Quasispecies of genotype 4 of hepatitis C virus genomes in Saudi patients managed with interferon alfa and ribavirin therapy

Background and Objectives : Many patients with hepatitis C virus (HCV) infection do not respond to antiviral treatment, possibly due to viral quasispecies. We aimed to investigate whether the quasispeices population could be used as a predictor of response to therapy in our patients. Methods : The quasispecies of HCV genotype 4 (HCV-4) were studied in 25 naïve Saudi patients at zero, three, and six months following interferon alfa and ribavirin combination therapy. Hypervariable region 1 within the E2/NS1 gene of the virus was analyzed by the single-strand conformation polymorphism (SSCP) technique after amplification. Results : Pretreatment DNA bands by SSCP (2-7 bands) were detected in all patients. In those who achieved a complete virological response within six months (viral load < 0.2 Meq/mL; n=7), bands ranged from 2-6 (mean = 3.71±1.25). In six of these seven patients, the number of SSCP bands remained either the same or decreased sequentially. In those patients who did not respond (viral load> 0.2 Meq/mL; n=18), the bands also ranged from 2-7; mean 3.77±1.73. In six of these non-responding patients, the SSCP bands remained the same or decreased sequentially. There was no significant difference between pretreatment quasispecies composition and response (P=.53). Two of the four patients with pretreatment high viral load and the same or decreased composition of quasispecies bands responded to the therapy. Conclusion : Quasispecies in our studied patients cannot be used to predict responsiveness to treatment, but may offer an explanation for failure of most HCV-4 patients to respond to interferon alfa and ribavirin therapy

Human papilloma virus-16/18 cervical infection among women attending a family medical clinic in Riyadh

Background: Prevalence information is lacking on human papillomavirus types 16 and 18 (HPV-16/18) in-fection in cervical tissues of women residing in Riyadh, Saudi Arabia. In addition, there are no observations on progression to cervical intraepithelial neoplasia (CIN). Subjects and Methods: Pap smear and HPV-16/18 DNA detection by PCR followed by Southern blotting was performed on 120 subjects (Saudi and other Arab nationals) during routine gynecological examination.Some HPV-positive subjects were followed for 4 years, by Pap smear every 6 months and by HPV DNA detection at the end of 4 years. Results: Overall HPV-16/18 prevalence was 31.6%. HPV-16 prevalence alone was 13.3%, HPV-16 as a mixed infection with HPV-18 was 15%, and all HPV-16 was 28.3%. HPV-18 alone was 3.3%, HPV-18 as a mixed infection with HPV-16 was 15%, and all HPV-18 was 18.3%. Ten subjects had cervical abnormalities with the Pap smear test, six of whom were HPV-16/18 positive, 1 with HPV-16, 1 with HPV-18, and 4 with a mixed infec-tion of HPV-16/18. Of all 23 HPV-16/18-positive subjects, either as individual or mixed infection, followed for 4 years, 7 showed abnormal cytology, 6 at initial examination and 1 during follow-up. Of these 7, 6 reverted to normal without treatment and 1 was treated and became normal after 3 years. None of the subjects progressed to CIN-III. Conclusion: A high prevalence of HPV-16/18 was found, but with a low rate of progression to CIN. A signifi-cant association with abnormal cytology was found only in patients with HPV-16/18 mixed infection

Molecular epidemiology and genotyping of TT virus isolated from Saudi blood donors and hepatitis patients

<b>Background: </b> In Saudi Arabia, the epidemiology and clinical signifi-nance of Torque Teno virus (TTV) infection alone and in patients with hepatitis virus infections have not been determined in a single study. In this paper, we molecularly investigated the rate and genotypes of TTV in-fection among Saudi Arabian blood donors and patients with viral hepa-titis. The effect of TTV coinfection on viral hepatitis was also examined. <b> Subjects and Methods: </b> DNA was extracted from the sera of 200 healthy blood volunteers, 45 hepatitis B virus patients, 100 hepatitis C virus patients, 19 hepatitis G virus patients, and 56 non-A-G hepatitis patients. TTV DNA was amplified using primers derived from the ORF1 and 5&#x2032;UTR regions. The alanine aminotransferase (ALT) level was deter-mined for each specimen. Sequencing of ORF1 amplicons was carried out to investigate TTV genotypes. <b> Results: </b> Using primers derived from ORF1 and 5&#x2032;UTR, TTV DNA was detected in 5.5&#x0025; and 50.5&#x0025;, respectively, of healthy blood donors, in 2.2&#x0025; and 88.8&#x0025; in hepatitis B patients, in 2.0&#x0025; and 70&#x0025; of hepatitis C patients, in 15.8&#x0025; and 100&#x0025; of hepatitis G patients, in 5.4&#x0025; and 12.5&#x0025; of non-A-G hepatitis patients and in 4.8&#x0025; and 56.4&#x0025; overall. No detrimental effect of TTV coinfection in viral hepatitis patients was noted. An overall prevalence of 4.8&#x0025; and 56.4&#x0025; was established. Phylogenetic analysis indicated that the most common genotype of TTV among Saudis is 2c. <b> Conclusion: </b> The rate of TTV infection among Saudi Arabians seems to be lower than that stated in previous reports on Saudi Arabia and in some other countries. The virus does not seem to worsen the status of those who are suffering from viral hepatitis infection