HEPATITIS-B VIRUS SUBTYPES AND HEPATITIS-C VIRUS GENOTYPES IN PATIENTS WITH CHRONIC LIVER-DISEASE IN NEPAL

A total of 145 patients with chronic liver disease, including 20 with chronic hepatitis, 63 with cirrhosis and 62 with primary hepatocellula r carcinoma from Nepal were tested for markers of hepatitis B virus or hepatitis C virus infection. HBsAg was detected in 57 (39%) and hepat itis C virus RNA in 12 (8%); the cause of liver disease was not known in the remaining 76 (52%). HBsAg was found in 5 (1.3%) of 379 normal c ontrols, whereas hepatitis C virus-associated antibodies were detected in 13 (3.4%), none of whom was positive for serum hepatitis C virus R NA. Subtypes of 102 HBsAg samples, from patients and asymptomatic carr iers, were adw in 35 (34%), adr in 4 (4%) and ayw in 48 (47%); the rem aining 15 (15%) were of atypical subtypes such as ad, ay and a. Of 12 hepatitis C virus RNA samples, genotype I was detected in 1, genotype II in 5 and genotype V in 1; the remaining five samples were not to be classified by polymerase chain reaction with primers specific for gen otypes I to V deduced from hepatitis C virus core sequences, despite h igh hepatitis C virus RNA titers in all of them. Sequences of 192 amin o acids in the entire El region of unclassifiable hepatitis C virus is olates from five patients differed from each other in 17% to 23%, and varied from reported isolates of defined genotypes in 13% to 44%. Thes e results indicate that atypical subtypes of hepatitis B virus and nov el genotypes of hepatitis C virus would prevail in Nepal.