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39
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JRC2009T・044
HBVGENOTYPEOFJAPANESE8LOODDONORS
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geOgてapllicallocdizatiorlOf
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patients・l¢Toprovide攣OVeTViewoflhepresentstateof 杜BVinrec【ion
anく】lheチ柑V geT】Otype d】5tributior）血
Japalle5ebIooddonorsバIleH王iVgen8りIleSqfh叩ati厄sB
5urfacea刀心gel－（打BsAかp85川〃edonor5魚omOctober
2006toSeptenlber20071Veredetern厄ned
MATERJALSAND METHODS
Data o†blood donors
Data oりapaneseblooddonorswereob一雨nedh・Omthモ
Jap811e5eRedCross（川C】dalaba5e．Thenurllberortotal
bloodd8nOr5WaS4．9玖911．a－1dtユIel1111hbe】■OrIIB班g・
positivedonor＄WaS2043（0．0419も）．Ⅵlentlmberof釦st－ time blood
dorIOr5Wa5594，096，and theJl11mber of
11BsAg－pOSitiveか＄t・【血eb】00ddonorswas1362（0．お％）
打01110ctober20b6toSept8nlber2007．
TIle】1umberofavaual）lesaInpleswa5】979．and山e
H上IVgellOtyPeSCQuldbedeterm虹色diユ11887sample5．Tbe
H8VDNAloador山eotller92samp18SWaStOOl（）Wfqr
thcdetcmliJla【iono［（he】iBVgenotypcs
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ACMCCCCⅣ汀C－3′Ints12297－2317）紺1dSl－2（anti・ 5enSe】were used．FQr
nモSted PC札 Hモ1106（neさted
SenSe．5′－CCCCm】℃YTATCM＾CACTrCCG・3’（n！s12310－
2332）aIldS2－2（nesledantisen5e）wereused．TllePriJnerS
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（SenSe．5′－C〟ⅣAG＾GGACTCrTGGACT・3’恒ts】1653－1672） and
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pC之－21ne5ted那Idsen5e，5′－TCC
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October200610September20【I7．
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WaS、ねul】d－tObe15IU／nlL（60copi8S／nlU乳CCOrdi11g10
Validation武udie5W鮎ぬeWHO銅れda∫dbyJRC．Se∫0－ logica山y positjve aJ】d
alaれ山e am王notr紺S血石e（Mト elevated（＞60】U／mU5amp】e5、Were◆eXduded血）mNAT
SCreenlJ】g・
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扇deJed軸n統御t．
RESULTS
me11umber占ftoI山blooddonorsdndtl】8tO一触トtble
b】00ddoIlOr＄－pfevery■agegroupfrolコOc【ober2006to
Septembモー2007aTe一もhol竹＝bfig．1・me汀】edi叩agビOf
rotaJdonor5Wa537yea用8れ州Ia【0他8t一触－e血noIS㈹き
24yeaナs．memak／ねnlderadooftot81dollOrSWaS‘l．89
（1・29forth05e20・29y朗rSOld∽d2．13for也05e30－39
y舘ISOld）andd－atOi触l・伽Iedonorswa＄1ゝ39．T鵬卿e
Vblume49．JuIy2009 TRÅNSFUSION13†5 ／
Age－andgender－SPeCi点cdistributionsofhepatitisBviruS（HBV）
genotypesinlapaneseHBV－POSitiveblooddonors
ノほ吉和拘∫吊たαW戊，抽たoGo旭相加，1わ5損ねarl15！jZuたi，肋αた0払わαた吼月drU7乃icJli肋お止レ和，
乃5旭S加Ⅵ励i．嘩榊血甑叫血軋肋甜如溝川以心灘欄相承献血糎旗研剖職 CJ℃∫∫
ガβVGe乃0り′pe月β∫eα汀わG7■の岬
hebepaliti＄Bvirus（11‡Ⅳ）genolypei5il叩0ト
taIltinepidel¶iolo由CSmdieミ，a11alysISOfn10des
ofi11Eecdon．alldrncdicE11treatment．Thercarc
eigbtJIBVgel－Ot）pe5designateda5AtoHontl－e T
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typ8SWer8determln8d． STUDYDESIGNANDMETHODS：DalaonJapan8S8
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We柑OblainedtromlheJapaneseRodCros5dalabase・
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theirnmuno910bulinM（lgM）antibQdyagalnsttheHBV
coreanlig即Wa5determ戸nedbyenzymeimmunoassay
amon9釧HβsA9・POSi伽edonors・
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ratiodecreas8SけOm83．1％inteen8gedono「StO55・1％
in†hoseinl佃ir505．lnbolh19Man紬Odya9alnSlhepa－
titFsBcoreanti9en帥dnucleicacidtesトPOS押ve
dono－S，gen01ypesAandBwe「e帽S†バctedtoma始 donors．
CONCLUS10NS；Theage－SPeCiricdlslnbu紬no＝18V
9enOlypesinJap即1eSe即00ddono「SWaSObseⅣ¢din
theB／CgenotyperatiD．ThegendeT・SPeC川cdistribulion
otHBVgen叫PeA，Whkho†i9inale郎－OmlheUSor
We5ternCOUntr戸e5．W∂SObseⅣedjnmaleJapanese donor＄．
basis ofsTeaterthan B％nucleotidevariationoverlhe
enむegenol－－e・l・3HBVgel－Ot押eS町edisvibutedindis・ 血ct
g印graphjcdloc址通日ons・Ⅰ■HBV gel－Ot叩e Ais
detectedinAmerica．NollherllEllrOpe．arldIlldia．一Geno・ types B and C
are prevalerl†血∧sia・S Gen8type Di5
detectcdaround［heMeditcrTaneanSea！Genotype玉is
re5山ctedtoAh・i鎚，2andGeI】Otype5fandIl訂epreValellt i11South and
CentralAm¢rica．6GellOtyPe G has becn
found王ユげrance．Germany■tbeUnitedStates■andMe氾CO・3
neclbicalsi官ni負亡anCeOfH丑Vgenoけp¢ha5been repoTted．The
HBVgeflOtYpe Znay a蝕ct hepatitis B e
折tigen（H王）鵬g）紀rOCO削er5血－rateS′mUtation山pat・
ternsh也eprecorealldcorepronlOterreg10n5，reSPOnSe
－Ointe－良一On∫and－hes即印IyOf】i、・erdisease・脚力Co汀ト
parね0－－S between GenoⅣpeSAandDinEurope and
∧n－erica，andb¢tWeenGenot）peSBandClnA5i8・have
beellrepOrted，GellO勺やe5Aand】】aremores叩5氾veto
山一eTf町Orltlla】1GellO切e5CandD．9
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Determl胴tiono1日t】Vgeno吋Pe＄and Subgenotypes
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typeel】乙叩1eilⅥnlⅥnOaSSayIE仏】，IllSd山一eoflmmu110logy
Tbkyo．Japar））．T】1i5me也OdhvoIvesthe偶eOrmOl10C10nal
antibodjesd汀ectedto月YeepitopeぶeXPOSedon血epre－S2
regiono仙eHBVgen8－ne・■叫Ⅵ－e－1agenOt叩eCOl－】d】】Otbe
delern血edbytbe苫uSんtlleyWeredeI併minedbydirecI
5eql】enClngOfthesu血cereglOnllSln印可Clesequ¢nCing
足tandagenedcilnal咋er（BigDyeTヒmhatorandAt引
Pf11SM3100．re5peCtively，pl∃AppliedBio＄y＄tem5，Fo飢er
Cit汎C旬／m孔naly詑Il－eSeqU8nC85，加Od肺≧rentCOnlput¢r pro訂amSWeIe
uSed（S王QU苫NCHERMAC，l厄rsion4．1．
甘血chiSof【wa∫eEngheering．恥kyo．ねp弧；0【GENm
MAC．Ⅶrsion9．0，So丘w8reI）eveloI）ment Co．，恥桓0，
Japan）・Theprilne∫＄丘olⅥH85Agr¢かnwere usedas
follows：Sl・1（SCnSe，5L－TCGTGmCIGGCGGGGT】T
3′lnt5】192－211）．Sl・2．（antisellSちS′－CGÅACCAC】℃AAGI
A灯GGC－3′rnし可68p－5・704）．S2・1【ne5ted5enSe．5‘・CAAG
GmGTTGCCCGTTTG－3′lnls】455・474），aZ）dS2・2（nesled amisensc・
5’・GGCACmGTMC7Y；AGCCA－3’rnts）668－ 6871
me5ubg餌叫pe5Aa（Askm吋pe）andAe（European
明】e）weredeterminedo□血ebasisof血eqre由OnOf1556
ba5eS（nr2333・3221a刀dl欄7）弧dthesubgenol）peSBa
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也eba5i50一也¢preCOTereglOl10fl】udeotide1838．1印¶1e
primersfr叩αregionwereasfb鮎ws、For釦stpqly－
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AbさREVtAT10NS‥¶B〟唱ミhep81id58eantjge口；
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】nen．
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meれい8p鋸IeS¢RモdCroさSH¢8dqu計代℃n．1bb・0；and伽eJ礼Pa・
】1eSenedCro5S7b吋ONj5hi別00dCeれtモー，TbkyQ、Japall・
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Cro5SぬねmaB】00dCenter．1370・12T泳止痛，Hidaよa－Sbi．
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Sむtama＿b亡．i【C．OT．ip．
Receivedねrpubli関山onOctoもer14．28咄一飢廟Ot】
receivedJanuaⅣ柑．2nO9；もndacceptdJanua叩22．20旧・
dく〉jニ10．1111／11537■2995・2009・02156．x
mNSPVSION2009；49：1314－1320．
′ 1314 TRANSFUS10N VoIume49．JuIy2009
42
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REFERENCES
1・Obmdtop．鴨udaf，ぬkug8Wa几Sa5甘口SOe両g可0札
h】8iM．Mjy由wa℃Ma叩ImlM．乃pjn8hepadtjさ8ヽ喧m18
bybornology】nnLlぐ】eoddesequ8nCe：COmP打ねOnOr
Sll血c＝J－1】gel－5ubtyp郎．JGeれⅥTO】1988；69：2575一敗
2・Norde川．CourouceAM．れ佃卯1usLO．Comple【ege110meS．
phylogellet】仁一elatedl旧£．and5廿uCtur8】proモモhsorぶ洩
柑ains、ofthehep紙皿‖い雨Ⅵ．わurorlサムich陀preS仰th明
nだWgemOI叩¢S．Ⅵ叩log）り99右19糾89－503．
3・StuyveILDeGeれdtS．1hnGepC．Zoul汗nF．Frled軋
S⊂1】5n誠iRF．加5Sau11，A加Wgモl】OtⅥIeOrhepa軌i8BⅥru㌫
COmP】etegeno汀Ieandphylogene血血atedn鴨S，JG印 Vjro】2000；81婚7・74．
4・M叩e柑†C．Man†eganjんF代iPC．Doe5hepal】ti88山一us
（H8VIgeれ0【ypeh仙encelbecl掴C山01几C01TleOfH8V
infec加－1り＼′】r扇Hep8I1999；6：299・304．
5・KaoJTl．qle】lp】．1鷹MY．CherlDSHepl†itls8genotyp¢S
∽汀¢1ate鵬血dh】C810UtCOm悌】npaden【‡鵬血cbronic
】1叩献旭川．Gさ抽0ⅢterOlogy2dno；118溺ヰ■9∴
6・A柁uZ・如izP●No－de－H■RobeHs01－．月H．M8g山uさLO・
Geれ叫peli：81－‘w人me血dk和g帥0切）eO＝】epa血J点B
Ⅵm＄陀VealediれQれt一山Amerlcm，】G引IVi∫012002；83：
2059・73．
7・LM訂」血jSA・C加icd托t即anCeOfvt∫ddy】吼mk‖md
geno呼pesむIh叩alitkBYh胴・lGお廿0印IerO＝†ep8tO1
2002；17：S32之・8．
乱ChuCJ．bたAS・qi血cd5卸i爺qnceorhepa正一i5Bv加8
もenOt叩e5・Hepa柏】0幻r2002；35：1274・q．
9・Jaれ郎enHLv餌IZon胱Ydd札馳ⅥtuTk礼Zeu祇mS．
仙00US．也bIo81u℃SimonC．知丁吼Gerk印G．de 鵬晶鋸触甑拍G■加d椚弧p．＝8れ画札S血由一SW・
pe如血叫徳血on血・地中血糊血ザ血柚融血川血
Vdume49．July200g TRANSFUS10N1柑1i
Ⅰ）OSitiveb】noddor10r．刀Tl】e5equenCeOf
GenorypcH．whichjsprcva］cntonlyinthcUlljtedStatcs
礼ndCentralA川erica．wasl－ighlyhomoIogol】S10tllO5eOf
tユ1eSlrainsisolatedill1月SAngele5．
Therewas】nOdi庁el・etlCeint】－eHBIJgenot叩edjstri－
1）t】tionbehvee11月柑卜山ⅥedoIlOrSandl・el】eatd別10r5aS
S】10ヽⅥ1山丁沌1el．111eOl11ydばerellCebαhveen餌ミt一山Ie
do∫－Or＄am】代pealdonorswa5fo111－dwllen－1－eGenotype
∧dis血bu血n50fdo∫－Or5aged16to39aれd40to69years
Wel■eC叩Sidered（d8tanOtSI－OWれ）・TheGel－OtⅥ1eAratio
ill丘柑卜山n¢donorsaged16to39year51VaS5．90％（40ノ
678）．where祁thatinrepeatdol10r5aged16to39yearswas
12，279ら（27／220；pく0．011」加Itralioin伽st・dmedonors
aged抑【069yearswas4．2別28／671）andinrepea【donors
aged40to69ye孔rSWaS3・5％（11／318川Ot扇glli触細t）．
Tllere5山川7aSqUiledi仔erentfroIT10ureXpeCta也on．
beca11Seit was expected that血e HBVipOSitive riskof
かsト【ilne血norswo山dbeIligher山anllla【ofrepeat
do110rSaSShownlntlle毯SeOfHCV－pOSidvedonorも．10
H別／Gen叫rpeA－pO5itiveyoungdonorきlⅥigbt】laVe a
Clear understaれding of血血r止血s釘d hlelld to te5t
Whe也er也eywo111dbeinfectdⅥ，i血】1BVoTnⅣThis nligh【be
suggestedwlleI－1gM－H】∋db－POSiかe donors l代re COflSidered；tlle ra【es
orrepeat donors用持tイ山11e
donorsofGenotypesÅ，軌andCwere7／6，4ノ5．and17／2乙 EeSPeCtively（dataJlOt
Shown）．However．we must
exaローinethere5ultp代Cisely．becausemo5trepea†d8nOrS
lnightrefusetorecdve血enoti乃00lioI】OfHBVil血ction
弧ddonaterepeatedlyItl－－ightl）einterestlng10COnlpare
也eleng巾of＄erOCOnVerSjon beひ代eれH】∋V and HCⅥ POSitiv8doJ10i＄．Tllany
CaSe，tO redllCe the∫isk of
－nleU■e‡】d toward nl由e－SpeCi百cjnfectjollisclearh
HBV－pOS摘ve donors who wcrcirげec（Cd recentlyこTllCy
are由0、Ⅷa塵IgM－】1BcAb－pOSiti、・edonor5（61donors）；量nd
N〟丁－pOSilive donors【68 do－10rS）exc】uding11B血b－
posi血′e（22dor10r5；1もble4）こお0血IgM・HBcAb－aIldNAT・
positivcdonorswcreprcdolninantlylnalccxccptfor山osc
inFecledwitllGellOtyPeC．
仙h91】gh we cou】d no（鑑C】ude仇e possib揖けOr
reactivatioI】5COmpIetelyi月 山e case of】gM・HBcAb－ 匹Sitive
dorIOrS，れ10St reaCtivadon ca5eS WOuld be
CXC］udedbythcinterview、扇t］ldonorswhcther－hcyhad
medica】hi5tOり′0川Ot．memale他male ratioofthose
infectedw肋GenotypeCaged16to39yearsisl口W（2．05：
43／21），a♪dtIlel¶如e／托nlderadoor血oseaged40to69
yearsishig】）（7．0：14／2；Pく0・05）．
DISCUSS10N
TherateorHBVpositivedonorshasdedinedyear】yln
J8pan・However，ー¢Cently．tl）edistrib11don ofGeno【押e A hasin⊂reaSedin
blood donors flTld acute†柑V
palients．1吼け■2～’「】1elI】8le侮れIale ra【io oftl10Seinfected
WittlGenotyl）e Ai5di紆erel】t frol】1ule ratio of t】1058
i11fected雨tbo血ergenotγpe5・particll厄Iy．1gM・HBヶor
NATpo5iかedonorsarere5trjctedtoma】es．
Iti55UggeStedtbalSubgen叫PeÅemigblhavebeen
broughtto如8n丘omtheUnitedStalesbyaブOung印ale・
T71ismiglltbesuI）POrtCdbythefindingtl）a†thcHBVGcTlOT
typeAwaspredonlinantam8ngH即ん汀Ⅳd11山Iyhfected
ねpanesemen、油ohadsexwilbolhe川en（MSM），17The
1318 TRAIヾSFUSION VoIum（き49，Juり2009
45
-
霊宝豊 り
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YOSHJKAWA ETAL
18mivudinerorH上さc∧R・PO5itivecllrO11ichcpa†itisB：ilran・
domised【rja】．bncct2005；365：123・g．
】仇 Ml】rOtalV8H．WsIlikawa∧．OllnUt】laH．lh，ata人．Kれ【DllN．
Mi）・an－OtOM一価neH■EローU－aH．¶dokロlnK・El－jde】両01・
Og〉′Ofb】00ddol－Or5inJapa】1．pO5ili、′erOrl－ePatiUs8ヽmlS
ilndhepat摘sC、加古bv】－1－C】ejcilCidamp】沌c∂－ion【亡5r】ng・
＼bxSang2005こ88：川－G，
1】．UsudaS．Oka汀Il）†OH．†lVa118l・iH．Bal〕aK．T5UdaF，れ仙ご－
akawaY．ト呵りmiM・Sernlogjぐ山detecUon口†hepatitlsB
Ⅵru5gel10【〉，pcsbyEuS∧wltllIれOnOCloIlalant】bodiesto
叩e・叩CCi玩ep血p¢Slrltl－CprCS2－regjor】PrOdl瓜J＼1ro】
Me血0由Ⅰ999；80：97－】12
12L Sugaし1Ch＝1KumadaIl．＾cllaryaSA．ShresthaSM．
G肌utanMT．閃1aれM，GishIIG．TanakaY．Xa10T．OlうtD王．
UcdaR■hllvaka、VaY，ト1ほOka】¶iM・EpjくIe】¶iolog】C之Ilal－【t
SCquenCedi汀ercnccsbH＼Veen【WOSutIlyPeStAeand∧a）of
b叩aljtj5Rviru5gel川り・Pe八丁GenlパーOI2004；85二8】1－20
13・S11巳aU⊂l－‖1m川－adaH．SakugawaH．Ko】¶atSuM，Niiト
Suma】1．Wa†aれa♭eH．瓜山1aneY，TolコtaH．KatoT．Tbn山こa
Y．0∫汗oE，Ue（1；lIl．Mj）′aklYaY．ル1iヱOkamiM．●nヾ051】b・
【yr）eSnrgenOt）pe8（Bn811dBj）ローhel】a甜sB、・irusjll
Japan．CliれJ11fecIDi52DO4；38：1222－8．
14・Ⅵ1giH，ト†iてU＝M．¶lnak8J．Yo＄l】jza、ヽ■aH．Hel）a【tnsB勇一us
け1BV）scTeen111g5trate訂tOel－5uTetI－eSa托Ⅳolbloodわー
け8n血si（In†1－rOugb丘1CO汀Ibiniltionofimmuno】ogjcaユ
ーestiJlga】ldn11Clejcacidanlp棚cati（）n【eさthlg一丁apanese
experience．】CljnViroIZ仙6；3G：S56－G4．
15・Mineli，EmuraH．hliya－nOtOM．TonlOnOT，Minegisl】5K，
Ml】r（）kれIVan．甑manakalいbshjka、憫んNishjokaにHigb
血■Oll由1PuてSCreeni】1gOf161mllionsero】0評Cdlyneg8山′e
b】00ddol－Or与払rllepahぬBv汀張．llepa【itisCvir11Sand
hurIla〉1血n】llnOde月cjel】Cy血us町Pe－＝〕yJIUCleicacid
肌叩1i丘catjol－teSて】ng雨1山叩eCほcalldsens】Uve一口山dp】ex
rcilgC」lth力1ParL）Ⅵro）Mcthods2OO3；112：145－51．
）6・ト加ngQ．1＼加IgC，Rangncllari人¶nlalSl】kuTtS．駄sakiM．
FjssE．ChengLRamal】kutTyT，ClarkeD，YawataH．
Sakak、一丁aY－H血seT■lT叩r8ilTIC・Alltロー¶atedmul【iplex
85SaySyStelTln汀Simlt】talleOuSdetectjo】】d‖】eP8日d＄B
ⅥrlISDNA．hepatitisC、・血sIIN八aIldhuTれan5mmuno（tぐJi－
CietlC），l雨usIYPe】RNA．JCJiTIMicTOl－io】20m，39：2937・
45．
】7・KoibいC】－jT，拙tanjんN濾卸－tlraT．NojillN，Na火ajilれaX．
恒頑T．Il、一礼刀nOtO九】〉re血minallぐeOfgenor〉」Peノ＼H8Vin
an11甘いHⅣ－1dl】山1ypos仙repop山adoncomparcdlⅥth
anHⅣ－1－r】egaLjvecou一つIerpa11inJapalりトサcd＼パーo1200丁；
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1a Koba）■aShiM．人raseY，1kedaX，Tstlbo【a＾，SuzukjY，SaltOh
S．KobavashiM、Suz11kJF，人kut∂N．Sonleヾal、、ト1atstldaM．
SatoJ，K川¶adaIl・Clj】－ical⊂h打nCt亡rjsdc50fp8血れt8
加ec†cdw仙hep那jt⊥SB、づmsgen叫下郎∧．B，andC．
JGastrDentel－0」2（）02；37：35・9．
19t Ori10E．IcⅢdaT．SakugalVaH．Sa†a札HorjjkeN，HjnoK
O最tれX．OlこanOlleT．1inoS，職nakaE．Su之t】山片．Wa【anabe
Il．1イigeS．hl比OkamiM■Geo£raphi亡dis汀ib用水mofhepnti－
【is8viru5（HI‡＼／）ge八0明雨l】pa†ien†5Wi111CI汀Ol】jcHおV
il－†ec【ioninIapan・Hepatolq訂ZQ叱34：S90－4．
20・乃tedaY．KatannY．Hayasl－‖〔HondaT．Yokoねk】S．
Nakanol．YanoM．1bshiokaK．ToyodaH，KumadaT，Goて0
Ii．Di打erenceo‖1ちVgenotypedi51l’ib11tlOnb¢h代enaCUte
hepatitis81】dd汀On‡cllePatit一石inJ叩81】．l】l托cHo】－20（聴34：
201・7．
21■ HayaslliK．Xata110Y．medaY．HondaT．15bigam‖M．1†oh
んHlr（10kaY．NakanoI．ⅥlれOM．Go†oH，1も5hiokilX，
1bl■0（】8H．XumadaT．Compahso爪Ofhcpntiti‘Bvin】551－b－
6e110り∇∝jⅥPal弓en†51VjlIlaCuteれJldchrojljcl】el）at】lj53
al－dal－SenCeOf】al－－ivud】neィes5sta爪tSmit】Sllla亡utehepa－
tjds8iIりapan．）Med＼／ir012007；79：366・73．
22・SugauchjF．Orjto】三．OhnoT，1bnilねY∫Ozasa几Ⅹ8ngJH，
To），0血丁，ⅩuTaT】ljtsuT．Su乙ukir．恥Ilakれ瓦Ak8加IleY，
lc】】idaT・Izun－jN11noueK■Hosh血H，1i】－OS，lbt5uyan昭一
H．Xahユ】れuS．¶ln－it8E．OkanDUeT，Njsl－i卯C11iS．
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di蝕－e－1CeSj】111epa【il】sI）virus酢－101γpe8たonll）aLiel】I霹
南山actIteJlepa血sBjIりapa爪・Hepa【01Res2006；36：107・
14．
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acteri週日onorge】つ0†〉′peIlh叩atiti5日virllSS【raiTljder1日一
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nu亡1eic8Cida－叩lほca【iont亡5りGenViT口12005那：595・9．
24・Erh8rdt人BlondinD，Ilauckズ．Sagir九KoI血eT．Heir噸es
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勇一U5ge110t）′Pedepく！IldeIlt：genOtypeノ、i5†nOleSen重曹かeto
intel†町Ontllal】genOけpeD，Gd12005；54ニ1009－13，
25・Sal－Cl－eZ・nl－】asJM．Cost8J．MasA．Bruguerah†．Rodeり．
1】ュ仇－el－Ce（J‖－ePadd5B勇一u5gen叫7PeOll血elong－【ern1
01】TCOm川fc】1rOnichep；l†iti5もh、VCStemPaden†s，GilSrrO・
eJlte－0】ogy2002；123：】848・56、
26・Sh血klズ．N8g8【al．1izukaT．KajlS．Motherべ0・inbJ】tjll良c・
tionb＼・hepa輔sBヽづmsand汁ipreVentjoI】inJ8pan．山It
Ilep∂†uIC（〉mmu111996r5：74・軋
27・huiA．Komatsu［I．SogoT，NagaiT，＾bcK，Fujis紺〟i－T・
Hepat】ti＄Bviru5getlO【）・peSill⊂l】jld－ellandadoIes00nlsj∫－
】apm：beforeal－daRerjn－川U－－lzatto＝わItllel汀e、・eIl【ionp【
mo止ertoinra－1t仕ansITlissionorhepadtisちlづⅣS．川1ed
Virolヱ007；79：670－S．n
T蒜器握意表
1320 TRANSFUS10N VoIume49，山Iy2009
47
-
JRC2009T・024
ⅥrulentStrainofHepatilis∈VirusGenotype3 RESEARCH
VirulentStrainofHepatitisEVirus Genotype3，Japan
KazuakiTakahashi．HiroakiOkamoto，NatsumiAbe，ManriKawakami，HiroyukiNlatsuda，
Satosh‖Ⅵochida，HiroshiSakugawa，YoshikiSuginoshita，SeishiroWatanabe，KazuMdeYamanlOtO・
YuzoMiyakawa，andShunjiMi＄h汀○
Methods
Wecnrol）cd8patieTltSWhowerejnftctedwithHEV
genotype3andhadc）山icalfbaturesofhepalitis（Tablel）・
ÅzoonotLcsourceofHEVinfbctionwasidentifiedfor30f
lh8SePa一飯mlS：p唱Iiverfbrpatiellt4，pigmらatねrpatient6，
andwi】dboarmeatfbrpaticn17∴Pro血ombintjlne，aSur－
rogatemarkerofhepaticiTISuf6cicncy，aYeraged63．9％（j＝
29．1％）o一拍ere托「印Cer訓geamO11gtl18811EVgenotype
3－ill托cIedpatient5．Hepatjdswa5Panicu如】ysever¢i爪pa－
tients3，5，7，and8；atthepe止ofdi5eお¢，prO仙ro】Ⅵbi】l
time5ねr血es8Pat封印日用nged舟om27％to46％ofthe
reftrcnceral】ge．TTleSeSPOradjcHEVcaseswerenotc！us－
teredgeographica11y；theyweredistributedacrossseveral
TegionsofJapan，i】】CIudhlgSOUtherr）（Okinawa）andnorth－
em（Saitama）pre托ctures（Figurel）．lnfbnれedcons即いVaS
Obtained打oma11patienbaRerth＝】紙汀eandpurpo5eOr
一九¢Study“・aSeXPlain由一o血enl・
Toassess pos5jb】ezoonoticor唱m50rtIleSehunl山1
in托ctions，WeSequenCedHEVstrainswJ】9isoIates打om
50f‖swinew血prevjousIydocuユⅥentedin托ctions（乃．
¶】eSeanima】shadbeenraisedcommercia】lyata魚m＝n
tlleSOuthempaTtOfMjyazakiPrefectt］reWhereHEVin一
托ctionsweredetectedduring2000JOO2，A】）aT）imalsre－
ceivedhumanecare，andtbesmdywasapprovedbytheiね－
St加tioTlalreviewcommi仕eeorTosIlibaGer18ra】IlospltaI， Tokyo，Jap肌
Todet¢mlinewh¢th即infもctiollS CO111d belir】kedto a
COmmOngenO勺叩e3vir心，We∽mpa陀d8沌genetjcstmc－
tureaJldseqtJenCehomo10旦yOf8ht］manand5swineHEV
Strajns．¶1eellかeor11ear－COmpI巳telluCleotides∝lu印CeS
Of也e8JIOstrai爪iso】ates打01ndlモhun】抑pati餌band tlle
SWJ19sけainiso】ates育om 山e5 swi11¢Were deter－
minedbyanle加odreportcdpreYiously（β，夕），Withso汀帽
modifications．］nbrietnucleicacidswercextTaCted危・OIT）
SeZblnwiththeQJÅampMinEJuteViTUispinKit（QLA－
GENGmb11：Hilden，Gennany）rliEV町】Agenomeswere
revcrsetl’抑SCribed，andcDNAwasaJr）Pl浦edbyPCRwjth prlmerS
SpeCi爺cfbr230VerIappmgreg】OIISOrtheHEV
旦enOI¶＆Reverse†ral】SC叩t】On弧d触トroundPCRwere
COnductedbyusiTlgtheSuperScriptlI10J】e－S†cpRT，PCR
System（lnYitrogenCorporation，CaTIsbad，CA，USA）；SeC－
b′．冨＝
Fi！lU帽1，M叩0りapan．showin；lPre一合dureswhelOhumancase電
Ofhepatili8∈vi和さh8V¢beenIound．Under‖ni叩indi00lesp8爪Of
prefedurenameinchJded】nis01∂t¢nam8；y釧OWindi∞te＄C∂SeSln
SWine；redindic∂teSC∂SeSinhumさnS tioIISinduce
ove11b叩atitis．A】thoII由the nleCllanisms
underl）′－nginductionorljvモrdamagebyHEVh紳¢nO【
b¢eれW81】cllaraCleri訟d，HEV genotypes see】¶tO have
distinctdisease－jnducingpotential．11EVsequenceshave
beenc】箪S摘edinlO4g¢nOtypeS（外Ge¶OtyPe】consists
ofcpidemicstrainsindcvelopl喝COut）tTjcsofAsiaand
A侶ca．Geno－ype21isrcprcsentedbythepTO（OtypeSeこ
qtlenCeS舟omaれepidemjcinMexico，W】－ic】－havealso
rec帥t】yb¢endetectedhA斤i¢a・Genot）・peS3and4are
distrlbutedヽVOrldwideandhavcbeenirnplicatedjnspo－
radjcca5eSOraCUtebepat竜tjsEinhu－nanS別－ddomeslic
pigs・H七Vgenotypes3and4arebt）ndjnJapaTl，but氏1ト
minantorseven∋aCutehepatitisdeve10pSmOre加quentl〉′
inper50nSinfぬedwithgenolype4・（オー明・meSeVerily
oflivcrdiseasemay（hercfbrebein伽encedbythcHEV
gen“ypew仙which加patjeローi5jnfect¢daswe】1asbost
factorssuchasage，gender，andpregnancyslatuS・
】¶1997，W¢identi鮎dastrail10‖柁V打omapa・
tientinJapanwholladacutehcpatitis（designatedJTO）
【ha【Clustered、州1gen叫仲e3sequ¢nCeS・From2004 through2006，JlO－ー¢】ated
vjntses wereisolated什om
7additjonalpatientswも0】－adacuteorseverehepatitis・
TobelteTuTLderstandgeneticfeaturesofHEVassociated
“亜seYereれepaHHs，WeCdmparedl加CO－叩】eteo川ear－
comp】etesequeれCeO川Oi50la－es打om一九ese8patients
Ⅵ7ithotherwe】トcllaraC【¢rizedgenot〉・Pe3and4isolates
TodeLerTninewhetherthesehumaLlgenOtyPe3sequences
weTCZOOnOticil－Or唱1n，WeSeqUCnCedtblト）ength、・血I
genonle5加n15swin¢in加edwith【he5WJ】9stTainor
＝EV・¶ese5a汀血a】sγ∈代partOr8largeTOutbreakor
HEVinLtctiontllaloccurredノinswjneatas］ngle’farmin
southemJapandu∫ingフ000－2002・meGenlねnk佗MBL／ DDBJaccessio】lnu爪】bers
fbT nuC】eolide sequences or 甘EV
，
Hepa†itis E virus（HEV）9enOtyPe3．which usualIy
ロUSeSaSymPtOmaticinfedioninJap8n，induced seve「e
hepatitisin8patientsTlbbetterunderstandgeneticfealures
ofHEVassociatedwithinc（eaSedvirulence．wedetermined the complete or
nearTCOmPlete nudeotide sequences o†
H∈Vfrornthese8patientsandfrom5swineinfectedwilh
genotype3str8inswJ19・Phylogeneticanalysisshowedthat
theisolatesfromthe8patientsandthe5swine9rOUPed
separatelyfromlheothergenotype3isolatestocreatea
un】quecIuster，designatedJFO・ThehumanJlO－reIatedvi・
rusesencoded18amino acids d粁erentf（Omthose oflhc
OtherHEVgenQtyPe3strains・Onesubstitutioncommonto
almosta”huTnanHEVstrainsintheJrOdusterwaslocaled
inlhehelicasedomain（V239A）andmaybeassociatedwilh
increasedvirulence，Azoonoticong■nOfJ10Trelatedviruses issuspecled
becauselheiso】atesfromthe5SWinealso possessedthe
i。 H慧j三雲霊も慧霊霊霊慧冒’慧iT言‰芸㌫
oftheg印era】populationi－りapanandれ－OStAsianco即卜
tries（J，フ）；llOWeVer．On】y8Smallhclio刀Ortbeseiれ触・
Ond－rOundPCRwasconductedwiththePlatiz）umTaqDNA
polynler鮎e（hlYitrogen）．me5’－aれd3しtennima】sequ即C¢5
WereaTr）Pl侮dbyusiT）gtheSMÅRTRACEcDNAÅmpJj・
ficationKit（CloTlteCllLaboratorjesJnc．，MountainVicw，
CÅ，USA）andOljgo（dり20打imマー（Inv如ogen），reS匹C－
tively．T71CSequenCeSenrichedinG・Cwereamp冊edwith theTaKaRaLATaqin
Ltd．，5higa，Japa叶ThesequeれCe5nOtamplj月ab】ebyl】lO
abovePCRm血od5W¢ー¢Su切eded18PCR．w仙pバm耶
deducd打oma句ac印t5■and3－se甲enCeS．m¢伽8】prod－
ucbw¢ー¢S¢甲飾Cediれ仙e377DNASequen眈TWit】川S¢
Ofth，e8igDy？TemljnatoTVl・】CycleScquencingKil（Ap－
pliedBiosyst？mS，FostcrCity！C4，USA）・Gepeticana】yses
Or11EVsequenc8SWerモ，COnductedわy血eunw¢ightdpaiト
訂Ouplngmethodwi血aritbmedcmeansbyusmg00mpu【餅
SOftwaTeGENTYX・MACVcrsion13（GenelyxCoTPOTa・ tio叫Tokyo，Japan）．
AuthoraffLLiations：lbshibaGeneraTHospital．Tokyo，Japan（K・Taka－
hashi．N．Abe．S．Mishiro）；JichiMedicalUniver拘Sdl00lofMedト
c加，旬d19i．Japan（H．Okamoto）：Kurash裾Med】∽1Center・Okaya－
mき，」叩an（M．由wakami）こM紬UdaNaikaCtinic．恥恍0「り叩訓（H・
Malsuda）；SaitamaMedi00】U巾耶拘．Sa托amさ，血四∩（S▲Modlid可：
HeaTl・〔侮Hosp瑚OkirLaWa．Japan（HLSakugawa）；KyotoUniveT－
s和GraduateSchooIofMedic事ne．Kyoto，Japan作Suginoshfta）；Ka－
g即〟aPrekdu帽‡Centra】Hospilal．Kagawa．Japan（S・Wね相加）ニ
0ねyamUn－∨粥汁yGradu釦eSchoolo†MedidnetDentist「yand
Phama∝血i00lScieno田．Ok8y8m∂（K．Ⅵm8mOtO）；訓dM吋akawa
Memo血IRese8「帥Fpundation．¶）kyo（YMiyakaw8）
D01：10．3201／eid1505，081†00
Tablel．Proflleso†8patientsitl†ededwithhepathisEvirus．）］Ostrain．Japan－
Pa†ient Montho† Nad行PT．Pre≦Umedrouteo† ■no． Age，y／seズ Res舶nce
dis餉SeOnSel Dla9nOStS ％ transmls扇on lsolatoname
100 Unltnown J10・SaI97L 50／M Sailama
76／M Tottori 63／M Okinawa
71／F Ok叫抑1む 65／M Tottori
78／M Okin8Wa
6封M Ka98Wa
1997 Apr
2004 Jan 2004 May
2004 Dec
2005Jun 2005J山
2006 Mar
2008Sep
Acutehepatitis
AcutehepaⅢis
Aclrte hepatllls
Acutehep引il短
Aculesevereh叩a価S
Ac肌Ohopさ鮒＄ Aculehepa拙烙
Fu】mi偶nt砧p融Ii5
92 Unkl10Wn
46 Unknown
75 Pi9INer
34 Unknown
92 Pigm8るt
45† 冊はbdarm88t 27 Urlknown
JYM・T0104L
JYU・OkiO4し
ノ■JSSこOkaO4し
JIYJTotO5し
JSO＝OkiO5L
JTK・Ka906C 0－FHO6L．′ 79／M K
－PT，PrOthro叩binl】me． †0∩け1deterl¶n8tのnW∂Sm8ぬ
Em即81n9回edbusDbeases・WW．dc、gOV／ek卜∨軋15．No．5，M∂y2009
50
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Emerg－∩9■nfedious【）i＄ea詑S・≠〝W・dc・gOV／eid・Vd・15】No・5・M∂y2009
49
704
-
VirulentStrainofHepatjlisEVlrusGenotype3
thattheVユ93Åsubstitt）t血aroseindepeTld¢nt】yinthisse－
れerica11yun－queC】uslerorgenotype3v加5eS・Notab】y，a】I
5isolatesrecovered付om sⅣineonllleMiYaZakiPT¢危c＿
山reねnⅥduringlJ－eOulbreakor2000－2002po5SeSSedthe
V239Asubst血tion，
Discu＄Sion
CiTC皿－StaⅢialevide＝Ceindical£S tbat HEV g¢nO－
type嗣uenc¢St】1eSeV融和0川verdiseasetR¢markab】y，
HEVseropreva】ence仙diesinEgyp‖bundnoclinica川ト
n¢SSinanyperson，－nCludingpregnantwom恥a肋ough
mo5t（67・7％一糾・3％）I－adbeenex匹SedtoHEVgenoけp8
3（／jノイ）・Incont柑Sいesu厄orasじⅣ¢yOf254palう¢nt5
WjthHEVinfectioninJapansl－OWedbepatilj5aSSOC如ed
Witll各モロOりpe4tob¢mOreSeVerethantha【assocjatedwitll
genoけpe3（イ）・Ourresultsshowedac】usteI・i喝Or811EV
isoIateso川OstTajn†genOtype3，reCOYered什0れ－pati印Is
Wjthcliれjca】hepalitis．
Despjtet】1eh；ghdisease－inducingactjvjtyofth¢打EV J10st摺れtlle g
patients拍托cted w柑】鋸5S匝in were
di5け拍uted、VidelyoverJapan．misdistributio¶isatodds
WitbalocalclllSlerof各enOけpe3i一雨ctionsrestrictedto
PerSOnSWjthhepadtisandtowi】daれin－als】iv一喝i¶Hyogo
P】’efぬure，Japan（Fj糾re2，panelA）（〃）．Wid¢regio鵬I
di5tナjbl－tjonI－aSalsobeenreportedねr50meHEVgeno－
type4iso】a【es（／∫）・W吋刀Osけajnscausedmoresev¢e
hepatidsthan－れighlt，eeXpeCtedfbrag¢nOlype3vimsIS
RESEARCH
Results
¶帽PrOtO㌢pICa】jsola†e．JlO－Sai97L、Ilad a geIlOnle
kng血or7，215＝【hatco‖ほineda5■l－nlransla†edregion
（UTR），30Penl‘eadjng＆anleS（ORFs），a3r UTR，and a
POl〉′・AtaiI．Le】1g山SOFHEVsenome5from60山erpatieれtS
（JYMTTotO4L，JYU，Ok了04L，JSS・OkaO4L，JIY・To【05L，
JSO－OkiO5しandJSW・Kyo－FHO5L）weTeidentical†Ot】】at OrJ】0－Sai97L An
exceptlOn WaSthe11EVisolateJTK－
KagO6C什0れ－Palie11t7，、Vhichwassligllt】ylotlger（7，236nt）．
¶】e5H上Visolates斤onlSⅥ・iれe（S軋‖9・l，5、VJ19・2，S＼川9－5、
S、刷9－7，ands、机‖9－8）hadgeno】¶eSOr7，210nt．¶le30RFs
Orallswhe山一dhujnaロト1EVgeno－neS】ladjdenticalprotein
COdingcapac）ty．】lEVisolatesfi－OTnall］1ulnanPatientshad
97．9％－98■6％sequence homo】ogy“・仙the protoりpjcat
J10TSai97LstraiTl丘ompatientl．The5swineswJ19isolales
I－ad98・3つる－99．9％seqtほ】】Cehomolog）・、、′heI】CO】npared“車h each
otl－era一一d98■0％←99・8％l】OJnOlogy whe－1COrnpaZred
、、・氾l山eJIOstrai】1幻om】lull柑－1Palie－1t5．
ConlParjso】10rnUC】eotjdesequenぐeSOrtl】e13血man
ands“・ineHEVisolaIesinthissttldy、、′油tho5eOfpub一
】ished】1EVgeno【）′Pe3seqt－enCeSSl－0、Ved【l－a†山e】3co∫ロー
PIeTea】ldneaJ’・COmPletesequencesdescribedintllisstudy C】ose】y
matc】－ed仙ose or2、、・e】トcharacterized gellOt）′Pe
3vjruses：JRAl（89．4％－g9，7％11UC】eotjdeide11tity）and
SWJ570（88．9ウもー89，0％nllCleotidejd訓†吋）．T¶eり11Uman
ands、Vinegenoり・Pe3isolatesdisplayed“′eakho】れ0】0呈〉・
Ⅵ′ithothertiEVge110年peS．¶eBlisolateor各eれ0りPel
（G¢nBankaccessjollnO．M732】8）、VaSOIlly74．1‰74．7％
SimiIaTtOthesegeno†ype3vjruses，tlleM】isoIa†eofgen－ Otype2（accessjon
no．M74506）Ⅵ一aS Oれ】y73．6％一74，0％ Sin－il町，a∫－d
theT】iso】ar¢Org6nOけP64（acc¢SSioJ川0．
AJ27210＄）、VaSOJlly75．69もー76．0％sinlilar．
Usin£血e13comp】eteorllear－COnlPle†egenonlicse－
queJ－CeSOfHEVgcnotype3isolatesdescTibedinthissてudy
（F短u】一e2），1VeCOnS仙C†eda phyIogene†ictree．】1EV se－
queJICeS打omthe8patiel】tS（JTK－KagO6C，JYU－OkiO4L，
JSS，OkaO4LJ】OTS∂i97L，JSO－OkjO5L，JSWTKyo－FIlO6L，
J】Y一丁o†05L，JYM一丁otO4L）cIusteredoTlabranchseparate
丘om仙eo仙訂genOt〉，pe3sequeJICeS，わ】Ⅵ】i丁場adistinct
g－■OUplngrelatedtot】1ePrOIor）・plCa＝】Os†rain．¶】eS、州9 日EV
seql】enCeS什om thc5s、Vi口e（swJ19－l，SWJ19一三， S＼＼′J19－7，SWJけ一5，aれd
s、V山9－8）c】ustel■ed close】y、V仙
血eJ】0－reIa†edviruses什onl仙ehtlmanpatients，indicaTlng
tllatthehul11日nandswine11EViso】a†esWereIligIlIysimト 加（F痩uJ●e2，pa】ld
A）．Anot】ほr柑swineisola†es，什om
fむⅧSOlllerth封1血elhl′OIvedil】tlleSll引90Utb】・e水，lVere
phy】ogelletjcall〉rdistind丘om†hoseortheolttbreakf∂rn15
（Figure2、pane＝ま）．
Anot】lergenOけPe3c】uster朋Sforl】1edb〉一6iso】a†es
什omH〉′OgOPre托cturい…一eSternJapalりFigure2，panel A）．ln
tl】iscIusterwere5】1EVi50】a†es打olれperSO】1Sin Ⅵ′hom
hepatitj5developed a允er加y ateulCOOkeddeer
meat（ブのand打om′sen】nlnOma】oca＝〕Oarandad早er
OfthecouJlu）・．BroaddisrributionoftheJ10・relatedvinlSeS
SeelⅥ5tObeuniquei刀HEVepidemjology．l112（25％）or
these8pa血一日，p－gIiveror一¶eathadbeenimpJicatedil】 IIEVinJもction．
Co叩訂isonortbeJ3JJOィ¢】atedvin－SeS（Figure2．
panelA）w油theothergeれ0サpe3strajれSalsosbowedlg
aa動恥rences：12inORFl，3iれORF2，and3h OJIF3
（Tab】e2）．¶】reeれ1し1talio11Sin血eJIOstraillWeTeCh包丁aCte；＿
isticorgenotype4v血se5，Ⅵ巾ich8retypical】ymorepatho・
genicth叩OtherI花VgeI－OtypeS・ORFldげ托r8れCeSWere
bu‖dataminoacid5605（Serjne10prOIine，S605fり，978
（isoIeucinetov左】jne，】978V），and12】3（、′a】涙toaIani叫
Vlヱ13A）・n8Vlヱ13Asubsl血tionispot¢ntia】1ynlOSけeト
eva刀tbecauseitwasnotfbundjntheprototypicalisolate
什ompatientl（J10），WhohadmjldcTinical
．
fTOm山eothe］・7pa（ientswhohadmoreseverehepatitisdur－
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Orll－eheljca5edomain，a－－dibsu汀Oundi喝SequenCeSWere
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1incAppeJldixFjguTe，aVai】ab7efron－WWW・Cdc・gOV佗TD′
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けPe3JIOィe】ated、′irusesfbTeVjdenceoriれtergらnOtyp－C
recombination・Comparisonor28genotype45equenceS
WjlhlhoseortheJ！0－relatedjso】afeSSIlOWedれ00bvioし15
5ignsorrecombi－－ation（dat8nOtSbown），Wbicl－Su鋳eSb
（1I）．U蛸kelheJ10－relatedvjmses，Which、VeTebroad7y di5tributed什om
themostsout】1el一月tOnO血emJapan¢Se
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＼、一I
Tab）e2，AminoacidTeSiduesln8humanand5swine hep引潮s∈virus
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DOJ：川．11三〟5Cicn∝．279．53ヰ9．39）
2乙 S】lrぐさ血MRS00¶RhりOSlliDM，M細れnl¢－－MPJr，Th叩aG8，m一
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NEngりM正三Oqフジ5‘：895－903．DOJ：廿105〟Nl臼M鵬61糾7
RESEARCH
】10tC）ear．bulthereasonmaydependontllemagnitudeof
Viru5repIICa【ioJl，AlteTnalivcly，reCOmbiJlationbetweendi－
Ve】－gentHEV5けail】S（／のれIaybaveplayedarole．mispos－
Sibi】1Q，PrOmpledusto）ookforaTlyreCOmbina【ioTlOfJ10
Strai－15Wi【llg¢nOlype4strainsthatcau5e5eVerehepatitis
inJapan・However，Wefblmdnocvjdenceofreco】Tlbhla－
tio】1b¢tWe印IheJ10sけainorgeれ0けpe3けEVwi山一、Vbjch
tbeさpersonswerein俺cteda】1d28iso】alesorg印Olyp84
relrieved什om†hepllb】icandourolⅥ1databases．me】8aa
Subs（itutjonswereun）quetOthe＄humanJ）0純d5swine
SW19isolalesandnolprese爪inolherぷe】】Otさ・Pe3vin15eS．
TllreedifferencesjnORFl（S605P，197SV，andV1213A）
WereCOmmOninwildtype各eれ0押4butT10tiれg帥○けpe
3i50IaIes（Tab】e2）．BecauseS605Pand1978VareIocated
inanOlミF】reg10nthaIh鮎hi呈】1Seql】enCedive柑enCe，血eY
訂e u月日kely10be responsible fora11enhanced disease－
induchlgCapaC）ty．lnconlrast，V1213Achangesatam；no
acid2390rhe】ica5e，∂nenZ）′】¶eCaPableofenhanclngth¢
e代cie11CyOrV汀alreplicatjon（／乃．w¢red¢teCtedin70rthe
8pat血11s（On】jneAppendixFigu∫■e）・lndeed，thehe】icase
reg－OnOr血eprot叫・ptCa‖10－Saj97Ljso】atediI】】997did no†con【ain
tlli5a】】1i】10aCidpol〉′mOrPh‡snl．Remarkab】y，
al】5s、l・inei50IalesreCOV¢redinMi〉・aZ8kiPrefecttlr¢dur－
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】）・SuggeSba乙00nOticoTlgi11ねrtheghumanHEVin触－
1ionswithJIO－re】atedvjru5eS．
ExperiローenlaIa一－d cjr⊂un－S【a－－tia】evidence sltgg¢StS
t】1a川eⅣ239Åma〉・haveeれ】1anCedthehe、Ii鎚SeaCtj＼′1Iyor
lhegenotype3J10sl和行＝0】eveIscot叩arablewi【hthose
OrthdnlOrepathogenicgenot）′p¢4v行u5eS．However，血e
rol＝用eⅣ239Ainenbanci－－きhe】jcas？aCけ呵Sbol11db¢
evaluatedinvitl■Oin餌加●estlldjes；itsI‘0】einiれducil唱hep－
ati【isisye【Iobec（）nfirTr）ed．7nadd侶on，theef柁ctofother
11111t8日OnSO†刀Ostrains¶eed10be餌11yexp】oredbeわrea
COnC】l－Sioncanbedrawnresardi咤t】－ehepalj－is－ind11Cin5
CapaCjtiesor山isstrainorHEV．
Findinss打omthisstudYhavepub）ichealthimplica－
tions・BecalIS8ねrn15Wjneconslituleam¢】tingpotforgeロー
erarTngVaTjoILSHEVmutants，at】easlinJapanwherc＼′jrtu－
allyal】s、、●inebecol¶ein托ctedl＼巾hHEVwit】1in4nlOntllS
Orb軸‖tisconc¢i、’ab】ethat、柚el－tHEVmutaロー（s）8rSe
OTIPjgLbrms．SuchoecttTre）lCellaSbeendescribedfoTITl・
伽enza，ねr、、′hicわ押Intmu†ationsareassociat¢d、、′itht】1－
CreaSed＼′iru】ence（路ノタ）；触‘eXanlp】e，－¶U【antin伽enza
Viruses11－atarOSeO高cllicken免mlSj】1Hon8Ko鴨川1997 Ⅵ′eretra11Sn軸ed
to】1uma】1S and】1adねtalconseqⅥ印CeS
（2β．2り．lれaddition，althoughavaccineagai11St11EVhas
rece口l】）′be印de＼■eloped（フフ），a、■aCCiJla山on strategyねr
h川MllSandanilれa】shas〉・et10bede加ed．TれereslIlbor
Ol汀StUdyindicate【】1als盲1ectivev∂CCjれationof’鳥rmswjne．
beari喝HEVisolaLeSローhighv血】ence，SuCh粥川oseoflh¢
J10s厄ipinMjyaz濾iPre氏cture，5h山一dberecommended
12、E】■k¢rJC，De5aiSトイ．5chlaudぐー（JG，D8≠‘S（1nGJ，M憬lla】11lrarlK＿A
l－CPatilisE、・血sYaパ00lrro爪血UnitcdSI批5＝n叩IecuI乱rCharac・
lcr加Ii¢na－1dtr抑S■れis5io－－inc押nmOl即Sn旭Caque5・JG印VirQ】．
1999；RO：‘8ト90．
1ユ．Sl（）Sエ¢kSK，入bdもl－HalⅥidM．SalqllDA，EIKも什恭≠ワS，N祁¢qlS，
HaⅥ・鮎h＼1ela】描かPre、・もl即CCOrhepatitisE8nlibdiポi－－pr喝－
－－an一丁：む・Ptla■lWO－－1Cn・Tr耶SRSのCl■rop入1cdH〉■g・ZO叫】00：95－
】0】．DOl：川…叫，帖tlnh．20肌】2．005
I4、Stosz¢kSK，伽如RE，Al－dcトHallljdM，M扶I血‖〉，AIxkトAzi之た
Mcdl－at∧，Ctれ批pa【itisEanliわdy父rO甲nY¢帽ionwithout茹凝郎
inhi帥）・endemicrura】E幻1）ll訓COm－－11tれitic£．T「a－ⅦRSoc升01－
M¢dH〉・各．200句1叩：ざ9づ4，DOJ：】0・川】略ホImh．2005・05，019
15．’托k8】18SlliK，OkadaK，KangJH，KⅣinoY．1dlidalこM8【sudaH，Ct
al，A】涙喝tOfll叩a【jti5EYjms“・ithillさ帥叩p亡IVさ∬∝iated“朝一
SCY椚ねm旭のrIl叩atitis【itl血I一打沌聞】・K利一狐ヱ005；47：3写シタ0【cil一
号dユ○∞MⅣ6】。AYもilめlo加mhttp：〟mjslagcj虞・印加血涙旭 b川Z〟4〟鯛‘3g9／椚ic】亡
16．YanCuyckH，FanJ】RoberbotlDし，Roqu¢Sl｝EYi血l比Pr代印mbト
】lationb¢価11di、・叩Clltb叩atiti5EYin措CS．JVirol．ヱ005；79二930ふ－
14．1X）l：】0．1t2針jVl．79．t4．9306・93】4．2005
け．AllQl8Td¢nBoonJ人，仙Iqlユ血11日ぐ1i¢鋸∈抑dcap即唱か1巧川CaC・
【ives加nlUtationsiIlbrく皿亡mOS8icviru5PrO【¢in】8侃uSC血危cui】l
tcl叩血tcrcαUi1111即ちn仁㌍Uvcづtr卸dRNA5yn仙⊂Sis，andv血IRNA
00pP＝皇・JVjl・0】．2仙0；74：R帥3－1LDOl：】0・t12鏑／JVI・74■】9・g803－
冨S】l，2り00
todccreasctheincidenceofh血inantorse、′eTeaCutehepa－
titisEinJapanand¢JsewherejnIhel㈹r】d．
Acknowledgments
ⅥJ仁一ll抑kCIlrist叩tlerM．Walkcr8IldSheikhMohamnlad
Faz】eAkbar穴）rd萬i即1nきa】－dcheckiれきIh¢m乱れUSCript．
Thisworkl＼′8SSuppO爪edill阿1byagmlt負・Om血Minis吟
Ofliじalth，Labol汀む】dW亡l如亡0り叩抑．
DrTakahashiispr川叩at加e紬さatOrint加Dep乱川Iれen【のr
Medica】ScjctlCモ5atToshibaGcncralHospねl・Ⅲ5rCS飽rCllinter・
CSli5l）CPalitjきYiruses，mOStreCe血yh叩atili5Eヽ・irus．
References
】Araれk州eVl，Tsar¢、・SA，Cl－ad】柑MS，A‖mさDW．Emc指OnSU，
88服づce札etal，Ag¢－S匹Ci翫pr…len∝Or肌t伽diqtokpa－
†ili5A訓1dEv血s∝inPll叫】ndj斗19g2nnd1992．JIれ托CIDis．
19！〉5；】7】：4ヰ7－50，
2．TanakaE，Natsumo†oA．TbkedaN，LiTC．u】lernurfLT．11，ShizaⅥ・3
K，亡Ial‥へgc－5P∝ificantibdy†oll印面tisEv血shasr6nlainくd∝・n・
51anldurれ－gthepas120yc礼帽inJ叩肌JⅥ相中I】叩弘ユ005；】2：ポサ・
42．DOl：10．】＝巧．1385－2写弊．コ005，00る】6，X
3・Enler50n5U，Al】dじr50n D，Arank山1亡んMじ喝㍊，Purdy M，
Schlal】derGG．eId．坤匹l・血J．Jn：F叩11dCトtMayoMA，h4a－
niIoLrJ，Dessclbc曙CrU．BAIIL＾．cdiors．Virus［8Xt）nOmy：VIJIth
rぐ匹れOr伽1n†cma†ionl11Co】¶m仙e¢0¶¶ⅨOn01ⅥyOrViru5亡S，b】1－
d印：E】scvicr／Acad¢micPr亡び；200」．p．名53－5・
4・Ab¢T，刃hl、′al．へbhan¢YÅ柑iM，Asa】liれaY，Atnra5】li、Ycl
id・Dcm（，graPhic，epid¢nlioIo呈l∽l、and viro】ogl見Ich訂れCICバsIic5
0rh印加Ii5E＼一irusinfぢCれ0帽inJapanbas¢don254humⅣICおCS
COllect¢d仰†】onlVid6【inJ叩抑亡沌】．KむuO．ヱ006；47：384－9l．DOl：
】0ヱ957爪さ喘0．47．5糾
5・ln（－ueJ，Ni5lli顎W刀T，T油劇化抽‖吠Aik帥・81MほUOH，SllZ11ki
K，Cl苅】・血刀lys】50r血餌山肌glhgcn（刑eOl■g印Ol汀e4h¢pllrilj5
Evjru5iso】餌e言付olⅥpa†血はWith爪l加innn†（汀aCl仙さ5eI川口li【ed
hepl1日li5王．JMdⅥroI．200句78：ヰ7♭朗．D01：JO．川02月川V．20565 6
0hnjshjS，K帥さJI†，Mれ∈kuboItAraknwaTK打in（・YTbvolれJ．et
止Comp打isoれOfdiれical鮎山Ireiofaculel呵油tis印IIS仁dbyhc甲一
†ilisEYjru5（HEV）さCI101〉・匹S3mdqinS8PPOrO，Jap肌‖叩810I
Rc5▲ユ006：36：301－7．DOl：10．IO】6月hq汀¢S．2006．0き．00三
7・乃kahashiM，Nisl一触walト1iy呵l汀柑Il．Go一礼ndaYl血丁恥uda
n¢lれIS、、・in¢h叩汀血isEvjrl巧51ra‡nsim．I叩aハねmlねurpllyIo－
さCれCljcch51c門印n－p即ablいV油Ihos亡い‖叩imCSei501aleSOfhu－
n18nhep81汀ISEvir瓜JGenⅥro1200〕；忘4：∬1－■2．DOl：10．1099／
Yir．0．】39ほ－O
S．TakahEIShiK．lwさLaK，War9TlabcN，7・1alahamT．Ohtal二88baK．
ぐ†at・F州－gCnOmじれUC】印l眈S亡甲■enCeOrllI18P油tisEl－irltSS什aln
伽【mり－bcindi皇enOuSlOJap卸．Viro10さy．加0Ⅰこ287：トIヱ．DOl：
】0．】00（〉／viro200】．1（）17
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れ1inan†h叩l血5inJ叩m．柚印加両酔∴00対6ニ〕OS－】さ．DOl： 川＿】】59ル000732】0
川 職うS，Iこi†毎血叫丁几k血shiKMishjroS．zoo佃ictrall；，¶jssi川Of
hcpalilisl三Yirus如－－¶d∝rlo加manbei喝S．L抑∝l．200jβ62．371－j．
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