It is estimated that 130-210 million people worldwide are chronically infected with the hepatitis C virus (HCV). Complications of chronic liver disease, like cirrhosis with or without hepatocellular carcinoma, will develop over many years in around 20% of these patients, making HCV infections a major public health issue (1).HCV has six major genotypes and more than 80 subtypes (2). Recently a seventh genotype was proposed (3). Genotypes may differ in their epidemiology, pathogenesis, and response to treatment (4). Type 1, 2, and 3 HCV infections are common throughout the world. Type 4 is prevalent in the Middle East and Africa and responsible for more than 80% of all HCV infections in some countries (5). Genotypes 5 and 6 are mainly found in South Africa and in Southeast Asia, respectively (6). Sustained virological response to standard pegylated interferon plus ribavirin treatment is usually lower for types Background/aim: The frequency of genotype 4 hepatitis C virus (HCV) infections is significantly higher in Kayseri compared to other provinces in Turkey. We aimed to characterize genotype 4 infections in Kayseri by analyzing the demographic and laboratory data of 218 HCV RNA-positive, treatment-naive patients admitted to the Kayseri Training and Research Hospital in 2010 and 2011. Materials and methods:The distributions of sex, age, and viral loads of these patients with respect to HCV genotypes were analyzed. We also characterized the type 4 sequences at the subtype level. Randomly selected sera from 32 of the 72 genotype 4 patients from this cohort were subjected to PCR amplification in the NS5B region and further characterized by sequencing and phylogenetic and molecular clock analysis.Results: Distribution rates of HCV genotypes 1, 4, and 2 in the 218 patients were 62.4%, 33.0%, and 4.6%, respectively. Most of the patients infected with types 1 and 4 were over the age of 40 and female. The NS5B sequences of 32 Kayseri genotype 4 isolates were closely related with type 4d sequences but formed a separate cluster. Conclusion:The introduction of type 4d HCV into the Kayseri region probably took place 30-75 years ago, as predicted by molecular clock analysis.
In Turkey, genotype 1, especially type 1b virus, causes approximately 90% of these infections, while types 2, 3, and 4 exist, albeit in low prevalences and are due to relatively recent and limited introductions. Two recent reports from Kayseri, a relatively large city in Central Anatolia, indicated unusually high prevalence for type 4 infections in the province reaching a 35% among patients admitted to hospitals for treatment of chronic hepatitis C. In this study, the origin, the demographic history, and the dynamic of the epidemic of unusual HCV genotype 4d in Turkey by using Bayesian coalescent-based method were investigated. A gene flow migration approach was also used to describe the synchronous geographical dispersal and genetic diversification of this unusual genotype in Kayseri province. The Turkish clade had a tMRCA of 44 years corresponding to the year 1967 and seems to have a different origin being completely segregated from the European one. Gene flow migration analysis indicated that Kayseri province appeared to be the epicenter of HCV-4d epidemic, exporting the infections. The demographic history of HCV-4d showed that the epidemic started in 1970s year then following a slow exponential growth until 1980s. The Turkish monophyletic clade suggests a segregate circulation of the epidemic in this region mostly due to unsafe parenteral medical procedures (with drug addiction playing a relatively negligible role).
Hantaviruses infect humans via inhalation of viral particles within secretions of infected rodents or rarely through direct contact with infected rodents. Determining the prevalence of hantavirus infections among rodent populations is of vital importance to obtain information on hantavirus-related cases and to predict possible outbreaks. We hypothesized that DOBV strains circulating in the Thrace Region in Turkey would be related to other Balkan DOBV strains. In this study, hantavirus infections in the rodent population of the Kırklareli-İğneada Region (north-western Turkey, near the Bulgarian border) were investigated. This region is of particular importance, as it is located in the south-eastern margin of the European continent and was used as an entrance point of Asian faunal elements into Europe. DOBV infection was detected in eight of 73 rodents; all were of the Apodemus flavicollis species. Partial sequences of the viral S-, M-, and L-genome segments were recovered and compared with previously reported DOBV sequences. The newly characterized Turkish strains were similar to other DOBV variants. Silent nucleotide mutations were dominant. The hantavirus prevalence in the İğneada region was similar to what has been reported in Greece and Bulgaria. For the first time, the M-segment sequences of DOBV from Turkey were recovered and genetic data of hantaviruses from Thrace region of Turkey were obtained.
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