Biological and clinicopathological features associated with hepatitis C virus type 5 infections

Background/Aims: The biological and clinicopathological features of hepatitis C virus infections of type 1 and type 2 have been well documented. However, little is known about the nature of HCV type 5 infections, which have been found to occur in South Africa but rarely elsewhere. Methods: We investigated the HCV genotypes in 125 viremic blood donors and 125 viremic patients by restriction endonuclease analysis of amplified 5' noncoding region sequences. Donors and patients infected with type 5 were further studied. Serum HCV RNA levels were assessed by a differential-size PCR-aided transcript titration assay. Results: HCV type 5 infections were identified in seven (5.6%) of the blood donors and in five (4.0%) of the patients. Sera from these 12 persons reacted with the core and NS3 antigens in both RIBA-2 and RIBA-3 tests. Six (50%) and 10 (83%) sera reacted with the NS4 antigens in RIBA-2 and RIBA-3 tests, respectively. HCV type 5 was found to replicate to high titers that ranged from 10(6.0) to 10(8.0) molecules/ml. Transfusion was the most frequently observed risk factor (5 of 12) and persons infected with type 5 were generally older than those infected with other types (<40 years vs. greater than or equal to 40 years, p=0.01). Cirrhosis was found in two of six (33%) donors and three of four (75%) patients. The duration of infection appeared to be an important determinant for the presence of cirrhosis. Conclusions: In this small group of Canadians infected with HCV type 5, a high proportion developed severe liver disease.