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                <title xml:lang="en">Predominance of hepatitis C virus genotype 4 infection and rapid transmission between 1935 and 1965 in the Central African Republic.</title>
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                    <surname>Labbé</surname>
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                    <surname>Pouillot</surname>
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                    <forename type="first">Jacques</forename>
                    <surname>Pépin</surname>
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                <idno type="issn">0022-1317</idno>
                <idno type="eissn">1465-2099</idno>
                <title level="j">Journal of General Virology</title>
                <imprint>
                  <publisher>Microbiology Society</publisher>
                  <biblScope unit="volume">90</biblScope>
                  <biblScope unit="issue">Pt 10</biblScope>
                  <biblScope unit="pp">2452-6</biblScope>
                  <date type="datePub">2009-10</date>
                  <date type="dateEpub">2009-06-17</date>
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              <classCode scheme="mesh">Central African Republic</classCode>
              <classCode scheme="mesh">Gene Expression Regulation, Viral</classCode>
              <classCode scheme="mesh">Time Factors</classCode>
              <classCode scheme="mesh">Genetic Variation</classCode>
              <classCode scheme="mesh">Genotype</classCode>
              <classCode scheme="mesh">Hepacivirus</classCode>
              <classCode scheme="mesh">Hepatitis C</classCode>
              <classCode scheme="mesh">Humans</classCode>
              <classCode scheme="mesh">Molecular Epidemiology</classCode>
              <classCode scheme="mesh">Molecular Sequence Data</classCode>
              <classCode scheme="mesh">Phylogeny</classCode>
              <classCode scheme="halDomain" n="sdv.mp.vir">Life Sciences [q-bio]/Microbiology and Parasitology/Virology</classCode>
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              <classCode scheme="halOldTypology" n="ART">Journal articles</classCode>
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              <p>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.</p>
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