Does mutation of hepatitis A virus exist in North India?
BACKGROUND
Human hepatitis A, a widespread infectious disease that is hyperendemic in vast areas of the world, results in the infection of the liver. Different human HAV strains of diverse geographic origin are remarkably closely related. HAV exploits all known mechanisms of genetic variation to ensure survival, including mutation and genetic recombination.


OBJECTIVE
The aim of the study was to undertake an in-depth analysis of the mutation in three groups: (i) mild acute hepatitis (m-AH), (ii) severe acute hepatitis (s-AH), and (iii) fulminant hepatitis (FHF) A patients, who were tested positive for HAV RNA.


METHODS
A total of 500 patients of acute viral hepatitis (AVH) were screened for HAV-IgM positivity from January 2003 to December 2004. HAV RNA positivity was subject to reverse transcription of RNA followed by polymerase chain reaction (RT-PCR) for the detection of HAV RNA. The HAV RNA positive cases were subject to single-stranded conformational polymorphism (SSCP).


RESULTS
Out of 500 acute cases of hepatitis, 80 (16%) were positive for HAV-IgM. HAV RNA was detected in 34 (42.5%) cases by RT-PCR. Twenty-four (70.5%) were m-AH, seven (20.5%) were s-AH, and three (8.8%) were FHF. All the positive samples were subject to SSCP. No mobility shift was observed with respect to any screened samples by PCR-SSCP. Four (m-AHI-54, m-AHI-80, s-AHI-341 and FHFI-195 suspected cases were directly sequenced to prove that there was no point mutation.


CONCLUSIONS
SSCP demonstrates no mobility shift in the VP1/P2A region of the HAV genome. No point mutation was observed in the four suspected cases by sequencing. However a large study from different geographical locations is needed to achieve a logical conclusion about the existence of HAV mutation in the Indian population.
Hussain
Zahid
Z
PCR Hepatitis Laboratory, Department of Medicine, Maulana Azad Medical College, New Delhi 110002, India. hussainzahep@gmail.com
Husain
Syed A
SA
Pasha
Syed T
ST
Anand
Ranjana
R
Chand
Abdullah
A
Polipalli
Sunil K
SK
Rehman
Shabeena
S
Kar
Premashis
P
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D024202:Electrophoretic Mobility Shift Assay; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology / Q000235:genetics; D030041:Hepatitis A virus / Q000235:genetics*; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D018807:Polymorphism, Single-Stranded Conformational; D012367:RNA, Viral / Q000032:analysis; D016036:Seroepidemiologic Studies
D012367:RNA, Viral