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Journal of Clinical Microbiology, February 2004, p. 784-791, Vol. 42, No. 2
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.2.784-791.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Hepatitis C Virus (HCV) Genotypes in the Caribbean Island of Martinique: Evidence for a Large Radiation of HCV-2 and for a Recent Introduction from Europe of HCV-4

Laboratoire de Virologie-Immunologie,¹ Service de Maladies Infectieuses et Tropicales,³ Service d'Hépato-Gastro-Entérologie,⁴ Centre Régional de Traitement de l'Hémophilie,⁵ Service de Santé Publique, Centre Hospitalier Universitaire de Fort-de-France,⁶ Laboratoire de Biologie, Centre Hospitalier du Lamentin, Martinique ,⁷ Laboratoire de Bactériologie, Virologie-Hygiène, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris EA 3406, Université Paris 13, Bobigny, France²

Received 14 April 2003/ Returned for modification 17 July 2003/ Accepted 25 September 2003

Molecular epidemiological studies of hepatitis C virus (HCV) in the Caribbean may help to specify the origin and spread of HCV infection. Indeed, the Caribbean population is intermixed from European and African origins and geographically close to the American continent. We characterized HCV genotypes in the Caribbean island of Martinique. HCV genotypes were analyzed by sequencing or reverse hybridization in the 5' noncoding region (5'NC) in 250 HCV-monoinfected and 85 HCV-human immunodeficiency virus (HIV)-coinfected patients. In addition, sequencing in the nonstructural 5B (NS5B) gene was required to determine the subtype or to perform phylogenetic analysis in selected samples. Genotypes 1 to 6 were found, respectively, in 84.4, 6.8, 5.2, 2.8, 0.4, and 0.4% of 250 HCV-monoinfected patients and in 71.7, 7.1, 15.3, 5.9, 0, and 0% of 85 HCV-HIV-coinfected patients. HCV-1b was found in 66.4% of the HCV-monoinfected patients and was associated with blood transfusion, whereas HCV-1a was detected in 41.2% of the HCV-HIV-coinfected patients and was associated with intravenous drug use (IVDU). The HCV-3 strains belonged to subtype 3a and were linked to IVDU. Phylogenetic analyses were focused on HCV-2 and HCV-4, which are common in Africa. Two opposite patterns were evidenced. NS5B sequences from 19 HCV-2 isolates were affiliated with many different subtypes described either in Europe or in West Africa, suggesting an ancient radiation. In contrast, seven of the nine HCV-4 NS5B sequences ranged within HCV-4a and HCV-4d clusters spreading in continental France by the IVDU route. Epidemiological data demonstrate the recent introduction of HCV-4a and -4d subtypes into the Caribbean.

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