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Heterogeneity of hepatitis C virus genotype 4 strains circulating in south-western France

¹ Service de Virologie, Hôpital Purpan, EA2046-IFR30, CHU Toulouse, 31059 Toulouse Cedex, France
² Service de Médecine Interne, Hôpital Purpan, EA2046-IFR30, CHU Toulouse, 31059 Toulouse Cedex, France
³ Service de Gastro-entérologie, Hôpital Purpan, EA2046-IFR30, CHU Toulouse, 31059 Toulouse Cedex, France

Correspondence
Jacques Izopet
izopet{at}cict.fr

Hepatitis C virus (HCV) is a major cause of liver disease. Knowledge of HCV variability is crucial for clinical and epidemiological analysis. HCV genotype 4 (HCV-4) has become increasingly prevalent in European countries, including France, in recent years. The present study investigates the heterogeneity of HCV-4 in south-western France by phylogenetic analysis of NS5B sequences from 166 patients. The E2 region of 90 strains was also analysed. Genotype 4 accounts for 7·4 % of HCV infections in this area. Analysis of the NS5B region revealed 12 subtypes and the NS5B and E2 phylogeny data were congruent, except for one strain. The epidemiological data indicated two main groups of patients. One included intravenous drug users (IVDUs) of French origin, who were infected by homogeneous strains of subtypes 4a or 4d. The second group comprised non-IVDU patients who were infected with heterogeneous strains. This group was subdivided into patients of French origin, who were infected with eight subtypes, and patients from non-European countries (Central Africa or the Middle East), who were mainly infected with 4f, 4k, 4r and other subtypes; they showed the greatest genetic heterogeneity. This study of a large cohort of patients shows the great diversity of HCV-4 strains, and that these subtypes have spread differently.

The GenBank/EMBL/DDBJ accession numbers for the NS5B sequences reported in this paper are AY743050–AY743215 and those for the E2 sequences are AY742960–AY743049.

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