Abstract
Brazil is a country of continental dimension with a population of different ethnic backgrounds. Thus, a wide variation in the frequencies of hepatitis C virus (HCV) genotypes is expected to occur. To address this point, 1,688 sequential samples from chronic HCV patients were analyzed. HCV-RNA was amplified by the RT-PCR from blood samples collected from 1995 to 2000 at different laboratories located in different cities from all Brazilian States. Samples were collected in tubes containing a gel separator, centrifuged in the site of collection and sent by express mail in a refrigerated container to Laboratório Bioquímico Jardim Paulista, São Paulo, SP, Brazil. HCV-RNA was extracted from serum and submitted to RT and nested PCR using standard procedures. Nested PCR products were submitted to cycle sequencing reactions without prior purification. Sequences were analyzed for genotype determination and the following frequencies were found: 64.9% (1,095) for genotype 1, 4.6% (78) for genotype 2, 30.2% (510) for genotype 3, 0.2% (3) for genotype 4, and 0.1% (2) for genotype 5. The frequencies of HCV genotypes were statistically different among Brazilian regions (P = 0.00017). In all regions, genotype 1 was the most frequent (51.7 to 74.1%), reaching the highest value in the North; genotype 2 was more prevalent in the Center-West region (11.4%), especially in Mato Grosso State (25.8%), while genotype 3 was more common in the South (43.2%). Genotypes 4 and 5 were rarely found and only in the Southeast, in São Paulo State. The present data indicate the need for careful epidemiological surveys throughout Brazil since knowing the frequency and distribution of the genotypes would provide key information for understanding the spread of HCV.
Highlights
Hepatitis C is an infection of worldwide occurrence with more than 170 million infected people around the world
The aim of the present study was to determine the frequency of hepatitis C virus (HCV) genotypes in a large number of samples from different regions in Brazil using a standardized methodology
Genotypes 1, 2, 3, 4, and 5 of HCV were found among the 1,688 Brazilian samples studied
Summary
Hepatitis C is an infection of worldwide occurrence with more than 170 million infected people around the world. Most of these hepatitis C virus (HCV) cases are asymptomatic carriers, but chronic infection becomes established in most (85%) of the infected individuals. Hepatitis C is frequently diagnosed in advanced clinical stages or when asymptomatic carriers present themselves as blood-donor candidates. The chronic stage evolves to severe liver disease in almost 20% of the infected individuals [1]. Six major viral genotypes and over 50 proposed subtypes of HCV have been identified worldwide [2]. Viral genotype determination before treatment is currently advised as a routine assay. Patients infected with genotypes 1 and 4 with viral loads
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