Hepatitis A virus genotype and its correlation with the clinical outcome of acute hepatitis A in Korea: 2006-2008.
Korea has recently experienced a nationwide outbreak of hepatitis A. This study aimed to investigate hepatitis A virus (HAV) genotypes and to compare clinical features between patients infected with HAV genotype IA and those with genotype IIIA. From September 2006 to August 2008, 595 patients with symptomatic hepatitis A were enrolled prospectively in four hospitals in Korea. Among them, 556 patients participated in this study by providing serum or stool samples for genotypic analysis. HAV RNA was detected in 499 patients (89.7%). Major genotypes included IA (n = 244, 48.9%) and IIIA (n = 244, 48.9%), and the remaining genotype was IB (n = 11, 2.2%). From September 2006 to August 2007, the distribution of genotypes IA and IIIA were 64.6% and 35.6%, respectively, which changed to 42.3% and 54.6%, respectively, from September 2007 to August 2008, indicating change of circulating HAV genotypes in the study period from IA to IIIA. Major patterns of amino acid substitution in the VP3/VP1 junction region were observed at position 512 (P → L) in genotype IA and at 520 (R → K) in genotype IIIA. Patients with genotype IIIA infection showed significantly higher aminotransferase levels, prothrombin time, and leukocyte count, with more severe symptoms than those with genotype IA at the time of admission. These results suggest the occurrence of a change of circulating HAV genotypes in recent community-wide outbreaks of hepatitis A in Korea, and genotype IIIA infection, compared with genotype IA infection, might show more severe clinical manifestations.
Center for Infectious Diseases, Korea National Institute of Health, Osong, Korea.
Haesun
H
Yun
Hyeok Jin
HJ
Lee
Je-Hyuck
JH
Jang
Jeong Sim
JS
Kim
Sang Hyub
SH
Lee
Jin-Wook
JW
Kim
Sang Jong
SJ
Park
Young Min
YM
Park
Seong Gyu
SG
Hwang
Kyu Sung
KS
Rim
Sook-Kyoung
SK
Kang
Hyun Seok
HS
Lee
Sook-Hyang
SH
Jeong
D000328:Adult; D005243:Feces / Q000821:virology; D005260:Female; D005838:Genotype; D006506:Hepatitis A / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D017957:Hepatitis A Virus, Human / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D020125:Mutation, Missense; D015995:Prevalence; D011446:Prospective Studies; D012367:RNA, Viral / Q000235:genetics; D056910:Republic of Korea / Q000453:epidemiology; D044967:Serum / Q000821:virology; D016896:Treatment Outcome; D014764:Viral Proteins / Q000235:genetics
D012367:RNA, Viral; D014764:Viral Proteins