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Brazilian Journal of Infectious Diseases

Print version ISSN 1413-8670

Braz J Infect Dis vol.15 no.3 Salvador May/June 2011 



HCV genotype 4 circulating in the city of Franca, São Paulo state, Brazil



Rejane Maria Tommasini GrottoI; Silvia Maria CorvinoII; Juliana Lara PadovaniIII; Sônia Maria de Coppio SiqueiraIV; Maria Inês de Moura Campos PardiniV

IBSPS, PhD Researcher; Molecular Biology Laboratory, Blood Transfusion Center, Medical School, Universidade Estadual Paulista (UNESP), Brazil
IIBS, MSc Researcher; Molecular Biology Laboratory, Blood Transfusion Center, Medical School, UNESP, Brazil
IIIBS, MSc Post-graduation Student; Molecular Biology Laboratory, Blood Transfusion Center, Medical School, UNESP, Brazil
IVMD, Physician, Santa Casa de Paraguaçu Paulista, SP, Brazil
VBS, PhD; Molecular Biology Laboratory, Blood Transfusion Center, Medical School, UNESP, Brazil

Correspondence to



The hepatitis C virus (HCV) genotype distribution worldwide depends on the geographic region1 and although genotype 1 is the most prevalent in Brazil, followed by types 3 and 2, other genotypes have been reported in the country, albeit with a low occurrence rate.2 Identification of the viral genotype has epidemiological, clinical and laboratory importance, as it is necessary for therapeutic indication, diagnostic assay target definition and indicates infection progression.3

In the city of Franca, in the countryside of São Paulo State, Brazil, one case of hepatitis C virus genotype 4 (HCV-4) was identified in a 38-year-old male patient from the town of Paraguaçu Paulista, whose HCV infection had been confirmed since 2005. The patient reported the use of intravenous drugs, having been an inmate for several years and having travelled around the state many times. He was currently living in the city of Franca.

Clinically, the patient had a confirmed case of pulmonary tuberculosis. The patient's circulating virus was genotyped by reverse hybridization and the result disclosed the presence of viral genotype 4c/4d. This result was confirmed by automated sequencing of the genomic regions 5'UTR, NS5B and core.

The analysis of the regions sequenced through HCV-Blast available at the database The Los Alamos HCV sequence ( confirmed the presence of genotype 4; however, the subtyping turned out to be 4a, which was in disagreement with the subtyping obtained through reverse hybridization. Discordant results in genotype 4 subtyping through sequencing and reverse hybridization have been previously reported by Zekri et al.,4 as well as in other genotypes.5

Case reports as the one described here are important to characterize the epidemics and to detect variation in genotype distribution in the country, as well as to promote epidemiological surveillance and acquire information about the virus introduction and transmission routes in the country.



1. Simmonds P, Bukh J, Combet C et al. Consensus Proposals for a Unied System of Nomenclature of Hepatitis C Virus Genotypes. Hepatology 2005; 42(4):962-73.         [ Links ]

2. Campiotto S, Pinho LR, Carrilho FJ et al. Geografic distribuition of hepatitis C virus genotypes in Brazil. Braz J Med Biol Res. 2005; 38(1):41-9.         [ Links ]

3. Zhou S, Terrault NA, Ferrell L et al. Severity of liver disease in liver transplantation recipients with hepatitis C virus infection: relationship to genotype and level of viremia. Hepatology 1996; 24(5):1041-6.         [ Links ]

4. Zekri ARN, El-Din HMA, Bahnassy AA et al. TRUGENE Sequencing Versus INNO-LiPA for Sub-Genotyping of HCV Genotype-4. J Med Virol. 2005; 75:412-20.         [ Links ]

5. Levada PM, Verdichio-Moraes CF, Corvino SM, Grotto RMT, Silva GF, Pardini MIM. Hibridização reversa e sequenciamento na genotipagem do vírus da hepatite C. Rev Soc Med Trop. 2010; 43(2):135-8.         [ Links ]



Correspondence to:
Rejane Maria Tommasini Grotto
Laboratório de Biologia Molecular, Divisão Hemocentro Faculdade de Medicina, UNESP
Distrito Rubião Júnior, s/nº
Botucatu, SP, Brasil 18618-000

Submitted on: 02/11/2011
Approved on: 02/13/2011
Financial Support: Secretary of Health of São Paulo State (SESSP), Brazil and Viral Hepatitis Program, São Paulo State, Brazil.
We declare no conflict of interest.

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