Suboptimal SVR rates in African patients with atypical Genotype 1 subtypes: implications for global elimination of Hepatitis C.

•Unusual genotypes (G1 non 1a/1b or G4 non 4a/4d) were common in African patients.•11 previously unclassified HCV subtypes were represented including novel G1p.•Patients with unusual G1 subtypes had a lower SVR rate than any other genotype.•Failures were driven by patients treated with a first generation NS5A inhibitor.•The majority of unusual G1 subtypes had baseline NS5A resistance mutations.