Abstract
Characterizing hepatitis C virus (HCV) genetic diversity not only allows us to trace its origin and evolutionary history, but also provides valuable insights into diagnosis, prevention and therapy of HCV infection. Although eight HCV genotypes and 86 subtypes have been classified, there are still some HCV variants that need to be assigned. The genotype 6 is the most diverse HCV genotype and mainly prevalent in Southeast Asia. In this study, we identified a new HCV subtype 6xg from injection drug users (IDUs) in Kachin, Myanmar. A distinctive feature of 6xg from other subtypes of the genotype 6 was a Lys insertion in NS5A gene, which changes the RRKR/K motif into RRKKR/K. Bayesian analyses showed that HCV 6xg originated during 1984–1988, and experienced a rapid population expansion during 2005–2009. We characterized HCV subtype profile among IDUs in this region, and detected six HCV subtypes, including 1a (12.0%), 3a (12.0%), 3b (24.0%), 6n (16.0%), 6xa (20.0%), and 6xg (12.0%). Importantly, we found that HCV subtype distribution in Kachin was very similar to that in Dehong prefecture of Yunnan, but very distinct from those in other regions of Myanmar and Yunnan, indicating that the China–Myanmar border region shared a unique HCV subtype pattern. The appearance of 6xg and the unique HCV subtype profile among IDUs in the China–Myanmar border region have significant epidemiological and public health implications.
Highlights
Despite living in the era of high-efficiency antiviral treatments (Sofosbuvir/Velpatasvir/ Voxilaprevir: Vosevi) (Heo and Deeks, 2018), hepatitis C virus (HCV) infection is still a major global health problem especially for the developing world (Luhmann et al, 2015; Hlaing et al, 2017; WHO, 2017)
Our previous studies showed that HCV prevalence among injection drug users (IDUs) along the China–Myanmar border was over 69% on the Yunnan side, and 48.1% on the Myanmar side (Zhou et al, 2011, 2012)
The most common subtype 1b was rarely detected in Kachin and Dehong. These results indicated that the China–Myanmar border region had a different HCV subtype pattern from other regions (Figure 1)
Summary
Despite living in the era of high-efficiency antiviral treatments (Sofosbuvir/Velpatasvir/ Voxilaprevir: Vosevi) (Heo and Deeks, 2018), hepatitis C virus (HCV) infection is still a major global health problem especially for the developing world (Luhmann et al, 2015; Hlaing et al, 2017; WHO, 2017). A national survey carried out in 2015 revealed that HCV prevalence among the general population was 2.7% in Myanmar, which was much higher than the global prevalence rates of 1% (Lwin et al, 2017; Ministry of Health and Sports Myanmar, 2017; WHO, 2017) These indicated a very severe HCV epidemic among IDUs in Myanmar and the China–Myanmar border region. Burmese IDUs staying in Yunnan appeared to be relatively separated from the local IDUs in IDU behavior (Wan et al, 2016), suggesting that they acquired infection with the new variants in Myanmar To further identify these variants and trace their origin, we performed a HCV molecular epidemiological. 1https://talk.ictvonline.org/ictv_wikis/flaviviridae/w/Sg_flavi/56/hcvclassification investigation among IDUs in Kachin, Myanmar, which borders with Dehong prefecture of Yunnan (Figure 1), and identified these variants as a new HCV subtype 6xg by full-length genomic sequence analyses
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