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Background. The dengue virus serotype 3 (DENV-3) Indian subcontinent strain emerged in Puerto Rico in 1998 after a 21-year absence. The rapid expansion of DENV-3 on the island correlated with the withdrawal of the other serotypes for 7 years. The DENV-3 prevalence declined in 2008 and remains undetected. Methods. We sequenced complete genomes of 92 DENV-3 clinical isolates to characterize the molecular evolution and phylogeography throughout 10 years of continued sampling (1998–2007). Results. We documented 8 distinct lineages that emerged simultaneously and evolved independently. Two of the 8 lineages were highly associated with transient introductions of foreign viruses, and 2 of the 3 endemic lineages covered the entire study period. We found evidence of temporal-geographical clustering only within the 3 endemic lineages. The phylogeography analysis combined with serotype-specific incidence data showed that transmission of a DENV serotype in a given location and time is usually correlated with the absence of the other serotype. Conclusions. Our study shows the cotransmission of DENV-3 lineages through a complex dissemination pattern dissimilar to the evolutionary dynamics of the other serotypes in the island. High virus genetic diversity and a large naive population were underlying factors in the expansion and collapse of DENV-3 in Puerto Rico.

Background Dengue is the most prevalent mosquito-borne viral disease in humans and a major urban public health problem worldwide.

Hepatitis C virus (HCV) is an enveloped, positive-strand RNA virus belonging to the Hepacivirus genus in the Flaviviridae family. Seven confirmed genotypes (1–7) are generally distinguished by phylogenetic methods and pair-wise distance calculations [1, 2]. On the basis of full genome nucleotide sequences, HCV genotypes diverged from each other by a pair-wise distance of >30%. Individual genotypes can be further divided into more closely related subtypes that diverged by a pair-wise distance of 15%–30%. All viral genotypes retain their repertoire of colinear structural and nonstructural genes, thereby facilitating preliminary genotype classification on the basis of partial genome sequences of short fragments (approximately 300–400 nucleotides) in the structural core/E1 region and the nonstructural NS5B region [3]. However, full genome sequences remain indispensible for the detection of genome recombination events. While only recombinant HCV genotype 2 k/1b viruses have been found to actively circulate in the population so far [4–7], recombinants of genotypes 2/5, 2b/1b, 2b/1a, and 2i/6p have been detected in single isolates from humans [8–11]. Furthermore, the frequency of HCV intergenotype and intragenotype recombination may be underestimated because of the lack of robust detection methods [12, 13]. Although genotyping based on core/E1 or NS5B sequences has resulted in the provisional classification of a large number of subtype variants within each genotype, at least 1 but preferably ≥2 full genome sequences are required to confirm subtype designation [2, 12]. Accurate genotype and subtype classification is clinically important because major genotypes differ considerably in their response rates to treatment with pegylated interferon and ribavirin and with directly acting antiviral drugs (DAAs) that are designed mainly against genotype 1 isolates. The limited efficacy of DAAs against other genotypes has been shown for genotype 3 [14], and treatment response rates for drug regimens containing boceprevir (an NS3 protease inhibitor) or BMS-790052 (an NS5A inhibitor) were found to vary even between subtypes 1a and 1b [15, 16]. Different baseline frequencies of drug resistance mutations may account for these differences [17], and such variation might become more significant if interferon-free regimens containing 1 or more DAAs could indeed displace the current standard of care [18]. Until clinically tolerable DAAs with high barriers to resistance against the complete spectrum of HCV genotypes become available [18, 19], accurate subtype determination and, possibly, drug resistance profiling of the individual's viral population may guide the optimal choice of drugs. Full genome deep sequencing, as performed in this study, allows the identification of drug resistance mutations across the genome that may exist as dominant or minor variants in treatment-naive patients, thereby informing the design of therapeutic regimens.