Hepatitis C virus (HCV) exhibits high genetic diversity, characterized by regional varia-tions in genotype prevalence. This poses a challenge to the improved development of vaccines and pan-genotypic treatments, which require the consideration of global trends in HCV genotype prevalence. Here we provide the first comprehensive survey of these trends. To approximate national HCV genotype prevalence, studies published between 1989 and 2013 reporting HCV genotypes are reviewed and combined with overall HCV prevalence estimates from the Global Burden of Disease (GBD) project. We also gener-ate regional and global genotype prevalence estimates, inferring data for countries lack-ing genotype information. We include 1,217 studies in our analysis, representing 117 countries and 90% of the global population. We calculate that HCV genotype 1 is the most prevalent worldwide, comprising 83.4 million cases (46.2% of all HCV cases), approximately one-third of which are in East Asia. Genotype 3 is the next most preva-lent globally (54.3 million, 30.1%); genotypes 2, 4, and 6 are responsible for a total 22.8% of all cases; genotype 5 comprises the remaining 185 million infections worldwide. 2 Persistent HCV infection is associated with the development of liver cirrhosis, hepatocellular cancer, liver failure, and death, 3 and HCV is now the most common cause of death in HIV-positive patients on highly active antiretroviral therapy. 4 While the incidence rate of HCV infection is apparently decreasing in the developed world, deaths from liver disease secondary to HCV infection will continue to increase over the next 20 years.
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