Temporal trends of the genotype and viral load of hepatitis C virus among patients in Dhaka, Bangladesh

Hepatitis C virus (HCV) has become a serious public health issue in Bangladesh, although the prevalence and temporal dynamics of different HCV genotypes have not been well studied. For the treatment of HCV patients, it is essential to know the prognostic variables, i.e., genotypes and viral load, because of their clinical and epidemiological implications. The objective of this study was to investigate the distribution and dynamics of HCV genotypes and viral load across three years, from 2023 to 2025 in 435 HCV-positive patients via real-time PCR. The identified HCV genotypes were 1a (5.29%), 1b (3.91%), 2 (0.23%), 3 (90.35%), and 6 (0.23%). The subjects aged 31–50 years had the highest prevalence of HCV infection. Although the prevalence of HCV in males and females was nearly the same (50.35% vs. 49.65%), multivariate linear regression revealed that the viral load was 4 times higher in males than females (β = 0.60, p < 0.0001). Categorization of the viral load revealed that genotype 3 had a higher viral load than genotypes 1a and 1b, whereas genotype 1b had higher high and medium viral loads than genotypes 1a and 3( p = 0.02). The dynamics of the genotypes and viral load across the three years revealed significant changes in the genotype distribution from 2023 to 2025 ( p = 0.04), whereas a decreasing trend in the viral load was detected ( p = 0.06). During the study period, genotype 3 was the most predominant genotype, followed by 1a and 1b, whereas in 2025, genotype 1b was absent. In conclusion, HCV genotype 3, which has a high pretreatment viral load, especially in male patients, has been the most prevalent genotype for the last three years in Bangladesh, and these findings can aid in HCV management and ground work for further research on viral behavior at different times and in different sexes.