Introducing the method of phylogenetic analysis into healthcare practices, allows not only to establish circulating genotypes/subtypes of the virus, but also to reveal HCV clustering amongst the injection drug users (UDIs) for HCV network characterizations in Belarus in general, as well as in every region. Aim of research: determining the spectrum and phylogenetic clustering of HCV genotypes/subtypes, circulating amongst UDIs in Belarus throughout 2004-2015. Materials and methods: Clinical

more »

... es received from 242 UDIs from all regions of Belarus. We carried out the sequencing of the core/E1 and NS5B regions of the HCV genome. The genotype/ subtype was confirmed by maximum-likelihood phylogenies. HCV introductions and domestic transmissions were determined using BLAST. Results: Among 242 UDIs the HCV genotype/subtype was spread as follows: G1a -17.4% (n=42), G1b -40.5% (n=98), G2a -2.5% (n=6), G3a -37.1% (n=90), G4d -0.8% (n=2), CRF 2k/1b -1.7% (n=4). No patient was infected with more than one genotype. Phylogenetic analysis showed multiple introductions of G1a, G1b и G3a into Belarus and that more than 70% of the G1a and G3a circulating in the county is due to domestic spread. Sequences, selected in different parts of the country, form clusters, separated into phylogenetic groups as on the way of infection in particular between the UDIs and different groups, as well as in regions of allocation. Conclusion: The analysis of the genotypic distribution of HCV in the UDIs group revealed significant differences in comparison to other groups of patients. Our findings suggest that genotypes 1a and 3a are the most common ones among UDIs. Among the other groups of patients the main subtype is 1b (59,9% from all patients with HCV). UDIs sequences demonstrated phylogenetic clustering, which can be used for developing a strategy of preventive actions with the goal of reducing the spread of HCV throughout UDIs, as well as for further epidemiological research. C viral hepatitis, is a studying model for evolution of individual and patient behavior, medical responses and society management. The evolution of knowledge has been rapid, 25 years from the discovery of the virus to the emergence of an efficient and tolerable treatment. The HCV infections were first linked to risk of addiction and medical procedures, it puts in the same loop responsibility and guilt. The politico-economic behavior for this infection request care. Looking hepatitis in terms of behavior helps to understand the denial that lead to delay diagnostic and therapeutic. We present an observational study from a private and urban practice in Paris, centered at the same time on the addiction behavior and infectious survey and treatments. This experience covered thirty years of practice, following nearly 500 patients HIV, HCV or HBV.