Jarvis L M, Watson H G, McOmish F, Peutherer J F, Ludlam C A, Simmonds P
Department of Medical Microbiology, Medical School, University of Edinburgh, United Kingdom.
J Infect Dis. 1994 Oct;170(4):1018-22. doi: 10.1093/infdis/170.4.1018.
The frequency and dynamics of infection with different genotypes of hepatitis C virus were investigated in a cohort of hemophiliacs repeatedly exposed to non-virus-inactivated clotting factor. Among 63 infected hemophiliacs, genotype 1 (n = 38, subtypes 1a [27] and 1b [11]) was predominant; genotypes 2a (n = 1), 2b (n = 3), 3a (n = 20), and 5a (n = 1) accounted for the remainder. This distribution was similar to that found in Scottish blood donors from whom the infected blood products were manufactured. Hemophiliacs with severe disease were more likely to be polymerase chain reaction-positive than those with moderate or mild disease. Over 10 years, changes in the circulating major genotype and serotype were observed in 9 of 29 hemophiliacs and from one subtype to another in 3, although there was no clear trend toward replacement with any particular variant. Replacement occurred after the introduction of inactivated clotting factor in 4 subjects, implicating reactivation rather than reinfection. Those coinfected with human immunodeficiency virus were more likely to show a change in genotype.
在一组反复接触非病毒灭活凝血因子的血友病患者中，对不同基因型丙型肝炎病毒感染的频率和动态变化进行了研究。在63名受感染的血友病患者中，1型（n = 38，亚型1a [27例]和1b [11例]）占主导；2a型（n = 1）、2b型（n = 3）、3a型（n = 20）和5a型（n = 1）占其余部分。这种分布与生产受感染血液制品的苏格兰献血者中发现的分布相似。患有严重疾病的血友病患者比患有中度或轻度疾病的患者更有可能聚合酶链反应呈阳性。在10多年间，29名血友病患者中有9名观察到循环中主要基因型和血清型的变化，3名患者从一种亚型转变为另一种亚型，尽管没有明显的趋势表明会被任何特定变体所取代。4名患者在引入灭活凝血因子后发生了替代，这意味着是再激活而非再次感染。合并感染人类免疫缺陷病毒的患者更有可能出现基因型变化。
