原位肝移植患者中乙型肝炎病毒的新发感染:通过确定基因组完整序列进行分析

De novo infection of hepatitis B virus in patients with orthotopic liver transplantation: analysis by determining complete sequence of the genome.

作者信息

Rokuhara A, Tanaka E, Yagi S, Mizokami M, Hashikura Y, Kawasaki S, Kiyosawa K

机构信息

Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.

出版信息

J Med Virol. 2000 Dec;62(4):471-8.

DOI:
Abstract

De novo infection of hepatitis B virus (HBV) occurs after liver transplantation from donors with HBV markers that suggest past infection. In the present study, the complete nucleotide sequences of HBV derived from a donor and recipients were determined to determine the clinical and virological characteristics. A total of 57 donor-recipient pairs, which underwent living-related orthotopic liver transplantation, were enrolled in the present study; all were negative for HBsAg before transplantation. HBV DNA was tested in serum, liver tissue, and peripheral blood mononuclear cells (PBMCs) by the polymerase chain reaction (PCR). The nucleotide sequence of HBV was determined based on PCR products and the phylogenetic analysis. De novo infection of HBV was found in 3 of the 57 recipients. Anti-HBc was positive in all donors of 3 recipients with the de novo infection but was positive only in 4 donors of the remaining 54 recipients (P=0.001). HBV DNA was detected in the liver but not in the serum or PBMCs in donor 3 whose recipient developed de novo HBV infection. The nucleotide sequence covering entire genome of HBV (3,215 bases) derived from the liver of donor 3 had a homology of 99.8-100% with that derived from the serum of corresponding recipient 3. The strain of recipient 3 showed the closest association with that of the donor 3 by phylogenetic analysis. Complete sequences from two recipients with de novo HBV infection including recipient 3 conserved the basic organisation of HBV genome. Analysis of the entire nucleotide sequence of HBV genome proved that HBV existed in the liver of the donor with anti-HBc, and it caused de novo infection in the corresponding recipient.

摘要

在接受来自有乙肝病毒(HBV)标志物提示既往感染的供体的肝脏移植后,会发生HBV的新发感染。在本研究中,测定了来自供体和受体的HBV的完整核苷酸序列,以确定临床和病毒学特征。本研究共纳入了57对接受活体亲属原位肝移植的供体 - 受体对;所有患者在移植前HBsAg均为阴性。通过聚合酶链反应(PCR)检测血清、肝组织和外周血单个核细胞(PBMC)中的HBV DNA。基于PCR产物测定HBV的核苷酸序列并进行系统发育分析。在57名受体中有3名发现了HBV的新发感染。在3名发生新发感染的受体的所有供体中抗 - HBc呈阳性,但在其余54名受体的仅4名供体中呈阳性(P = 0.001)。在受体3发生新发HBV感染的供体3的肝脏中检测到HBV DNA,但在血清或PBMC中未检测到。来自供体3肝脏的覆盖HBV全基因组(3215个碱基)的核苷酸序列与相应受体3血清来源的序列具有99.8 - 100%的同源性。通过系统发育分析,受体3的毒株与供体3的毒株显示出最密切的关联。包括受体3在内的两名发生新发HBV感染的受体的完整序列保留了HBV基因组的基本结构。对HBV基因组全核苷酸序列的分析证明,抗 - HBc阳性的供体肝脏中存在HBV,并在相应受体中引起了新发感染。

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