nishijima N., Takahashi K., Osaki Y., Yamashita Y., Inokuma T., Tamada T. et al. 2011; Genetic heterogeneity of hepatitis C virus in association with antiviral therapy determined by ultra-deep sequencing. PLoS One 6:e24907 [View Article][PubMed]
    [Google Scholar]
  30. Negro F. 2014; Epidemiology of hepatitis C in Europe. Dig Liver Dis 46:S158–S164 [View Article][PubMed]
    [Google Scholar]
  31. Ohno T., Lau J. Y. 1996; The “gold-standard,” accuracy, and the current concepts: hepatitis C virus genotype and viremia. Hepatology 24:1312–1315 [View Article][PubMed]
    [Google Scholar]
  32. Panigrahi A. K., Roca J., Acharya S. K., Jameel S., Panda S. K. 1996; Genotype determination of hepatitis C virus from northern India: identification of a new subtype. J Med Virol 48:191–198 [View Article][PubMed]
    [Google Scholar]
  33. Patel D. A., Gupta P. A., Kinariwala D. M., Shah H. S., Trivedi G. R., Vegad M. M. 2012; An investigation of an outbreak of viral hepatitis B in Modasa town, Gujarat, India. J Glob Infect Dis 4:55–59 [View Article][PubMed]
    [Google Scholar]
  34. Pawlotsky J. M. 2003; Hepatitis C virus genetic variability: pathogenic and clinical implications. Clin Liver Dis 7:45–66 [View Article][PubMed]
    [Google Scholar]
  35. Pestova T. V., Shatsky I. N., Fletcher S. P., Jackson R. J., Hellen C. U. 1998; A prokaryotic-like mode of cytoplasmic eukaryotic ribosome binding to the initiation codon during internal translation initiation of hepatitis C and classical swine fever virus RNAs. Genes Dev 12:67–83 [View Article][PubMed]
    [Google Scholar]
  36. Razavi H., Waked I., Sarrazin C., Myers R. P., Idilman R., Calinas F., Vogel W., Mendes Correa M. C., Hézode C. et al. 2014; The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm. J Viral Hepat 21:34–59 [View Article]
    [Google Scholar]
  37. Richter S. S. 2002; Laboratory assays for diagnosis and management of hepatitis C virus infection. J Clin Microbiol 40:4407–4412 [View Article][PubMed]
    [Google Scholar]
  38. Savey A., Simon F., Izopet J., Lepoutre A., Fabry J., Desenclos J. C. 2005; A large nosocomial outbreak of hepatitis C virus infections at a hemodialysis center. Infect Control Hosp Epidemiol 26:752–760 [View Article][PubMed]
    [Google Scholar]
  39. Sharma S. D. 2010; Hepatitis C virus: molecular biology & current therapeutic options. Indian J Med Res 131:17–34[PubMed]
    [Google Scholar]
  40. Singh S., Malhotra V., Sarin S. K. 2004; Distribution of hepatitis C virus genotypes in patients with chronic hepatitis C infection in India. Indian J Med Res 119:145–148[PubMed]
    [Google Scholar]
  41. Steinhauer D. A., Domingo E., Holland J. J. 1992; Lack of evidence for proofreading mechanisms associated with an RNA virus polymerase. Gene 122:281–288 [View Article][PubMed]
    [Google Scholar]
  42. Suzuki T., Aizaki H., Murakami K., Shoji I., Wakita T. 2007; Molecular biology of hepatitis C virus. J Gastroenterol 42:411–423 [View Article][PubMed]
    [Google Scholar]
  43. Tamura K., Stecher G., Peterson D., Filipski A., Kumar S. 2013; MEGA6: Molecular Evolutionary Genetics Analysis version 6.0. Mol Biol Evol 30:2725–2729 [View Article][PubMed]
    [Google Scholar]
  44. Thompson N. D., Perz J. F., Moorman A. C., Holmberg S. D. 2009; Nonhospital health care-associated hepatitis B and C virus transmission: United States, 1998–2008. Ann Intern Med 150:33–39 [View Article][PubMed]
    [Google Scholar]
  45. Van der Poel C. L., Cuypers H. T., Reesink H. W., Weiner A. J., Quan S., Di Nello R., Van Boven J. J., Winkel I., Mulder-Folkerts D., Exel-Oehlers P. J. 1991; Confirmation of hepatitis C virus infection by new four-antigen recombinant immunoblot assay. Lancet 337:317–319 [View Article][PubMed]
    [Google Scholar]
  46. Verma R., Behera B. K., Jain R. B., Arora V., Chayal V., Gill P. S. 2014; Hepatitis C, a silent threat to the community of Haryana, India: a community-based study. Australas Med J 7:11–16 [View Article][PubMed]
    [Google Scholar]
  47. World Health Organization 2002; Hepatitis C. (accessed 23rd October 2015) http://www.who.int/csr/disease/hepatitis/Hepc.pdf?ua=1
/content/journal/jmm/10.1099/jmm.0.000284
Loading
/content/journal/jmm/10.1099/jmm.0.000284
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error