Wang Y, Okamoto H, Tsuda F, Nagayama R, Tao Q M, Mishiro S
Institute of Hepatology, Beijing Medical University, China.
J Med Virol. 1993 Jul;40(3):254-60. doi: 10.1002/jmv.1890400316.
China has not been extensively investigated for the prevalence of hepatitis C virus (HCV) infection among people with or without liver disease. We analyzed serum from 2,177 liver disease patients from 7 cities in different areas of China. Of 435 acute hepatitis patients, only 11% were positive for HCV RNA, while hepatitis B surface antigen (HBsAg) was detected in 33%. Of 1,668 patients with chronic liver disease, 14% and 74% were positive for HCV RNA and HBsAg, respectively. Nearly 80% of non-B chronic liver disease were negative for HCV RNA. The frequency of HCV RNA in chronic liver disease was significantly higher in Hami (32%) and Shenyang (30%) than in other cities (6-12%). The HCV genotype distribution varied by region. Genotype III was detected in 46-70% of HCV infections in Hami, Shenyang, and Lanzhou, while more than 90% of patients from southern cities (Nanjing, Nanning, and Chengdu) had genotype II. No evidence for genotype I or IV infections was found. A full-length HCV genome sequence (HC-C2) derived from a Beijing patient with genotype II was closely related to previous isolates from Japanese and Taiwanese patients. These results suggest that HCV prevalence and genotype distribution vary from region to region in China, and that the HCV now predominant in China may have evolved epidemiologically with infections in Japan and Taiwan. The study identified a high frequency of non-B, non-C chronic liver disease in China, suggesting possibly a new agent or infections with extreme variants of HCV.
中国尚未对有或无肝脏疾病人群中丙型肝炎病毒（HCV）感染的流行情况进行广泛调查。我们分析了来自中国不同地区7个城市的2177例肝病患者的血清。在435例急性肝炎患者中，仅11%的患者HCV RNA呈阳性，而33%的患者检测到乙肝表面抗原（HBsAg）。在1668例慢性肝病患者中，分别有14%和74%的患者HCV RNA和HBsAg呈阳性。近80%的非乙型慢性肝病患者HCV RNA呈阴性。慢性肝病中HCV RNA的检出率在哈密（32%）和沈阳（30%）显著高于其他城市（6%-12%）。HCV基因型分布因地区而异。在哈密、沈阳和兰州，46%-70%的HCV感染患者检测到基因型III，而来自南方城市（南京、南宁和成都）的患者中超过90%为基因型II。未发现基因型I或IV感染的证据。来自一名北京基因型II患者的全长HCV基因组序列（HC-C2）与先前来自日本和台湾患者的分离株密切相关。这些结果表明，中国HCV的流行率和基因型分布因地区而异，且目前在中国占主导地位的HCV可能在流行病学上与日本和台湾的感染情况共同演变。该研究发现中国非乙型、非丙型慢性肝病的发生率较高，提示可能存在一种新的病原体或HCV极端变异株感染。
