Hepatitis C virus genotype 4 is highly prevalent in central Africa (Gabon)

Xu, Lizhe; Larzul, Daniel; Delaporte, Eric; Bréchot, Christian; Kremsdorf, Dina

doi:10.1099/0022-1317-75-9-2393

Cited by 95 publications

(78 citation statements)

References 31 publications

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“…Our results demonstrate that HCV genotypes 1 and 2 are present in Cameroon -previous studies have typically found genotype 4 in Central Africa (Xu et al, 1994;Fretz et al, 1995;Stuyver et al, 1994Stuyver et al, , 1995. The Cameroonian genotype 4 strains are more diverse than those sampled from other Central African countries or from Egypt; in the latter country, the HCV epidemic is quite homogeneous and is dominated by subtype 4a (Rapicetta et al, 1998;Ray et al, 2000).…”

Section: Discussionsupporting

confidence: 53%

“…It is also clear that several genotype 1 and 4 lineages were present in Egypt about 80 years ago, since these lineages were all spread within Egypt by parenteral antischistosomal treatment (PAT) campaigns initiated around 1920 (Frank et al, 2000;Ray et al, 2000;Pybus et al, 2003). The higher prevalence of HCV infection in Cameroon compared to other Central and West African countries is consistent with long-term endemicity in Cameroon (Louis et al, 1994;Kowo et al, 1995;Nkengasong et al, 1995a;Ndjomou et al, 2002;Xu et al, 1994;Fretz et al, 1995;Ruggieri et al, 1996;Jeannel et al, 1998;Wansbrough-Jones et al, 1998). We are unaware of a scenario in Cameroon similar to the Egyptian PAT campaign, so it is possible that the high prevalence of HCV in Cameroon has been favoured by long-term stability in virus transmission, facilitated possibly by unsafe parenteral practices.…”

Section: Discussionmentioning

confidence: 73%

“…These strains have spread rapidly through infected blood products and intravenous drug use (Pybus et al, 2001). The distribution of HCV genotypes in non-Western countries is less well documented, although small-scale surveys have found considerable sequence diversity of genotypes 1, 2 and 4 in African countries (Xu et al, 1994;Fretz et al, 1995;Ruggieri et al, 1996;Wansbrough-Jones et al, 1998;Jeannel et al, 1998), suggesting that these strains have been endemic to the continent for several hundred years (Smith et al, 1997;Pybus et al, 2001). The investigation of HCV genetic diversity in subSaharan Africa is, therefore, necessary to provide insights into the global epidemiology, epidemic history and origin of HCV.…”

Section: Introductionmentioning

confidence: 99%

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Phylogenetic analysis of hepatitis C virus isolates indicates a unique pattern of endemic infection in Cameroon

Ndjomou

Pybus

Matz

2003

Journal of General Virology

101

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Hepatitis C virus (HCV) is a blood-borne pathogen that poses a significant threat to public health worldwide. The genetic diversity and distribution of HCV genotypes in non-Western countries, particularly subSaharan Africa, is poorly documented. This study reports a phylogenetic analysis of core and NS5B gene sequences of 37 HCV strains sampled in Cameroon. A high level of genetic diversity of both genotypes 1 and 4 was found, indicating a unique pattern of long-term HCV infection that has not been observed elsewhere. These results lead to the hypothesis that these HCV genotypes originated and diversified in west Central Africa before spreading to other regions. INTRODUCTIONHepatitis C virus (HCV) is a leading global cause of liver disease. It is estimated that more than 170 million people worldwide are chronically infected with HCV and are at risk of developing liver cirrhosis and liver cancer (WHO, 1997).HCV is a single-stranded, positive-sense RNA virus, with a genome of 9?7 kb long containing a single ORF. The ORF encodes three structural proteins (including the capsid protein, core) and six non-structural proteins (including the RNA polymerase, NS5B). The ORF is flanked by two NCRs located at the 59 and 39 ends (Choo et al., 1991).HCV is genetically diverse and is classified into six major genotypes, each of which is divided further into several subtypes (Robertson et al., 1998). HCV genotypes differ at more than 30 % of nucleotides across the entire genome, while HCV subtypes vary at more than 20 % of sites (Simmonds, 1995). HCV genotypes show different geographical distributions and levels of diversity, reflecting their different epidemic histories and routes of transmission. HCV isolates from Western countries typically have limited sequence diversity, resulting from the recent introduction of a few strains (such as subtypes 1a, 1b and 3a) from endemic areas. These strains have spread rapidly through infected blood products and intravenous drug use (Pybus et al., 2001). The distribution of HCV genotypes in non-Western countries is less well documented, although small-scale surveys have found considerable sequence diversity of genotypes 1, 2 and 4 in African countries (Xu et al., 1994; Fretz et al., 1995;Ruggieri et al., 1996;Wansbrough-Jones et al., 1998;Jeannel et al., 1998), suggesting that these strains have been endemic to the continent for several hundred years (Smith et al., 1997; Pybus et al., 2001). The investigation of HCV genetic diversity in subSaharan Africa is, therefore, necessary to provide insights into the global epidemiology, epidemic history and origin of HCV. Furthermore, availability of more sequence data from subSaharan Africa may help to refine the HCV classification system.In this work we present a phylogenetic analysis of core and NS5B gene sequences obtained from 37 HCV strains isolated in Cameroon. We show that HCV genotypes 1 and 4 are both highly divergent in Cameroon, indicating the longterm presence of both strains in west Central Africa. This pattern of HCV endemicity i...

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

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Phylogenetic analysis of hepatitis C virus isolates indicates a unique pattern of endemic infection in Cameroon

Ndjomou

Pybus

Matz

2003

Journal of General Virology

101

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“…1,6,7,48 Despite the fact that HCV genotype 4 is sometimes found in Europe, this genotype is the predominant one in the Middle East and Africa, excluding the Republic of South Africa. 16,[49][50][51] In this study, 96% (74 of 77) of the Egyptian HCV strains were genotype 4. This is consistent with the report by McOmish and others, 16 who found genotype 4 to be the predominant one in Egypt.…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma in Egyptians with and without a history of hepatitis B virus infection: association with hepatitis C virus (HCV) infection but not with (HCV) RNA level.

Yates

Hafez²,

Beld³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. The aim of this study was to analyze the association of hepatocellular carcinoma (HCC) with hepatitis C virus (HCV) in Egypt, using hepatitis B virus (HBV) and hepatitis E virus (HEV) as virus controls. In addition, the association of HCC with HCV RNA levels among persons seropositive for HCV was analyzed. We compared 131 patients with proven HCC, 247 with bladder cancer, and 466 healthy hospital employees. Age, sex, and place of residence were recorded to study confounding factors. Among the healthy controls, 16% were seropositive for HCV, 21% for HBV, and 31% for HEV. When healthy controls were age-matched with HCC patients, the latter were significantly (P Ͻ 0.001) more often HCV seropositive (67%) than were the controls (30%). The seropositivity for HBV and HEV did not differ significantly in frequency between the two groups. The seropositivity for HCV was also significantly (P Ͻ 0.001) more often found in HCC patients (76%) than in BC patients (47%), with seroprevalences for HBV and HEV not differing significantly in these age-matched groups. In HBV-negative HCC and bladder cancer patients, seroprevalence for HCV was significantly (P ϭ 0.002) higher in HCC patients (68%) than in bladder cancer patients (36%). This difference was even more pronounced (P Ͻ 0.001) in HBV-positive HCC and bladder cancer patients (78% versus 52%, respectively). Of HCV-seropositive individuals, 49% were HCV RNA positive by branched DNA assay, and of these, 96% were infected by HCV genotype 4. No correlation between HCV RNA load and seropositivity of HBV or age or disease state was found. Infection with HCV and HCV-HBV double infection, but not HBV or HEV infection alone, is strongly correlated with HCC in Egypt.Hepatitis C virus (HCV) causes more than 90% of parenterally transmitted non-A, non-B (NANBH) hepatitis.1-4 In more than 85% of HCV infections, the infection persists and leads to chronic hepatitis. 4,5 Once chronic hepatitis is established, it may slowly progress to worsening stages of fibrosis and cirrhosis and ultimately lead to the development of hepatocellular carcinoma (HCC). 1,[6][7][8] In the first two decades after acute HCV infection, both mortality and morbidity remain modest in frequency, but after this period both can be expected to increase.1,2 Infection with HCV is widely recognized as the most common indication for liver transplantation 9 in the United States, Europe, and Japan. Although no firm data are available, death rates for HCC in Egypt appear to be increasing over the last decade. 10,11 Hepatitis virus infections of any kind are highly prevalent in the general population. The relatively high prevalence of HCV infections in Egypt was first established in 1992 by Kamel and others. 12 Other groups thereafter found HCV seroprevalence rates ranging from 6% to 38% with an average of approximately 15%. [12][13][14][15][16] The reasons behind these high HCV infection rates being 5-35-fold higher than reported elsewhere in the world are still unknown. In Egypt, the HCV seroprevalence was 55% among ...

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“…Further work has help to understand the history of the HCV epidemic in Cameroon, where mass therapeutic or vaccine campaigns would have contributed to the spread of this infection during the colonial era [131]. In Gabon and Central African Republic, the predominance of the heterogeneous genotype 4 has been reported [132,133,134]. Equally, few HBV genotype studies have been conducted Central Africa.…”

Section: Hepatitis Virusesmentioning

confidence: 99%

Application of PCR Technologies to Humans, Animals, Plants and Pathogens from Central Africa

Odile¹,

Migot-Nabias²,

Born³

et al. 2012

Polymerase Chain Reaction

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Hepatitis C virus genotype 4 is highly prevalent in central Africa (Gabon)

Cited by 95 publications

References 31 publications

Phylogenetic analysis of hepatitis C virus isolates indicates a unique pattern of endemic infection in Cameroon

Phylogenetic analysis of hepatitis C virus isolates indicates a unique pattern of endemic infection in Cameroon

Hepatocellular carcinoma in Egyptians with and without a history of hepatitis B virus infection: association with hepatitis C virus (HCV) infection but not with (HCV) RNA level.

Application of PCR Technologies to Humans, Animals, Plants and Pathogens from Central Africa

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