Hepatitis A Virus genotype and its correlation with the clinical outcome of acute hepatitis A in Korea: 2006–2008 (pages 2073–2081)

摘要

Korea has recently experienced a nationwidenoutbreak of hepatitis A. This study aimed to investigatenhepatitis A virus (HAV) genotypes andnto compare clinical features between patientsninfected with HAV genotype IA and those withngenotype IIIA. From September 2006 tonAugust 2008, 595 patients with symptomaticnhepatitis A were enrolled prospectively in fournhospitals in Korea. Among them, 556 patientsnparticipated in this study by providing serum ornstool samples for genotypic analysis. HAV RNAnwas detected in 499 patients (89.7%). Majorngenotypes included IA (n ?244, 48.9%) and IIIAn(n ?244, 48.9%), and the remaining genotypenwas IB (n ?11, 2.2%). From September 2006 tonAugust 2007, the distribution of genotypes IAnand IIIA were 64.6% and 35.6%, respectively,nwhich changed to 42.3% and 54.6%, respectively,nfrom September 2007 to August 2008, indicatingnchange of circulating HAV genotypes innthe study period from IA to IIIA. Major patternsnof amino acid substitution in the VP3/VP1 junctionnregion were observed at position 512n(P ! L) in genotype IA and at 520 (R ! K) inngenotype IIIA. Patients with genotype IIIA infectionnshowed significantly higher aminotransferasenlevels, prothrombin time, and leukocytencount, with more severe symptoms than thosenwith genotype IA at the time of admission.nThese results suggest the occurrence of anchange of circulating HAV genotypes in recentncommunity-wide outbreaks of hepatitis A innKorea, and genotype IIIA infection, comparednwith genotype IA infection, might show morensevere clinical manifestations. J. Med. Virol.n83:2073–2081, 2011.nu0001 2011 Wiley Periodicals, Inc.