Wu J C, Choo K B, Chen C M, Chen T Z, Huo T I, Lee S D
Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China.
Lancet. 1995 Oct 7;346(8980):939-41. doi: 10.1016/s0140-6736(95)91558-3.
The outcome of hepatitis D virus (HDV) superinfection varies among patients and in different geographical areas. To find out whether HDV genotype affects outcome, we used a simple genotyping method based on restriction-fragment length polymorphism with enzymes XhoI and SacII for cleavage of PCR products of the HDV genome. Of samples from 88 patients studied, the genotypes of 61 were confirmed by two methods--analysis with both enzymes or by combined restriction-enzyme and direct sequencing analyses--with consistent results. No genotype III HDV was detected among these patients. The majority of patients with acute HDV infection (35/41 [85%]) had genotype II HDV. Among the 41 patients with acute infection, four of six with genotype I had fulminant disease compared with two of 35 with genotype II. Among patients in chronic stage, cirrhosis or hepatocellular carcinoma were found in 12 of 18 with genotype I HDV and eight of 29 with genotype II. Thus genotype II was the predominant HDV genotype in this study in Taiwan. Genotype II HDV was less frequently associated with fulminant hepatitis at the acute stage or with an unfavourable long-term clinical outcome at the chronic stage than was genotype I.
丁型肝炎病毒（HDV）重叠感染的结果在不同患者和不同地理区域有所不同。为了确定HDV基因型是否会影响感染结果，我们使用了一种基于限制性片段长度多态性的简单基因分型方法，用XhoI和SacII酶切割HDV基因组的PCR产物。在研究的88例患者样本中，61例的基因型通过两种方法得到确认，即同时用两种酶进行分析或通过限制性酶切和直接测序分析相结合的方法，结果一致。这些患者中未检测到基因型III HDV。大多数急性HDV感染患者（35/41 [85%]）感染的是基因型II HDV。在41例急性感染患者中，基因型I的6例患者中有4例发生暴发性疾病，而基因型II的35例患者中有2例。在慢性期患者中，基因型I HDV的18例中有12例发生肝硬化或肝细胞癌，基因型II的29例中有8例。因此，基因型II是本研究中台湾地区主要的HDV基因型。与基因型I相比，基因型II HDV在急性期较少与暴发性肝炎相关，在慢性期较少与不良的长期临床结果相关。
