title: Mixed genotypes infection with hepatitis D virus.
abstract: Heterogeneity of hepatitis C viral (HCV) genomes results in escape from immune clearance. Super-infection or mixed infection of different genotypes of HCV are seen commonly in humans. Hepatitis D virus (HDV) is classified into 3 genotypes. This study was planned to investigate if mixed genotypes infection of HDV occurs in humans. HDV genotyping based on restriction fragment length polymorphism (RFLP) was used to screen 60-99 HDV clones from each case of 7 prostitutes and 11 patients. Mixed infections were diagnosed by the finding of two or more different RFLP patterns in a case and were confirmed by sequencing. Five prostitutes had mixed infections of genotypes IIa and IIb HDV, while only 2 patients had mixed infections of genotypes I and II HDV (P< 0.05). The heterogeneity in nucleotide sequence was generally below 2% among HDV quasi-species from the same subject, while the heterogeneity was 27.7% between genotypes I and II HDV, and 22.8% between genotypes IIa and IIb HDV from a subject with mixed infection. Multiple HDV clones from the spouses of the 2 index cases were also analyzed. One spouse had mixed infection and the other did not, corresponding to the index cases. In cases with mixed genotypes infections, the prevalence of the minor strain was less than 10% of the total colony population analyzed.
authors.affiliation: Department of Medicine, National Yang-Ming University School of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China. jcwu@vghtpe.gov.tw
authors.forename: J C
authors.initials: JC
authors.lastname: Wu
authors.forename: I A
authors.initials: IA
authors.lastname: Huang
authors.forename: Y H
authors.initials: YH
authors.lastname: Huang
authors.forename: J Y
authors.initials: JY
authors.lastname: Chen
authors.forename: I J
authors.initials: IJ
authors.lastname: Sheen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D018740:Genetic Heterogeneity; D005838:Genotype; D003699:Hepatitis D / Q000821:virology*; D003698:Hepatitis Delta Virus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D012150:Polymorphism, Restriction Fragment Length; D011477:Sex Work; D015163:Superinfection / Q000821:virology