Molecular and Clinical Characterization of Hepatitis A Virus in Gwangju and Jeonnam Province

Du Young Noh; Sung Bum Cho; Yeon Joo Kim; Wan Sik Lee; Chang Hwan Park; Young Eun Joo; Hyen Soo Kim; Jong Sun Rew; Sung Kyu Choi

doi:10.4166/kjg.2011.57.6.346

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Noh, Cho, Kim, Lee, Park, Joo, Kim, Rew, and Choi: Molecular and Clinical Characterization of Hepatitis A Virus in Gwangju and Jeonnam Province

Original Article

Korean J Gastroenterol 2011;57(6):346-351.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.57.6.346

Molecular and Clinical Characterization of Hepatitis A Virus in Gwangju and Jeonnam Province

Du Young Noh, Sung Bum Cho, Yeon Joo Kim, Wan Sik Lee, Chang Hwan Park, Young Eun Joo, Hyen Soo Kim, Jong Sun Rew, Sung Kyu Choi

Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea

Correspondence to: Sung Kyu Choi, Department of Internal Medicine, Chonnam Hospital, 671, Jaebong-ro, Dong-gu, Gwangju 501-757, Korea. Tel: +82-62-220-6296, Fax: +82-62-225-8578, E-mail: choisk@chonnam.ac.kr

Received 6 December 20106 March 2011 Accepted 22 March 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Dominant genotype of hepatitis A virus (HAV) in Korea had been known to be genotype 1A in 1990s. Recently, the epidemiologic change of HAV genotype was reported with an upsurge of acute hepatitis A in Korea. The aim of this study was to investigate the change of HAV genotypes and clinical characteristics in Gwangju and Jeonnam province.

Methods

From November 2008 to October 2009, a total of 82 patients with acute hepatitis A were enrolled prospectively. HAV genotype was determined using reverse transcriptase polymerase chain reaction and sequencing of the PCR products of VP1/2A region of HAV.

Results

HAV RNA was detected in 82% (67/82). The genotype IIIA (88%, 59 cases) was significantly more frequent than genotype IA (12%, 8 cases) (p≤0.01). The subtypes of genotype IIIA were AJ299467 Norway (49%), HA-JNG04-09 Japan (27%), HS-14-12-00 Spain (22%) and H-122 Sweden (2%). The subtypes of IA were FH1 Japan (50%) and HA J04-3 Japan (50%). The substitutions of amino acid were more frequent in genotype IIIA than IA (p≤0.01). There was no difference in the clinical characteristics between the patients with genotype IIIA and IA.

Conclusions

Genotype IIIA was a dominant genotype of recent HAV infection in Gwangju and Jeonnam province. This study provides valuable epidemiologic information of genetic distributions of HAV in Korea.

Keywords: Hepatitis A virus, Genotype, Epidemiology

References

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Fig. 1.

The phylogentic tree generated by clustral V method within MegAlign package in the nucleotide sequences of VP1/2A region of HAV.

Table 1.

Genotypic Distribution and Characterstics of HAV RNA in Acute Hepatitis A Patients

	Genotype IA	Genotype IIIA	p-value
Total number of patients (%)	8 (12)	59 (88)	0.000
Subgenotypes (n)	FH1 Japan (4)	AJ299467
		Norway (29)
	HA J04-3	HS-14-12-00
	Japan (4)	Spain (13)
		HA-JNG04-90
		Japan (16)
		H-122
		Sweden (1)
Mean identity	99.1±0.4	98.4±1.4	0.136
Number of amino acid change (%)	0	31 (53)	0.005

Table 2.

Comparison of Clinical Findings in Two HAV Genotypes

Parameter	Genotype IA (n=8)	Genotype IIIA (n=59)	p-value
Mean age (years)	27±2.7	30.4±7.0	0.017
Sex (male/female)	6/2	36/23	0.363
Underlying liver disease
Hepatitis B virus	1	4	0.482
Heavy alcohol	1	11	0.250
Cirrhosis	0	0
Province (Gwangju/Chonnam)	6/2	44/15	0.674
Laboratory findings
Peak ALT (U/L)	4,413±2,775	3,622±2,587	0.466
Peak total bilirubin (mg/dL)	7.6±4.1	7.8±4.6	0.938
Prothrombin time (INR)	1.41±0.44	1.42±0.44	0.939
Complication
Fulminant hepatitis	0	3	0.514
Cholestatic hepatitis	0	1	0.711
Acute kidney injury (Cr≥2.0 mg/dL)	1	4	0.563
Duration of admission (days)	11±13	12±14	0.385
Death	0	1	0.711

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