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1 May 2006

Volume 42, Number 9
Clinical Infectious Diseases 2006;42:1254–1259
© 2006 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2006/4209-0006$15.00
DOI: 10.1086/503040
MAJOR ARTICLE

Selective Transmission of Hepatitis C Virus Quasi Species through a Needlestick Accident in Acute Resolving Hepatitis

Chen‐Hua Liu,1

Bing‐Fang Chen,2

Shu‐Ching Chen,3

Ming‐Yang Lai,3,4

Jia‐Horng Kao,3,4,5 and

Ding‐Shinn Chen4

1Department of Internal Medicine, National Taiwan University Hospital, Yun‐Lin Branch, Yun‐Lin County, and 2School of Medicine, Fu Jen Catholic University, and Departments of 3Medical Research and 4Internal Medicine and 5Hepatitis Research Center, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan

Background.Little is known about the transmission of variant hepatitis C virus (HCV) genome through needlestick injuries.

Methods.To demonstrate how HCV quasi species are transmitted and adapt to the new host in acute resolving infection, we analyzed the nucleotide and deduced amino acid sequences of the hypervariable region 1 (HVR‐1) in the E2 domain of HCV in both the source of the virus (“donor”) and the person who received the virus through a needlestick accident (“recipient”). In addition, we also performed phylogenetic analysis of HCV quasi species in these patients to document the viral transmission.

Results.We obtained a total of 33 clones at different time points by using polymerase chain reaction amplification and cloning and sequencing of HVR‐1. A predominant HVR‐1 variant (in 4 of 10 isolates) in the donor was not present in the recipient 6 and 14 weeks after the accident. In contrast, a minor variant (in 1 of 10 isolates) in the donor became the predominant strain in the recipient 6 weeks (in 10 of 12 isolates) and 14 weeks (in 6 of 11 isolates) after the accident. Additional phylogenetic analysis showed high homology of nucleotide sequences between isolates obtained from the donor and isolates obtained from the recipient. In addition, the variants in the recipient's virus showed substantial genetic preservation in the course of acute resolving hepatitis.

Conclusions.These data suggested that a minor HCV variant from a donor was transmitted to the recipient through a needlestick injury and that it prevailed as the dominant species. The preserved genetic homogeneity of the transmitted viral variants in patients with acute HCV infection may account for their clinical outcomes of resolving hepatitis.

Received 16 November 2005; accepted 23 December 2005; electronically published 31 March 2006.

Reprints or correspondence: Prof. Jia‐Horng Kao, Hepatitis Research Center, National Taiwan University Hospital, 1 Chang‐Te St., Taipei 100, Taiwan ().
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