A novel hepatitis C virus genotype 4 subtype identified by next generation sequencing full-genome characterization in a patient from Saudi Arabia

HCV infection is a major global public health concern, being the main cause of chronic liver disease: cirrhosis, chronic hepatitis and hepatocellular carcinoma. HCV strains are classified into 8 genotypes and 93 subtypes with different geographic distribution. Genotype 4 is the most predominant in the Middle East and Eastern Mediterranean where has been reported the highest rates of hepatitis C infection worldwide. An isolate of this study has been unclassified by amplifying and sequencing of three genes. It was identified from a plasma sample of a 64-year-old Saudi man diagnosed with hepatitis C. The objective of the study was to identify a new subtype of genotype 4 of the hepatitis C virus through next-generation sequencing of full genome characterization. The full genome of the HCV isolate (141) was analysed using whole genome sequencing. Phylogenetic reconstructions based on the entire genome of HCV-4 strains showed that the 141-HCV isolate was a separate group within HCV-4, adding this new information on HCV variability.