ABSTRACT
Hepatitis C virus (HCV) isolates circulating in Morocco are poorly documented. To determine the subgenotype distribution of HCV in chronically infected patients, serum samples from 185 anti-HCV-positive patients were analyzed. Determination of the HCV genotype and subtype was performed by sequencing the 5'UTR, NS5B and core regions. According to the NS5B phylogeny, the HCV strains primarily belonged to subtypes 1b (75.2%), 2i (19.1%) and 2k (2.8%). Using a Bayesian approach, the mean date of appearance of the most recent common ancestor was estimated to be 1910 for HCV-1b and 1854 for HCV-2i. Although it is currently the most frequent genotype in Morocco and the dominant form in hepatocellular carcinoma, it thus appears that HCV-1b was introduced into the population subsequently to HCV-2i.
Subject(s)
Evolution, Molecular , Genetic Variation , Hepacivirus/classification , Hepacivirus/genetics , Hepatitis C, Chronic/epidemiology , Hepatitis C, Chronic/virology , RNA, Viral/genetics , 5' Untranslated Regions , Adult , Aged , Aged, 80 and over , Cluster Analysis , Female , Genotype , Hepacivirus/isolation & purification , Humans , Male , Middle Aged , Molecular Epidemiology , Molecular Sequence Data , Morocco/epidemiology , Phylogeny , Sequence Analysis, DNA , Viral Nonstructural Proteins/geneticsABSTRACT
BACKGROUND: In Morocco, chronic liver disease related to hepatitis B virus (HBV) is a public health burden. Treatment of chronic hepatitis B is often complicated by the appearance of escape mutants after treatment with nucleoside analogs, especially with genotypes responsible for the more severe form of the disease. OBJECTIVES: In the present study we investigate the prevalence of the different HBV genotypes in Morocco since no previous careful study has been attempted. METHODS: Epidemiological data from 91 chronically infected patients (45 women and 46 men) were collected prospectively. Sera were tested for anti-HBc IgG, HBeAg, anti-HBe antibody and liver enzymes. Restriction Fragment Length Polymorphism (RFLP) analysis was confirmed by subsequent sequencing of the pre-S and S region of the viral genome in order to determine which HBV genotypes were prevalent among Moroccan patients. RESULTS: The mean age was 41+/-12.4 years. Ten patients (11%) were positive for hepatitis B e antigen (HBeAg) and 81 (89%) were positive for anti-HBe antibodies. By the RLFP method, genotype D, pattern D2, was found in the 77 cases where HBV was successfully amplified. Phylogenetic analysis based on pre-S/S sequences revealed that genotype D in Morocco differed from others D strains subgenotypes (D1, D2, D3 and D4). In addition, the pre-core mutant defined as HBeAg-negative/anti-HBe-positive and HBV DNA positive was detected in 86% of cases. CONCLUSIONS: Our results clearly show that genotype D and pre-core mutant are highly prevalent in Morocco.
