title: Mix-infections with different genotypes of HCV and with HCV plus other hepatitis viruses in patients with hepatitis C in China.
abstract: OBJECTIVE
  Clinical therapy and prognosis in HCV infections are not good, and mix-infections with different HCV genotypes or quasispecies and mix-infections with HCV plus other hepatitis viruses are important concerns worldwide. The present report describes the sequence diversity and genotying of the 5'NCR of HCV isolates from hepatitis patients mix-infected with different HCV genotypes or variants, and the conditions of mix-infections with HCV plus other hepatitis viruses, providing important diagnostic and prognostic information for more effective treatment of HCV infections.
  
  
  METHODS
  The 5' non-coding region (5'NCR) of HCV was isolated from the patients sera and sequenced, and sequence variability and genotypes of HCV were defined by nucleotide sequence alignment and phylogenetic analysis, and the patients mix-infected with HCV plus other hepatitis viruses were analyzed. The conditions and clinical significance of mix-infections with HCV plus other hepatitis viruses were further studied.
  
  
  RESULTS
  Twenty-four out of 43 patients with chronic hepatitis C were defined as mix-infected with different genotypes of HCV. Among these 24 patients, 9 were mix-infected with genotype 1 and 3, 7 with different variants of genotype 1, 2 with different variants of genotype 2, 6 with different variants of genotype 3. No patients were found mix-infected with genotype 1 and 2 or with genotype 2 and 3. The clinical virological analysis of 60 patients mix-infected with HCV plus other hepatitis viruses showed that 45.0 % of the patients were mix-infected with HCV plus HAV, 61.7 % with HCV plus HBV, 6.7 % with HCV plus HDV/HBV, 8.4 % with HCV plus HEV, 3.3 % with HCV plus HGV. Infections with HCV plus other hepatitis viruses may exacerbate the pathological lesion of the liver.
  
  
  CONCLUSIONS
  The findings in the present study imply that mix-infections with different HCV genotypes and mix-infections with HCV plus other hepatitis viruses were relatively high in Yunnan, China, providing important diagnostic and prognostic information for more effective treatment of HCV infections.
authors.affiliation: Key laboratory, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming 650118, Yunnan Province, China. chenyd@km169.net
authors.forename: Yuan-Ding
authors.initials: YD
authors.lastname: Chen
authors.forename: Ming-Ying
authors.initials: MY
authors.lastname: Liu
authors.forename: Wen-Lin
authors.initials: WL
authors.lastname: Yu
authors.forename: Jia-Qi
authors.initials: JQ
authors.lastname: Li
authors.forename: Qin
authors.initials: Q
authors.lastname: Dai
authors.forename: Zhen-Quan
authors.initials: ZQ
authors.lastname: Zhou
authors.forename: Sergio G
authors.initials: SG
authors.lastname: Tisminetzky
mesh_terms: D020121:5' Untranslated Regions; D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001483:Base Sequence; D002681:China; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D006506:Hepatitis A / Q000150:complications / Q000821:virology; D006509:Hepatitis B / Q000150:complications / Q000821:virology; D006526:Hepatitis C / Q000150:complications* / Q000201:enzymology / Q000821:virology*; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000201:enzymology / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D012689:Sequence Homology, Nucleic Acid
chemical_list: D020121:5' Untranslated Regions; D004279:DNA, Viral; D000410:Alanine Transaminase