Detection of HCV mixed-genotype infection in the hemophilic population

ALOISI NATALIA; BASTON MARIELA; BRACCO MARÍA MARTA; RUIBAL ARES BEATRIZ; DE TEZANOS PINTO MIGUEL; PÉREZ BIANCO RAÚL; BARÉ PATRICIA

Buenos Aires

Congreso; XXIXth International Congress of the World Federation of Hemophilia; 2010

The detection of minor HCV genotypes becomes imperative in hemophilic individuals that are likely to show mixed-genotype HCV infections. Especially in the coinfection setting, our cell culture experiments demonstrated the presence of occult HCV genotypes that were not detected in plasma samples. Additional HCV genotypes emerged in cell cultures from 23 out of 50 HCV chronic hemophilic patients. Forty plasma samples belonging to 19 patients were analyzed with the Versant HCV LIPA and restriction fragment length polymorphisms techniques. The aim was to discover occult HCV genotypes that were observed in cell culture samples, comparing both methodologies. Although 24 out of 40 samples showed the same HCV genotype, comparative results in 5 samples showed a greater sensitivity of the commercial technique to mixed genotypes presence. Nevertheless, the analysis of serial plasma samples contributed to verify the existence of more than one genotype. In addition, discordant results were observed in 10 out of 40 samples, maybe caused by a different ability between the methodologies to detect different HCV genotypes. The use of Versant technique allowed us to confirm the existence of the genotypes that were only discovered under cell culture, supporting the reliability of the results in culture supernatants. Because culture methodologies are difficult to perform in a routine laboratory, the use of a reliable genotyping technique in combination with serial sample analysis could contribute to the correct identification of the infecting HCV genotype and in consequence, would help to provide the proper dose and duration of antiviral therapy.