Molecular Epidemiology of Hepatitis C and Their Correlation With Chronic Liver Disease Progression in Patients Attending a Tertiary Care Hospital

Background: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and may progress to fibrosis, cirrhosis, and hepatocellular carcinoma. Molecular detection of HCV RNA is important for confirming active infection and evaluating its association with advanced liver disease. The aim is to investigate the molecular epidemiology of HCV infection and assess its association with chronic liver disease progression among patients attending a tertiary care hospital. Materials and Methods: An observational cross-sectional study was conducted in the Department of Microbiology, Index Medical College Hospital and Research Centre, Indore, Madhya Pradesh, from January 2023 to January 2026. A total of 220 adult patients with clinically diagnosed chronic liver disease and suspected or confirmed HCV infection were included. Serum samples were screened using the SD BIOLINE HCV Rapid Test and HCV Microlisa ELISA. HCV RNA was extracted using the QIAamp Viral RNA Mini Kit and detected by real-time RT-PCR using the artus HCV RG RT-PCR Kit on a Rotor-Gene Q system. Clinical risk factors and liver disease stages were evaluated, and appropriate statistical tests were applied. Results: Anti-HCV antibodies were detected in 52 (23.6%) patients by rapid testing and 60 (27.3%) by ELISA, whereas HCV RNA was detected in 66 (30.0%) patients by RT-PCR. The difference among diagnostic methods was statistically significant (χ²=3.94, p=0.047). Among RT-PCR-positive patients, chronic hepatitis was observed in 31 (47.0%), fibrosis in 14 (21.2%), cirrhosis in 15 (22.7%), and hepatocellular carcinoma in 6 (9.1%). Blood transfusion (OR=4.2, p<0.001), hemodialysis (OR=3.7, p=0.006), and injectable drug use (OR=5.9, p=0.002) were significantly associated with HCV RNA positivity. HCV RNA positivity was significantly associated with liver cirrhosis (OR=1.98, 95% CI: 1.01–3.88, p=0.038). Conclusion: Real-time RT-PCR detected a higher proportion of active HCV infections than rapid antibody testing and ELISA. The significant association between HCV RNA positivity and cirrhosis highlights the importance of molecular confirmation and early identification of patients at risk of advanced chronic liver disease.