Detection of concurrent infection with multiple dengue virus serotypes in Thai children by ELISA and nested RT-PCR assay.

The prevailing global spread of four dengue virus (DENV) serotypes and the resultant co-circulation of multiple serotypes in the same region have invariably led to conditions supporting the periodic occurrence of simultaneous infection of individuals with more than one DENV serotype. This raises the issue of how best to detect concurrent multiple infections. We report here the use of a nested reverse transcription-polymerase chain reaction (RT-PCR) assay, which detected concurrent infection with three DENV serotypes (DENV-1/DENV-2/DENV-3) and two serotypes (DENV-1/DENV-2 and DENV-2/DENV-4), respectively, in three serum specimens from Thai children hospitalized during the dengue epidemic of 2000-2001. In contrast, an enzyme-linked immunosorbent assay used previously for virus serotype identification failed to detect multiple DENV serotypes in these specimens. Serotype identification by RT-PCR was confirmed by sequence analysis of each amplified PCR product. Phylogenetic analyses performed on PCR-amplified DNA fragments further supported the occurrence of concurrent infections with multiple DENV serotypes in these children. Although the sample set was small, our data suggest that nested RT-PCR is an effective method for the detection of concurrent DENV infections.

TT virus infection in acute non-A to E hepatitis in northern Thailand.

TT virus is a novel DNA virus widely distributed in the general population. We examined the prevalence of TTV infection in a population with acute non-A to E hepatitis and in comparison groups located in Northern Thailand. The prevalence of TTV in subjects with non-A-E hepatitis was 19% (21/112), 6% (4/72) in healthy volunteers, 17% (12/72) in those with hepatitis A or B, and 17% (8/48) in hospitalized patients with non-hepatitis illnesses. A significant association with TTV infection and non-A-E hepatitis was seen in all groups (OR 3.9, p = 0.02) and in children (OR 25.8, p = 0.001). Among subjects with non-A-E hepatitis, TTV was associated with higher alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels (significant for AST, p = 0.02). Our observations suggest that TTV in our study population may be associated with non-A-E hepatitis and that children in particular may be at risk of hepatocellular injury as a result of TTV infection.

High prevalence of hepatitis G viremia among kidney transplant patients in Thailand.

Patients receiving kidney transplants (KT) are at high risk for blood borne viral infections. To determine the prevalence of a recently discovered hepatitis G virus (HGV) in this patient group, reverse transcription-polymerase chain reaction (RT-PCR) employing primers derived from the NS5 region of the viral genome was utilized. HGV RNA was detected in 40 of 94 KT patients (43%), as compared to 3 of 69 healthy subjects (4.3%). Cocirculation of HGV and hepatitis C virus (HCV) RNA was detected in 12 patients (13%). Comparison of patients with and without HGV revealed that the former had received hemodialysis before transplantation for a significantly longer duration than the latter (28 vs. 17 months, respectively; P < 0.05). The amount of blood transfused and mean levels of liver enzymes, including alkaline phosphatase, alanine transaminase, and aspartate transaminase, were the same in both groups. Sequence analysis of 275-base pair DNA clones obtained from 2 patients revealed approximately 92% sequence homology to the published HGV and GB virus C sequences. These results suggested that HGV infection among Thai KT patients was high and the role of HGV in causing liver disease remains to be determined.

Detection of hepatitis E virus infections among domestic swine in the Kathmandu Valley of Nepal.

The prevalence of hepatitis E virus (HEV) infections among 55 domestic swine living in the Kathmandu Valley of Nepal was investigated. Sera and stool specimens were collected from 47 free-roaming swine and examined for the presence of HEV genomic sequences by the reverse transcription-polymerase chain reaction. Sera from these animals, as well as sera from eight other swine, were also examined for the presence of HEV-specific antibodies by an enzyme-linked immunosorbent assay and by a fluorescent antibody blocking assay. Hepatitis E virus RNA was detected in the sera and/or stool of three of 47 swine, while HEV-specific antibodies were detected in 18 of 55 swine. These results indicate that HEV is a zoonotic virus, and that swine are among its natural hosts.

Detection of dengue virus RNA using nucleic acid hybridization.

Conditions for using slot-blot nucleic acid hybridization to quantitatively detect dengue-2 virus using a radiolabelled cDNA probe, pVV17, were determined. As little as 11 plaque-forming units of virus were detected using a hybridization mixture without formamide and performing the test at 70 degrees C. While predominantly serotype-specific using stringent (65 degrees C) washing conditions, the probe detected all four dengue virus serotypes using astringent (28 degrees C) washing conditions. No significant qualitative differences were detected using Thai dengue-2 viruses isolated over a 10-year period. High titered, anti-flavivirus antibodies blocked virus detection by an antigen capture, enzyme-linked, immunosorbent assay or by intrathoracic inoculation of Toxorhyncites mosquitoes, but not by nucleic acid hybridization. The appearance of virus-specified RNA coincided with the detection of antigen in infected C6/36 (Aedes albopictus) cells by immunofluorescence, or in cell culture supernatants by the antigen capture method. The method has potential as a diagnostic tool for identifying dengue viruses in clinical and field specimens.