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Fig. 6. Phylogenetic relationship of the index patient, potential source patient, and environmental sample using the hypervariable region of HCV partial envelope gene (E1–E2). A phylogenetic tree constructed using partial envelope gene sequences (E1–E2) of HCV genotype 6a strains (detected in the index case, the potential source patient, and the tube holder) and 30 epidemiologically unrelated patient samples collected from patients in Pamela Youde Nethersole Eastern Hospital (PYNEH, 7 patients); Queen Elizabeth Hospital (QEH, 6 patients); Queen Mary Hospital (QMH, 10 patients); Ruttonjee Hospital (RH, 1 patient); and United Christian Hospital (UCH, 6 patients) between May 2017 and January 2018 in this study. The tree was inferred from data using the neighbor-joining method with bootstrap values calculated from 1,000 trees. A total of 653 nucleotide positions in the E1–E2 region were included in the analysis. While the base-pair differences between the index case and the 30 epidemiologically unrelated control samples were 73 to 125, the number of base-pair differences between the index case and the potential source patient was 2, and the base-pair difference between the index case and inner side of tube holder was only 1, suggesting clonality between the virus strains infecting the index case, the potential source patient, and the tube holder (highlighted in yellow and with a red bar). Scale bars indicate estimated number of nucleotide substitutions per 50 nucleotides.
Supplementary material. To view supplementary material for this article, please visit
https://doi.org/10.1017/ice.2018.175
Acknowledgments. The authors thank Dr Hin Chu and Wen Lei for the illustrations used in the figures, and the technical support from the staff at the Department of Microbiology.
Financial support. This work was supported in part by the donations of Mr. Michael Tong, Providence Foundation Ltd (inmemory of the late Lui HacMinh) and the Hong Kong Hainan Commercial Association. Funding was also received from the Consultancy Service for Enhancing Laboratory Surveillance of Emerging Infectious Diseases of the Department of Health, Hong Kong Special Adminis- trative Region and from the Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the Ministry of Education of China.
Conflicts of interest. All authors report no conflicts of interest relevant to this article.
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