PREVALENCE, GENOTYPES, AND AN ISOLATE (HC-C2) OF HEPATITIS-C VIRUS INCHINESE PATIENTS WITH LIVER-DISEASE

China has not been extensively investigated for the prevalence of hepa titis C virus (HCV) infection among people with or without liver disea se. We analyzed serum from 2,177 liver disease patients from 7 cities in different areas of China. Of 435 acute hepatitis patients, only 11% were positive for HCV RNA, while hepatitis B surface antigen (HBsAg) was detected in 33%. Of 1,668 patients with chronic liver disease, 14% and 74% were positive for HCV RNA and HBsAg, respectively. Nearly 80% of non-B chronic liver disease were negative for HCV RNA. The frequen cy of HCV RNA in chronic liver disease was significantly higher in Ham i (32%) and Shenyang (30%) than in other cities (6-12%). The HCV genot ype distribution varied by region. Genotype III was detected in 46-70% of HCV infections in Hami, Shenyang, and Lanzhou, while more than 90% of patients from southern cities (Nanjing, Nanning, and Chengdu) had genotype II. No evidence for genotype I or IV infections was found. A full-length HCV genome sequence (HC-C2) derived from a Beijing patient with genotype II was closely related to previous isolates from Japane se and Taiwanese patients. These results suggest that HCV prevalence a nd genotype distribution vary from region to region in China, and that the HCV now predominant in China may have evolved epidemiologically w ith infections in Japan and Taiwan. The study identified a high freque ncy of non-B, non-C chronic liver disease in China, suggesting possibl y a new agent or infections with extreme variants of HCV.