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1、JOURNALOFCLINICALMICROBIOLOGY,Apr.2006,p.12881294Vol.44,No.40095-1137/06/$08.000doi:10.1128/JCM.44.4.12881294.2006Copyright?2006,AmericanSocietyforMicrobiology.AllRightsReserved.MolecularEpidemiologyandEvolutioninanOutbreakofFulminantHepatitisBVirus1121MariaAlmaBracho,Mar?′aJ
2、ose′Gosalbes,FranciscoGonza′lez,Andre′sMoya,1andFernandoGonza′lez-Candelas*InstitutCavanillesdeBiodiversitatiBiolog?′aEvolutivaandDepartamentdeGene`tica,UniversitatdeVale`ncia,46071Vale`ncia,12Spain,andDireccio′nGeneraldeSaludPu′blica,ConselleriadeSanitatiConsum,MicerMasco′26,
3、46010Vale`ncia,SpainReceived27July2005/Returnedformodi?cation14October2005/Accepted31January2006InordertoestablishthetransmissionpathwayfortwooutbreakpatientsaffectedbyfulminanthepatitisB(FHB)followingasharedperiodofhospitalization,wesequencedthecompletegenomesofthehepatitisBv
4、iruses(HBV)isolatedfromthemaswellasfromthesuspectedcommonsourceand11additionalcontrols.PhylogeneticandstatisticalanalysesofthesesequencesrevealedthatthetwoFHBpatientswereindeedinfectedbyacommonsourceandthatthefataldevelopmentofthediseasedidnotappeartobeassociatedwithDownloaded
5、fromanymutationpreviouslyreportedtoberelatedtoFHB.ThesedatahavealsoallowedustoestimatetheextentanddistributionofgeneticvariabilityalongthegenomesofHBVgenotypeDsamplesfromthesamesourcepopulation.Asaresultoftheseanalyses,weprovideanimprovedstatisticalmethodtoindividualizetheassi
6、gnmentofeachsuspectedpatientandthesourceofanoutbreakandinformationonwhichgenomeregiontoanalyzeinthemolecularepidemiologicalassessmentofhepatitisBvirustransmissioncases.jcm.asm.orgHepatitisBvirus(HBV),theprototypememberoftheHe-representativeportionoftheHBVgenome.However,thereis
7、padnaviridaefamily,causesacuteandchronicliverdisease,noconsensusonthebestchoiceofregionforthiskindofchronicallyinfectingmorethan400millionpeopleworldwide,analysis.Severalauthorshaveusedthecoreregion(11,38),withanestimatedriskofdeathof25%forchronicallyinfectedothershaveemployed
8、theSregion(13),andmanyhaveusedatPennStateUnivonFebruary12,200
