K. Fujiwara et al., Analysis of full-length hepatitis A virus genome in sera from patients with fulminant and self-limited acute type A hepatitis, J HEPATOL, 35(1), 2001, pp. 112-119
Background/Aims: Type a hepatitis still poses a considerable problem worldw
ide. Why some patients progress to fulminant type A hepatitis and others do
not is still unknown. To examine whether genomic differences of hepatitis
A virus (HAV are responsible for the severity of the disease, we analyzed t
he whole HAV genomes from patients with fulminant and self-limited acute ty
pe A hepatitis.
Methods: Sera from three patients with sporadic type A fulminant hepatitis
(FR) and three patients with acute hepatitis (AII) were examined for HAV RN
A. Full-length nucleotide sequences were determined using long reverse tran
scription polymerase chain reaction, 5 ' and 3 ' rapid. amplification of cD
NA ends methods, and direct sequencing. The amino acid sequences were deduc
ed from the nucleotide sequences.
Results: HAV RNA was detected in all six patients examined. From the sequen
ce of viral protein 1/2A, all cases were revealed to be genotype IA. By com
paring with genotype Ia, wild-type HAV strain GEM, the analysis of whole ge
nomes from the six cases showed no specific substitutions between FH and AH
. Completely identical nucleotide sequences were observed at 3 ' non-transl
ated region (NTR) in all six cases. In 5 ' NTR, less nucleotide substitutio
ns were found in FH than in AR, and in the non-structural protein 2B region
, a little more amino acid substitutions seemed to be found in FH than in A
IP.
Conclusions: This study showed that full-length HAV could be analyzed from
serum samples. Although there were no unique nucleotide or amino acid subst
itutions, possible associations were suggested between the severity of type
A hepatitis and the nucleotide substitutions in 5 ' NTR and the amino acid
substitutions in 2B. (C) 2001 European Association for the Study of the Li
ver. Published by Elsevier Science B.V. All rights reserved.