Prevalence and Genotype Distribution of Hepatitis C Virus Infection at Zonal Hospital in Northern India

Sir, In May 2024–August 2024, issue of the Journal of Marine Medical Society, Thoke and Yadav[1] used serology to study hepatitis C virus (HCV) infection prevalence and genotype distribution at Zonal Hospital, Northern India. They reported HCV prevalence of 5.7% and 12.5% by rapid test and enzyme-linked immunosorbent assay, respectively. After testing the HCV genotype, the prevalence became 12.1%. They detected the genotypes of 3A, 1A, 1B, 3B, and 4 in 69.49%, 16.95%, 8.47%, 3.39%, and 1.69% of patients, respectively.[1] Because of the following methodological limitation, the study results should be viewed with caution. Recombinase polymerase amplification (RPA) is a new technology to speedily amplify particular nucleic acid from low-processed clinical samples using small portable sets. It is an excellent option for pathogen detection, particularly in low-resource settings.[2] It has many advantages such as a rapid amplification speed, simple operation, and reaction at 37°C–42°C. It is highly appropriate for field detection of various bacteria, viruses, fungi, and parasites.[3] Compared to serology, the reverse transcription RPA (RT-RPA) test is capable of detecting all genotypes of HCV with a detection limit of detection of 25 copies per reaction. The specificity and sensitivity of the RT-RPA test were found to be 100% when assessed utilizing various clinical specimens. Moreover, its short runtime, precision, and little heating needs could importantly facilitate its application in a point-of-care HCV test to widely broaden the access to useful therapy through fast HCV diagnosis.[4] As with any diagnostic kit, its applicability in a clinical setting is based on cost, time, labor involved, and purpose of application. To the best of our knowledge, RT-RPA kit for HCV detection is not available for commercial purposes, but is limited for scientific research, costly, and has not yet received FDA/in-vitro diagnostic approval. Nevertheless, we believe that better insight into HCV prevalence and genotypes could be obtained if Thoke and Yadav[1] could refer to the RT-RPA test rather than serology in the study methodology. We understand that using the RT-RPA test in research in India might be challenging due to limited availability and constrained financial resources. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.