Sequence analysis of hepatitis C virus isolated from a fulminant hepatitispatient

Although hepatitis C virus (HCV) is a major cause of non-A non-B hepatitis, its pathogenic role in fulminant hepatitis remains controversial. A 32-yea r-old man contracted hepatitis. Serum ALT concentration was reached to 6,97 0 IU/L, the lowest prothrombin time value was 16% and jaundice and stage II encephalopathy were developed. HCV RNA was detected in this patient by rev erse transcription polymerase chain reaction in sera at the acute phase, an d it was undetectable during the remission phase when anti-HCV was found. T he entire genome of infected HCV was recovered, cloned, and sequenced from this patient, and compared with the clones of six other chronic hepatitis p atients. Phylogenetic analysis revealed a clustering around genotype 2a and a deviation from the other 2a chronic hepatitis strains. Calculating the g enetic distance in each subgenomic region revealed that the 5' untranslated region (5'UTR), core, nonstructural (NS) 3, and NS5A were severely deviate d. Of 20 clones of the hypervariable region (HVR), 17 showed an identical s equence with the others showing a difference of only one amino acid. HCV wa s isolated from a fulminant hepatitis patient and its entire genome was rec overed; a clustering around genotype 2a was observed, but the sequence devi ated especially in 5'UTR, core, NS3, and NS5A; and monoclonality of the HVR sequence was found not only in the fulminant hepatitis patient but in a ce rtain percentage of chronic hepatitis patients. (C) 2001 Wiley-Liss. Inc.