Phylogenetic analysis confirms hepatitis C virus transmission among hemodialysis patients in Kosovo

  • Xhevat Jakupi Department of Microbiology, National Institute of Public Health of Kosovo, Prishtina, Kosovo
  • Jana Mlakar Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • Maja M Lunar Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • Ibrahim Rudhani Faculty of Medicine, University of Prishtina "Hasan Prishtina", Prishtina, Kosovo
  • Lul Raka Faculty of Medicine, University of Prishtina "Hasan Prishtina", Prishtina, Kosovo
  • Norma P Tavakoli Division of Genetics, Wadsworth Center, New York State Department of Health, Albany, New York, United States
  • Mario Poljak Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Keywords: HCV, phylogenetic analysis, dialysis, transmission

Abstract

Introduction: It has recently been demonstrated that there is a very high prevalence of hepatitis C virus (HCV) infection among hemodialysis patients in Kosovo with HCV subtype 1 being the most prevalent subtype. In this study, we further detail the molecular epidemiology of HCV outbreaks occurring in seven dialysis centers in Kosovo.

Methodology: In total, 273 samples obtained from HCV RNA positive patients undergoing hemodialysis at one of the seven centers in Kosovo were selected for this study: 171 subtype 1a samples, 91 subtype 4d samples, and 11 subtype 1b samples. A partial HCV NS5B region was amplified and sequenced. Subtype-specific phylogenetic analyses were performed with the inclusion of control sequences and transmission clusters were identified.

Results: NS5B sequences were successfully obtained in 257/273 (94.1%) of samples; 162 subtype 1a, 84 subtype 4d, and 11 subtype 1b sequences. Phylogenetic analyses showed a high degree of phylogenetic clustering of HCV sequences subtyped 1a (99.4%), 1b (63.6%), and 4d (76.2%). Distinct phylogenetic clusters of sequences obtained from hemodialysis patients were observed for all three subtypes studied. In addition, several smaller clusters within the large clusters were identified, mainly from a single dialysis center.

Conclusions: Phylogenetic analyses confirmed nosocomial transmission during dialysis as a major factor in the spread of HCV at the seven dialysis centers in Kosovo.

Published
2019-12-31
How to Cite
1.
Jakupi X, Mlakar J, Lunar M, Rudhani I, Raka L, Tavakoli N, Poljak M (2019) Phylogenetic analysis confirms hepatitis C virus transmission among hemodialysis patients in Kosovo. J Infect Dev Ctries 13:1142-1149. doi: 10.3855/jidc.12099
Section
Original Articles