Genetic epidemiology of hepatitis C virus throughout Egypt

Hepatitis C virus (HCV) infection is a major health problem in Egypt, where the seroprevalence is 10-20-fold higher than that in the United States. To characterize the HCV genotype distribution and concordance of genotype ass essments on the basis of multiple genomic regions, specimens were obtained from blood donors in 15 geographically diverse governorates throughout Egyp t. The 5' noncoding, core/E1, and NS5B regions were amplified by reverse tr anscription-polymerase chain reaction and analyzed by both restriction frag ment length polymorphism (RFLP) and phylogenetic tree construction. For the 5' noncoding region, 122 (64%) of 190 specimens were amplified and analyze d by RFLP: 111 (91%) were genotype 4, 1 (1%) was genotype 1a, 1 (1%) was ge notype 1b, and 9 (7%) could not be typed. Phylogenetic analyses of the core /E1 and NS5B regions confirmed the genotype 4 preponderance and revealed ev idence of 3 new subtypes, Analysis of genetic distance between isolates was consistent with the introduction of multiple virus strains 75-140 years ag o, and no clustering was detected within geographic regions, suggesting wid espread dispersion at some time since then.