Egypt is one of the countries with very high rates
of hepatitis C virus (HCV) related morbidity
and mortality. However, little is known about
geographical and clinical differences in genetic
variability of HCV in Egypt. Using direct sequencing and phylogenetic analysis of partial core/E1
and NS5B regions of the HCV genome, HCV
genotype/subtype was determined in 129 HCVinfected patients residing in three governates
in south Egypt: Assuit, Sohag, and Qena. According to clinical stage of infection, patients were
categorized into four groups: asymptomatic
carriers, n
¼ 16; chronic hepatitis C patients,
n
¼ 36; liver cirrhosis, n ¼ 54; and hepatocellular
carcinoma (HCC), n
¼ 23. Genotype 4a was
detected in 80.6%, whereas 1g, 4l, 4n, 4o, 4f, and
4m were identified in 7.7%, 4.7%, 3.9%, 1.6%,
0.8%, and 0.8% of cases, respectively. The
prevalence of 4a differed regionally; from 88.5%
(in Sohag) to 64% (in Assuit,
P ¼ 0.002). Genotypes 4l and 4n had a higher prevalence in Assuit
(12.8%, 10.3%) than Sohag (0%, 0%;
P 0.011).
Difference in clinical features of determined
genotypes/subtypes was observed; more carriers
of non-4a variants (4l and 4n, 4f, or 4m) had
chronic hepatitis compared to carriers of 4a
(53.3% vs. 23.1%,
P ¼ 0.025), while more patients
with 4a had liver cirrhosis (45.2% vs. 13.3%,
P ¼ 0.023). Two HCV-4o strains were isolated in
this study, both from patients with HCC. In
conclusion, geographical diversity of HCV was
revealed in this study in southern Egypt. A further
case–control study is required to confirm
the trends of differential pathogenicity of HCV
subtypes, indicated by this study.