Sep 3, 2014 - Siew-Lin Ngui,1* Lisa Brant,1 Peter V. Markov,2 John-Paul Tung,1 Oliver G. Pybus,2. Chong-Gee Teo,1 and Mary E. Ramsay1. 1Health ...
Journal of Medical Virology 87:417–423 (2015)
Hepatitis C Virus Genotype 4 in England: Diversity and Demographic Associations Siew-Lin Ngui,1* Lisa Brant,1 Peter V. Markov,2 John-Paul Tung,1 Oliver G. Pybus,2 Chong-Gee Teo,1 and Mary E. Ramsay1 1 2
Health Protection Agency, London, United Kingdom Department of Zoology, University of Oxford, Oxford, United Kingdom
HCV strains belonging to genotype 4 may be gaining endemicity across Continental Europe but the extent of their spread in the United Kingdom is unknown. Sera referred from patients attending hospitals in England between 2004 through 2008 were characterised. A total of 243 sera carried HCV genotype 4. The most common subtypes were 4a (33%) and 4d (35%). Compared to patients infected by 4d, those infected by 4a were 20 times more likely to be Middle Eastern than English, and those infected by non-4a/4d were older, tended to be female, and 50 or 12 times more likely to be Middle Eastern or South Asian, respectively, than English. Persons infected by 4d tended to be English rather than Middle Eastern or South Asian. One group of 4d strains clustered with strains reported from persons in Europe engaged in male homosexual activity. Surveillance of trends in the importation and subsequent spread of HCV genotype 4 and its subtypes is advocated. J. Med. Virol. 87:417– 423, 2015. # 2014 Wiley Periodicals, Inc. KEY WORDS:
genotype 4; phylogenetic analysis; diversity
particularly prevalent in North Africa and the Middle East. This genotype is remarkably heterogeneous, with 21 subtypes so far described (European Hepatitis C Virus Database; http://euhcvdb.ibcp.fr/euHCVdb/). It is thought to have originated from Central and West Africa before spreading out to neighbouring regions [Ndjomou et al., 2003]. Although the routes by which HCV genotype 4 was transmitted to this region are unknown [Pybus et al., 2007; Kamal and Nasser 2008], it has been speculated that during the last century unsafe injection practices associated with mass vaccination programmes against smallpox and poliomyelitis [Njouom et al., 2007] and syringe-mediated treatment of trypanosomiasis, yaws, syphilis, malaria and schistosomiasis (Findlay et al., 1941; Beheyt 1958; Strickland 2006; Pe´pin et al., 2010a,b) have contributed. HCV genotype 4 is less prevalent in Europe, comprising
