title: Predominance of hepatitis C virus genotype 4 infection and rapid transmission between 1935 and 1965 in the Central African Republic.
abstract: The molecular epidemiology of hepatitis C virus (HCV) in the Central African Republic (CAR) is poorly documented. Thus, we conducted phylogenetic analyses of NS5B gene sequences from 58 HCV-infected inhabitants of a remote area of south-west CAR, which indicated that 48 (82.8%) were infected with genotype 4 (HCV-4), five (8.6%) with genotype 2 and five (8.6%) with genotype 1. HCV-4 strains were highly heterogeneous, containing previously described subtypes 4k (48%), 4c (27%), 4r (4%), 4f (4%) and unclassified subtypes (17%). To estimate the epidemic history of these HCV-4 strains, an evolutionary analysis using the coalescent approach was used. The estimated date of the most recent common ancestor of the CAR HCV-4 strains was 1539 (95% confidence intervals, 1317-1697). They exhibited a rapid, exponential spread from 1935 to 1965, simultaneously with what was recently reported in neighbouring Cameroon and Gabon. The hypothesis of a massive iatrogenic transmission during interventions for the control of endemic tropical diseases is discussed.
authors.affiliation: Laboratoire de Virologie, Centre Pasteur du Cameroun, Yaoundé, Cameroon.
authors.forename: Richard
authors.initials: R
authors.lastname: Njouom
authors.affiliation: Département de Microbiologie et Infectiologie, Université de Sherbrooke, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Frost
authors.affiliation: Département de Microbiologie et Infectiologie, Université de Sherbrooke, Canada.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Deslandes
authors.affiliation: Ministry of Health, Bangui, Central African Republic.
authors.forename: Fleurie
authors.initials: F
authors.lastname: Mamadou-Yaya
authors.affiliation: Department of Microbiology, Hôpital Maisonneuve-Rosemont, Montréal, Canada.
authors.forename: Annie-Claude
authors.initials: AC
authors.lastname: Labbé
authors.affiliation: Laboratoire d'Épidémiologie, Centre Pasteur du Cameroun, Yaoundé, Cameroon.
authors.forename: Régis
authors.initials: R
authors.lastname: Pouillot
authors.affiliation: Ministry of Health, Bangui, Central African Republic.
authors.forename: Pascal
authors.initials: P
authors.lastname: Mbélesso
authors.affiliation: Ministry of Health, Bangui, Central African Republic.
authors.forename: Sylvestre
authors.initials: S
authors.lastname: Mbadingai
authors.affiliation: Laboratoire de Virologie, Centre Pasteur du Cameroun, Yaoundé, Cameroon.
authors.forename: Dominique
authors.initials: D
authors.lastname: Rousset
authors.affiliation: Département de Microbiologie et Infectiologie, Université de Sherbrooke, Canada.
authors.forename: Jacques
authors.initials: J
authors.lastname: Pépin
mesh_terms: D002488:Central African Republic / Q000453:epidemiology; D015967:Gene Expression Regulation, Viral; D014644:Genetic Variation; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics*; D006526:Hepatitis C / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D010802:Phylogeny; D013997:Time Factors