Identification of hepatitis C virus 2k/1b intergenotypic recombinants in Georgia LIVER INTERNATIONAL Zakalashvili, M., Zarkua, J., Weizenegger, M., Bartel, J., Raabe, M., Zangurashvili, L., Kankia, N., Jashiashvili, N., Lomidze, M., Telia, T., Kerashvili, V., Zhamutashvili, M., Abramishvili, N., Hedskog, C., Chodavarapu, K., Brainard, D. M., McHutchison, J. G., Mo, H., Svarovskaia, E., Gish, R. G., Rtskhiladze, I., Metreveli, D. 2018; 38 (3): 451–57

Abstract

This study aimed to evaluate the prevalence of the hepatitis C virus intergenotype recombinant strain RF1_2k/1b in Georgia, confirm viral recombination by full genome sequencing, and determine a genetic relationship with previously described recombinant hepatitis C viruses.We retrospectively analysed data from 1421 Georgian patients with chronic hepatitis C. Genotyping was performed with the INNO-LiPA VERSANT HCV Genotype 2.0 Assay.Virus isolates were assigned to nonspecific hepatitis C genotypes 2a/2c (n = 387) as performed by sequencing of core and NS5B genes. Subsequently, sequencing results classified the core region as genotype 2k and the NS5B region as genotype 1b for 72% (n = 280) of genotype 2 patients, corresponding to 19.7% of hepatitis C patients in Georgia. Eight samples were randomly selected for full genome sequencing which was successful in 7 of 8 samples. Analysis of the generated consensus sequences confirmed that all 7 viruses were 2k/1b recombinants, with the recombination breakpoint located within 73-77 amino acids before the NS2-NS3 junction, similar to the previously described RF1_2k/1b virus. Phylogenetic analysis revealed clustering of the Georgian 2k/1b viruses and RF1_2k/1b, suggesting that they are genetically related.The 19.7% prevalence of RF1_2k/1b in Georgia patients is far higher than has generally been reported to date worldwide. Identification of recombinants in low income countries with a high prevalence of HCV infection might be reasonable for choosing the most cost-effective treatment regimens.

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