Kao J H, Chen P J, Lai M Y, Chen D S
Department of Emergency Medicine, National Taiwan University Hospital, Taipei.
Gastroenterology. 1993 Aug;105(2):583-7. doi: 10.1016/0016-5085(93)90737-w.
A Taiwanese woman who had chronic infection of type II hepatitis C virus was superinfected by type III hepatitis C virus after blood transfusion. The subtypes of the hepatitis C virus were determined by direct sequencing of the envelope region of the viral genome in serial serum samples before and after transfusion. The original virus in the patient had a 95.6% homology to the Taiwanese isolate (a type II virus) by comparing nucleotide sequences of the envelope region. After transfusion, markedly elevated serum aminotransferase activities were noted and the virus sequenced showed only a 55.2% homology to the Taiwanese isolate but had a 88.9% homology to a Japanese isolate (a type III virus). After recovery from the acute episode, the newly introduced type III virus became undetectable and type II virus predominated again but with significant genetic variation in the follow-up samples as compared with the original type II virus. It was concluded that superinfection of hepatitis C virus indeed occurs in humans, and this should be taken into consideration in the pathogenesis of reactivation of chronic type C hepatitis.
一名患有慢性丙型肝炎病毒II型感染的台湾女性在输血后被丙型肝炎病毒III型重叠感染。通过对输血前后系列血清样本中病毒基因组包膜区域进行直接测序来确定丙型肝炎病毒的亚型。通过比较包膜区域的核苷酸序列，患者体内的原始病毒与台湾分离株（II型病毒）具有95.6%的同源性。输血后，血清转氨酶活性显著升高，测序显示该病毒与台湾分离株的同源性仅为55.2%，但与日本分离株（III型病毒）具有88.9%的同源性。急性发作恢复后，新引入的III型病毒无法检测到，II型病毒再次占主导地位，但与原始II型病毒相比，后续样本中存在显著的基因变异。结论是丙型肝炎病毒重叠感染确实在人类中发生，在慢性丙型肝炎再激活的发病机制中应考虑到这一点。
