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Genotype 4 infection in the Spanish native population was reported in 1997,43 especially with the 4c/4d subtype, and less with the 4a subtype26,32,43,44 and mainly in HIV-coinfected patients infected through the IDU route.20,4548 Our series of 183 mainly native patients with genotype 4 conformed to this pattern, with only four infected individuals from sub-Saharan Africa and a single HIV-positive immigrant, (a hemophiliac from Latin America), among the 35 HIV coinfections with this genotype

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