This issue of Hot Topics in Viral Hepatitis deals with the epidemiology and clinical aspects of the hepatitis C virus genotype 4 infection. If initially this viral genotype was essentially affecting some Middle East and sub-Saharan countries (it represents about 90% of all infections in Egypt, and between 80 and 100% of strains circulating in Congo and, respectively, Uganda), with the increasing migrating waves and the unabated epidemics among drug users it has become relatively frequent also in the West. In selected Mediterranean countries, HCV genotype 4 accounts for about 10% of all HCV infections. A better knowledge of this viral genotype is therefore important, since the natural history, comorbidity factors and pattern of response to therapy may vary with respect to other genotypes. The cure rate with the current standard of care varies between 50 and 70%, depending on the studied populations and, possibly, the viral subtype. These rates can be further increased by treating insulin resistance, when present, with appropriate schedules using insulin sensitizers. However, the limited number of direct-acting antivirals being developed for the infection with this genotype is worrisome. As a result, genotype 4 appears to be the "neglected" little brother of the more diffuse genotype 1, for which a large panoply of novel drugs is coming soon to the market. However, being overlooked does not mean being less ominous in terms of clinical burden. A better awareness may make a change, and for this reason we have asked Dr Moucari to write a review article on this topic, benefitting from his long-standing experience in the field, built on the very large and diverse patients’ cohort followed at the Beaujon Hospital of Clichy.