Abstract
Hepatitis C virus (HCV) is genetically highly divergent and classified in seven major genotypes and approximately hundred subtypes. These genotypes/subtypes have different geographic distribution and response to antiviral therapy. In Ethiopia, however, little is known about their molecular epidemiology and genetic diversity. The aim of this study was to investigate the distribution and genetic diversity of HCV genotypes/subtypes in Ethiopia, using 49 HCV RNA positive samples. HCV genotypes and subtypes were determined based on the sequences of the core and the nonstructural protein 5B (NS5B) genomic regions. Phylogenetic analysis revealed that the predominant was genotype 4 (77.6%) followed by 2 (12.2%), 1 (8.2%), and 5 (2.0%). Seven subtypes were identified (1b, 1c, 2c, 4d, 4l, 4r and 4v), with 4d (34.7%), 4r (34.7%) and 2c (12.2%) as the most frequent subtypes. Consistent with the presence of these subtypes was the identification of a potential recombinant virus. One strain was typed as genotype 2c in the NS5B region sequence and genotype 4d in the core region. In conclusion, genotype 4 HCV viruses, subtypes 4d and 4r, are most prevalent in Ethiopia. This genotype is considered to be difficult to treat, thus, our finding has an important impact on the development of treatment strategies and patient management in Ethiopia.
Highlights
Hepatitis C virus (HCV) is an important human pathogen that causes substantial morbidity and mortality worldwide
In this study we report the first nationwide molecular epidemiology and genetic diversity of HCV in Ethiopia, one of the geographically diverse and the second most populous country in Africa
We found a high level of HCV genetic diversity, with four major genotypes (1, 2, 4 and 5) and seven subtypes circulating in the country
Summary
Hepatitis C virus (HCV) is an important human pathogen that causes substantial morbidity and mortality worldwide. The most recent study estimated that more than 185 million people are chronically infected with HCV and 3–4 million new infections occur each year [1]. HCV is one of the leading causes of end-stage liver disease, cirrhosis and hepatocellular carcinoma [2], resulting in over 700,000 deaths annually [3]. HCV is the most common cause of death in HIV-positive patients on highly active antiretroviral therapy [4]. The burden of HCV-related morbidity and mortality will likely continue to increase over the twenty-five years due to the existing pool of chronic HCV infections in low-income countries [5]. HCV is an enveloped, positive-sense, single-stranded RNA virus belonging to the genus Hepacivirus in the family Flaviviridae.
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