title: Molecular and epidemiological profiles of hepatitis C virus genotype 4 in Denmark.
abstract: The prevalence of hepatitis C virus (HCV) genotype 4 has increased throughout Europe. This is an epidemiological study of patients infected chronically with HCV genotype 4 in Denmark. The HCV strains analyzed originated from patient samples collected between 1999 and 2007 as part of the national Danish hepatitis B and C network, DANHEP. Sequence analyses were based on the envelope 1 region of HCV. Results from a total of 72 patients indicated a high degree of genetic heterogeneity. Fifty-six patients (78%) were infected with one of the three dominating subtypes: 4d, 4a, or 4r. The remaining 16 patients (22%) were infected with subtypes 4h, 4k, 4l, 4n, 4o, or 4Unclassified. Three epidemiological profiles were identified: (1) patients infected with HCV by intravenous drug use were infected solely with subtype 4d. They were all of European origin, and 15 of the 16 patients were ethnic Danes. No single transmission event could be confirmed, but the pairwise nucleotide identity within the patients of Danish origin was relatively high (∼95%), suggesting a recent introduction into Denmark. (2) The 21 patients infected with subtype 4a all came from Northern Africa, Egypt, Pakistan, or the Middle East. (3) Patients from Southern Africa dominated among patients infected with subtype 4r (10 of 12 patients). This study demonstrates that HCV genotype 4d has been introduced in and spread among Danish intravenous drug users. The remaining subtypes show restricted distribution, infecting almost exclusively patients from geographical areas with a relatively high prevalence of HCV genotype 4 infections.
authors.affiliation: Department of Virology, State Serum Institute, Copenhagen, Denmark.
authors.forename: Mette Brandt
authors.initials: MB
authors.lastname: Eriksen
authors.forename: Louise Bruun
authors.initials: LB
authors.lastname: Jørgensen
authors.forename: Henrik
authors.initials: H
authors.lastname: Krarup
authors.forename: Alex Lund
authors.initials: AL
authors.lastname: Laursen
authors.forename: Peer Brehm
authors.initials: PB
authors.lastname: Christensen
authors.forename: Axel
authors.initials: A
authors.lastname: Møller
authors.forename: Poul
authors.initials: P
authors.lastname: Schlichting
authors.forename: Carla
authors.initials: C
authors.lastname: Kuiken
authors.forename: Jens
authors.initials: J
authors.lastname: Bukh
authors.forename: Nina
authors.initials: N
authors.lastname: Weis
mesh_terms: D000328:Adult; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000208:ethnology / Q000635:transmission / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010802:Phylogeny; D015995:Prevalence; D017422:Sequence Analysis, DNA; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology; D014759:Viral Envelope Proteins / Q000235:genetics
chemical_list: C087035:E1 protein, Hepatitis C virus; D014759:Viral Envelope Proteins