HCV-Geographic integration; An Epidemiological Phenomenon Could it be Approved ? This is your introductory slide – use it to introduce yourself and your paper Mohamed Ali Daw, MD, PhD, FTCDI,MPS Department of Medical Microbiology &Immunology, Faculty of Medicine, Tripoli-LIBYA

Highlights-Prevalence rates No country rich or poor is save of HCV infection any more HCV levels; Very high, High, low and intermediate - very rational and can not be easily applied nowadays ? Southern European( i.e EU) regions have a higher HCV levels than that of Libya in North Africa ??? Replace this box with an image Provide a summary of your main findings, and the major relevant points. If possible, include an image that illustrates your research.

Highlights-Prevalence rates Spatial geographic areas in Netherlands and Germany have higher HCV (7%)than Sub-Saharan Africa ( Chad , Niger and Mali 2-4%) The picture is more evident in Old Russian states , Old Eastern Europe (e,g Romania vs Bulgaria), Latin and North America Iraq and Turkey (2-3%) adjacent to Iran (1.2%) Less populated Gulf sates ( e.g Qatar HCV 6%) even similar to Pakistan ??? This is also applicable to Fareast Asia , SEA and Australia Explain the importance and relevance of your research, putting it in context.

HCV Genotypes- Global Re-emergence No certain HCV-genotype could be recognized being specific to a certain geographic area , though it may be higher HCV genotype 7 recently discovered & emerged genotype in Canada though its Congolese strain-West Africa ?? In China, genotype 1 is a predominant (69.6%) one In Africa, genotypes 1, 2 and 4 appear to be endemic In EU, USA, Australia; African-Asian genotypes are emerging Egypt world no 1 for HCV restricted mainly to Genotype 4, adjacent Libya (low prevalence) have a mosaic distribution of 5 different genotypes ??? Explain the importance and relevance of your research, putting it in context.

HCV Recombinant Genotypes RF2k/1b, was initially identified in Russia Now it has been identified in ; Ireland ?? ! Estonia ?! Uzbekistan ?! Cyprus ?! Explain the importance and relevance of your research, putting it in context.

Worldwide Prevalence of HCV Talk through your results – what stood out? What surprised you?

Endemic pattern diversity of phylogenetic clades of HCV (1-7) Continue to describe your results on this second slide if you need more time.

HCV-History Evolution HCV- Prevalence HCV- genotypes HCV-Integration

HCV-Plausible route of integration Talk through your results – what stood out? What surprised you?

Factors Associated with HCV-Integration Immig-ration Drug-Trafficking HCV-Integration HCV/HIV Co-infection Miscellaneous factors

The integration complexity of HCV

Concepts and future steps Epidemiological parameters are needed. Integration Index Evaluation and Assessment of integration Factors Talk about next steps and future work. Where do your conclusions lead? If you’ve worked on a medical treatment or product, what’s the next step in its development? Are you working on a related but different project? Here’s the place to point readers to your new research.