Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
J Formos Med Assoc. 2020 Jan;119(1 Pt 3):413-419. doi: 10.1016/j.jfma.2019.07.021. Epub 2019 Aug 13.
BACKGROUND/PURPOSE: Abbott RealTime Genotype II assay can effectively identify hepatitis C virus (HCV) genotypes (GTs), but some GT 6 subtypes might not be differentiated from GT 1. Abbott RealTime Genotype II PLUS and sequencing might be needed to resolve these ambiguous results. Unlike the high prevalence of GT 6 in Southeast Asia, GT 6 had rarely been reported in Taiwan except in intravenous drug abusers (IDU). But the prevalence of GT 6 in Taiwan might be underestimated. We conducted this study to determine the GTs in a HCV endemic area in Southern Taiwan.
A total of 1147 patients with hepatitis C viremia for direct acting antivirals (DAA) treatment at the Chi Mei medical system in Tainan were enrolled. Genotype was determined using a working flow consisted of Abbott GT II, PLUS assays and 5' untranslated region (5' UTR)/core sequencing.
Among the 1147 patients, 883 (77.0%) obtained GT results by GT II, 264 (23.0%) samples with ambiguous results by GT II assay received further tests, including 194 (73.5%) with PLUS assay and 70 (26.5%) with 5'UTR/core sequencing. Nearly three-quarters (73.5%) of ambiguous results by GT II assay were GT 6. Overall, 18.3% of samples were GT 6. Phylogenetic study of 11 samples of GT 6 subtypes showed 7 (63.6%) were 6 g.
GT 6 is the major factor for high ambiguous rate by GT II. Unexpected high prevalence of GT 6 (18.3%) in Southern Taiwan, especially subtype 6 g, closely related to Indonesian strains, is first reported.
背景/目的：Abbott RealTime Genotype II assay 能够有效鉴定丙型肝炎病毒（HCV）基因型（GT），但某些 GT 6 亚型可能无法与 GT 1 区分。需要 Abbott RealTime Genotype II PLUS 和测序来解决这些模棱两可的结果。与东南亚 GT 6 的高流行率不同，台湾除了静脉药物滥用者（IDU）外，很少有 GT 6 的报告。但台湾 GT 6 的流行率可能被低估了。我们进行这项研究是为了确定台湾南部 HCV 流行地区的 GT 情况。
共有 1147 名在台南奇美医学系统因直接作用抗病毒药物（DAA）治疗而出现丙型肝炎病毒血症的患者入组本研究。通过 Abbott GT II、PLUS 检测和 5' 非翻译区（5'UTR）/核心测序的工作流程来确定基因型。
在 1147 名患者中，883 名（77.0%）通过 GT II 获得 GT 结果，264 名（23.0%）GT II 检测结果不明确的样本进行了进一步检测，包括 194 名（73.5%）用 PLUS 检测和 70 名（26.5%）用 5'UTR/core 测序。近四分之三（73.5%）的 GT II 检测结果不明确的样本为 GT 6。总的来说，18.3%的样本为 GT 6。对 11 份 GT 6 亚型样本的系统发育研究表明，其中 7 份（63.6%）为 6g。
GT II 的高不明确率主要归因于 GT 6。台湾南部（尤其是与印度尼西亚株密切相关的 6g 亚型）GT 6 的意外高流行率（18.3%）是首次报道。
