Authors: Martha Powell, Future Science Group
Three new strains of hepatitis C have been identified in a population study in Africa. The new strains were found to be circulating in the general population in sub-Saharan Africa and their susceptibility to currently used antiviral treatments remains unknown.
In 2016 the WHO announced an initiative to eliminate hepatitis C as a public health problem globally by 2030. However, direct-acting antiviral drugs, which are effective against multiple strains, are tailored towards strains prevalent in high-income countries and research on the virus in sub-Saharan Africa and other resource-limited areas has been limited.
Senior author, Emma Thomson (Glasgow University, UK), explained: “It is important that there is a concerted effort to characterize hepatitis C strains in sub-Saharan Africa at a population level in order to assist countries to select optimal treatments for national procurement. It will also be important to inform vaccine design which would catalyze the elimination of hepatitis C by 2030.”
This study, published recently in Hepatology, screened the blood of 7751 individuals from the general population in Uganda using next-generation and Sanger sequencing. The analysis of these samples, and two further samples from individuals born in the Democratic Republic of Congo, revealed three completely new strains of the virus, in addition to previously known strains.
The team also discovered that many of the strains present in Sub-Saharan Africa carry mutations in genes known to be associated with resistance to commonly used antiviral drugs, proving that careful approaches are needed to diagnose and treat hepatitis C effectively in Africa.
Joint first author, George Mgomella from the Wellcome Sanger Institute and University of Cambridge (both Cambridge, UK), commented: “In the largest study of hepatitis C in the general population in sub-Saharan Africa to date, we found a diverse range of hepatitis C virus strains circulating, and also discovered new strains that had never been seen before.”
“Further research is needed as some antiviral drugs are effective against specific strains of hepatitis C virus and may not work as well in these populations.”
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Source: Davis C, Mgomella GS, da Silva Filipe A et al. New highly diverse hepatitis C strains detected in sub‐Saharan Africa have unknown susceptibility to direct‐acting antiviral treatments. Hepatol. doi:10.1002/hep.30342 (2018).