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. 2019 Oct 22;19(1):875.
doi: 10.1186/s12879-019-4514-1.

Molecular characterization of hepatitis C virus in liver disease patients in Botswana: a retrospective cross-sectional study

Lynnette Bhebhe  1   2 , Motswedi Anderson  1 , Sajini Souda  3 , Wonderful T Choga  1   2 , Edward Zumbika  2 , Zachary M Shaver  1 , Tshepiso Mbangiwa  1   4 , Bonolo B Phinius  1 , Chabeni C Banda  1 , Pinkie Melamu  1 , Rosemary M Musonda  1   5 , Max Essex  1   5 , Jason T Blackard  6 , Sikhulile Moyo  1   5 , Simani Gaseitsiwe  7   8
Affiliations

Molecular characterization of hepatitis C virus in liver disease patients in Botswana: a retrospective cross-sectional study

Lynnette Bhebhe et al. BMC Infect Dis. .

Abstract

Background: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease globally. Direct acting antivirals (DAAs) have proven effective in curing HCV. However, the current standard of care (SOC) in Botswana remains PEGylated interferon-α (IFN-α) with ribavirin. Several mutations have been reported to confer resistance to interferon-based treatments. Therefore, there is a need to determine HCV genotypes in Botswana, as these data will guide new treatment guidelines and understanding of HCV epidemiology in Botswana.

Methods: This was a retrospective cross-sectional pilot study utilizing plasma obtained from 55 participants from Princess Marina Hospital in Gaborone, Botswana. The partial core region of HCV was amplified, and genotypes were determined using phylogenetic analysis.

Results: Four genotype 5a and two genotype 4v sequences were identified. Two significant mutations - K10Q and R70Q - were observed in genotype 5a sequences and have been associated with increased risk of hepatocellular carcinoma (HCC), while R70Q confers resistance to interferon-based treatments.

Conclusion: Genotypes 5a and 4v are circulating in Botswana. The presence of mutations in genotype 5 suggests that some patients may not respond to IFN-based regimens. The information obtained in this study, in addition to the World health organization (WHO) recommendations, can be utilized by policy makers to implement DAAs as the new SOC for HCV treatment in Botswana.

Keywords: Botswana; DAA; Genotypes; HCV; Hepatitis C virus; Mutations.

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Conflict of interest statement

SM is an editorial board member for BMC Infectious disease. The remaining authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
a Boxplot that shows the age distribution of HCV positive participants with a median of 55.5 years and interquartile range of 39.25–57.5 years. b The age distribution was further stratified by gender and observed in older men (~ 65 years) and in middle-aged women
Fig. 2
Fig. 2
Phylogenetic tree using Bayesian analysis of the 6 amplified Botswana HCV sequences and GenBank references. Reference sequences are labelled with the genotype + accession number + country. The genotype 5a sequences from Botswana are highlighted in red with the prefix LB, while the genotype 4v sequences from Botswana are highlighted in blue with the prefixes LB
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