Analysis of GB virus C infection among HIV-HCV coinfected patients / Análise da infecção pelo vírus GB-C em pacientes com coinfecção VIH-VHC

The aim of this study was to evaluate the effect of GB virus C on laboratory markers and histological parameters among HIV-seropositive patients coinfected with HCV. Lower degrees of hepatic lesions were observed in the triple-infected patients, in comparison with HIV-HCV coinfected patients who were negative for GBV-C RNA.

O objetivo do estudo foi avaliar o efeito da infecção pelo vírus GB-C em marcadores laboratoriais e parâmetros histológicos em pacientes HIV soropositivos coinfectados com VHC. Menor grau de lesão hepática foi observado nos pacientes com tripla infecção em comparação aos pacientes coinfectados com VIH-VHC negativos para GBV-C RNA.

Molecular characterization of hepatitis G virus (HGV) isolates from healthy adults and risk groups in the Philippines

Hepatitis G virus (HGV) infection has been detected in Filipinos through a prospective study of 1,088 blood samples. HGV RNA was found in sera of 6/516 (1.2 percent) healthy adults (volunteer blood donors), 11/138 (8.0 percent) chronic liver disease patients, 7/207 (3.4 percent) hemodialysis patients, and 14/227 (6.2 percent) multiply transfused patients using reversetranscription polymerase chain reaction (RT-PCR) with random hexamer primers and a set of PCR primers from the 5 untranslated region (5UTR) of the HGV genome. A total of 38/1,088 subjects were HGV RNA-positiveThe PCR products derived from the 5UTR of HGV RNA+ samples were sequenced to determine the genotypic variant of HGV in the Philippines. Pairwise alignment of sequences and phylogenetic tree construction revealed that among the five known HGV genotypic variants, the Philippine isolates are most closely related to the Asian type (III)Considering that HGV is a highly mutable organism, surveillance for new genotypes may be the only way to assess accurate asymptomatic infection rates. How much this virus evolves in the future may have an impact on its virulence, transmissibility and invasiveness. It is therefore important, from an evolutionary perspective, to continue and monitor evolution of HGV specifically with studies at the molecular level. (Author)

The Phylogenetic Analysis of the NS-5 Region Sequence of Hepatitis G Viruses Isolated in Korea

We examined the hepatitis G virus infections among 227 Koreans who were healthy or were suspected of hepatitis and determined the phylogenetic relationship based on a part of the NS-5 region of 5 positive samples. Viral RNA was extracted from sera and cDNA was synthesized and subsequently amplified by RT-PCR (reverse transcription-polymerase chain reaction) or RT-nested PCR using random hexamer and NS-5 specific primers (470-20-1-77F, 470-20-1-211R, HGVNESTFO, HGVNESTRE). Five positives were found to belong to samples of patients showing symptoms of viral hepatitis. Primers used for PCR or nested PCR were derived from the NS-5 region. On the other hand, no amplification was detected using primers derived from the 5'-NCR (G-146F, G-401R). We performed TA cloning and sequencing of 5 amplified fragments, and their sequences were compared with those of foreign isolates of HGV. The phylogenetic analysis using MegAlign programme of DNAstar has shown that the Korean isolates are clustered on the phylogenetic tree. In summary, we confirmed the hepatitis G virus infection in 5 cases out of 12 patients showing the symptoms of viral hepatitis. The phylogenetic analysis of sequences of 5 amplified fragments showed that their relations to each other were closer than those to the foreign HGV isolates reported.

The Prevalence of Hepatitis G Virus by Reverse Transcription-Polymerase Chain Reaction / 대한임상미생물학회지

BACKGROUND: Hepatitis G virus(HGV) is known to be associated with non-A-E hepatitis but pathogenic relevance and mode of transmission are still unclear. In this study, we analyzed the prevalence and clinical implicati ons of HGV infection in patients on hemodialysis or being treated for hematologic disease, and healthy controls. METHODS: HGV RNA was identified in serum by reverse transcription-polymerase chain reaction(RT-PCR) with nested primers deduced from highly conserved area of the 5'-untranslated region. Other parenterally transmissible hepatitis viral markers(HBsAg and anti-HCV) and alanine aminotransferase(ALT), history of transfusion, duration of hemodialysis were assessed. RESULTS: HGV RNA was detected in 12.5%(8 of 64) of the patients on hemodialysis and in 24.1%(14 of 58) of the patients treated for hematologic disease, as compared with 0.8%(1 of 120) of healthy controls(P<0.05). HBsAg, anti-HCV, ALT level, rate of transfusion history and duration of hemodialysis were not significantly different between HGV-infected patients and non-HGV-infected patients. In patients treated for hematologic disease, sex was significantly different between HGV positive and negative groups. CONCLUSIONS: Patients on hemodialysis and being treated for hematologic disease have increased risk for HGV infection, but there was no clinical difference between HGV RNA positive and negative groups. HGV infection itself does not seem to be a frequent cause of liver disease in these patients. The clinical significance of long-term infection with HGV remains to be established.

Hepatitis G Virus Infection Rate in Blood Donors, Hemodialysis Patients and Hepatitis C Infected Patients / 대한임상병리학회지

BACKGROUND: A recently identified Flaviviridae-like agent, termed hepatitis G virus (HGV), has been recognized as a non A-E hepatitis agent, but its relation to liver disease and transmission mode are not well understood. We investigated HGV infection rate in Korea and tried to clarify its relation to the liver disease. METHODS: 145 blood donors, 39 hemodialysis patients and 22 hepatitis C virus (HCV) infected persons were investigated for the presence of HGV by nested reverse transcriptase polymerase chain reaction (nested RT-PCR) with primers from the 5' UTR of HGV and some liver function tests. In each PCR assay, one positive and two negative controls were included. RESULTS: HGV-RNA was detected in 11 (7.6%) of 145 young voluntary blood donors and in 5 (12.8%) of 39 hemodialysis patients and in 8 (36.4%) of 22 HCV infected patients. All HGV RNA positive hemodialysis patients have a past history of transfusion, but they had a remarkably shorter duration of hemodialysis than those of HGV-negative patients. HCV infected patients with HGV-RNA tended to be younger than those without HGV-RNA. In all 15 HGV-RNA infected individuals without hepatitis B and C infection, alanine amino transferase was not increased except in 2 cases. Liver function tests did not show a significant difference between HGV-RNA positive patients and negative patients. CONCLUSIONS: Hepatitis G virus infection rate was much higher in Korea than other countries, so we suggested that group life could be another transmission mode other than blood transfusion. But even in infected cases, HGV did not seem to cause hepatitis and a high proportion cleared the virus after a relatively short time.

The Incidence and Clinical Significance of GB Virus C/hepatitis G Virus Infection in Hemodialysis Patients / 대한신장학회잡지

The incidence and clinical significance of GB virus C/hepatitis G virus(GBV-C/HGV) infection were evaluated in 68 patients on maintenance hemodialysis. GBV-C/HGV RNA was identified in serum by a reverse transcription-polymerase chain reaction assay with nested primers deduced from a nonstructural region. Hepatitis B surface antigen(by RIA) and anti-hepatitis C(by ELISA) were checked simultaneously. Out of 68 patients, GBV-C/HGV RNA was detected in 5(7.4%), HBsAg in 4 patients(5.9%) and anti-HCV in 15 patients(22%). All 5 patients with positive GBV-C/HGV RNA had a history of blood transfusion. Out of 5 patients with positive GBV-C/HGV RNA, 2 patients were coinfected with hepatitis C virus, who showed chronic hepatitis clinically. Three patients with isolated GBV-C/HGV infection showed normal liver function during last 18 months' period. Between the patients with positive GBV-C/HGV RNA and those with negative GBV- C/HGV RNA, there was no difference in age, sex, duration of hemodialysis and amount of transfusion. Our data suggest that GBV-C/HGV infection may be present, with or without hepatitis C virus infection, in maintenance hemodialysis patients. Although the liver function of patients with isolated GBV-C/ HGV infection was normal, the clinical significance of this new virus remains to be determined.

Hepatitis G virus / 대한임상미생물학회지

Recently, two groups reported independently on the isolation of new positive-trand RNA viruses, designated hepatitis G virus (HGV) & GB virus C (GBV-C). Sequence analysis revealed that both genomes are different isolates of the same virus & represent a new genus of Flaviviridae. The prevalence of HGV ranges from 0.9 to 10% among blood donors throughout the world. A high prevalence of HGV RNA has been found in subjects with frequent parenteral exposure, including intravenous drug users, patients on hemodialysis, patients with hemophilia and patients with anemia. HGV is a blood borne virus that is parenterally transmitted. Vertical transmission has also been reported. HGV commonly occurs as a coinfection with another hepatitis virus such as HCV or HBV. However, HGV coinfection usually does not alter the clinical course or level of biochemical marker and the response to antiviral therapy of chronic hepatitis B or C in these patients. Acute HGV infection rarely causes acute hepatitis and is unlikely to be a major cause of chronic non-A-E hepatitis or fulminant viral hepatitis. HGV infection can be diagnosed by PCR assay to detect the viral RNA in serum. An enzyme-linked immunosorbent assay (ELISA) for detection of antibodies to recombinant HGV putative envelope protein E2 was recently available. But antibodies to E2 appears to be a serological marker for diagnosing recovery from HGV infection. Since the role of HGV as a etiologic agent of liver disease is unclear, therapy is not recommended at this point.

Hepatitis G virus infection in hemodialysis and continuous ambulatory peritoneal dialysis patients

To determine the prevalence and clinical relevance of HGV infection in dialysis patients, we performed a cross-sectional study of 61 HD patients and 79 Continuous Ambulatory Peritoneal Dialysis (CAPD) patients. HGV-RNA was identified by reverse-transcription (RT) polymerase chain reaction (PCR) assay with primers from the 5'-untranslated region of the viral genome. The prevalence of HGV infection was similar in HD and CAPD patients (9.8% vs. 12.7%), while that of HCV infection was significantly higher in HD patients compared to CAPD patients (16.4% vs. 1.3%, p < 0.05). The mean age (49.2 +/- 13.4 vs. 46.7 +/- 13.0 years), male to female ratio (2.4:1 vs. 1.3:1), history of transfusion (62.3% vs. 49.4%), history of hepatitis (27.9% vs. 26.6%), mean ALT level during the previous 6 months (22.4 +/- 37.9 vs. 14.0 +/- 7.4 IU/L), and the prevalence of HBsAg (8.2% vs. 6.3%) showed no difference between HD and CAPD patients. In both HD and CAPD patients, the presence of HGV RNA was not related to age, sex, duration of dialysis, history of transfusion, history of hepatitis, or to the presence of HBV or HCV markers. There was no significant difference in the clinical and biochemical data between patients with isolated HGV infection (n = 12) and patients without viremia (n = 106). The clinical feature of patients coinfected with HGV and HBV (n = 2), or HGV and HCV (n = 2) seemed to be similar to those of patients with isolated HBV (n = 8) or HCV (n = 9) infection. In conclusion, the prevalence of HGV infection was not different between HD and CAPD patients, and HGV infections did not seem to be associated with clinically significant hepatitis. The routes of HGV transmission, other than transfusion or contamination during HD procedure, were suspected.

Hepatitis G virus in hemodialysis patients and gene alignment analysis / 中华肾脏病杂志

Objective To evaluate the prevalence and clinic relevance of hepatitis G virus(HGV)infection in maintenance hemodialysis patients. Methods Reverse-transcription(RT) nested polymerase chain reaction(PCR)was used to detect HGV in 50 HD patients. The prevalence of HGV infection, their relationship with risk factors, liver function and HBV, HCV infection were investigated. Results HGV RNA was found in 14 percent of the HD patients (7 of 50), as compared with none of health blood donors(0 of 20, P

Original Articles: The Detection of Hepatitis G Virus RNA by RT - PCR in Various Liver Diseases / 대한간학회지

BACKGROUND/AIMS: Recently, nucleotide sequences from a novel virus, termed hepatitis G virus (HGV), were identified in serum from a patient with cryptogenic hepatitis and suggested as agent of non A-E hepatitis. HGV has been isolated from patients with various liver diseases but clinical implications of this new agent remain largely unresolved. In Korea, the etiology of substantial fraction of hepatitis has remained undefined and there has been no report concerning HGV. METHODS: To determine the infection rate of HGV, RT-PCR of 5 UTR of HGV was performed, and to understand the clinical implication of HGV, medical records of 115 patients with various liver diseases were reviewed. Of 115 patients, 63 were male and 52 were female. Their mean age was 44 years (19-74) and their mean AST and ALT were 121.3+278.7 IU/L and 172.2+253.3 IU/L, respectively. Of 115 patients, 58 (50.4%) had no specific cause of liver diseases, 37 (32.2%) were infected with hepatitis B and/or C virus and 20 (17.4%) had non-viral identifiable liver diseases. RESULTS: 1. HGV RNA was detected in 15 (13.0%) patients of 115 patients. 2, Among the 15 HGV RNA positive cases, 7 were male and 8 were female. Their mean age was 48 years (19-72) and their mean AST and ALT were 71.9+45.2 IU/L, 97.4+66.8 IU/I respectively. 3. HGV RNA was detected in 8(13.8%) of 58 patients without obvious causes of their liver diseases and in 7 (18.9%) of 37 patients infected with HBV and/or HCV. However, HGV RNA was not detected fram 20 patients with non-viral liver diseases such as alcoholic liver diseases, autoimmune hepatitis, PBC, or fatty liver. 4. HGV RNA was detected in 5 (19.2%) of 26 patients with acute hep- atitis, in 6 (9.4%) of 64 patients with chronic hepatitis, in 1 (14.3%) of 7 patients with liver cirrhasis, and iB 3 (27.3%) Of 11 pafients with hepatocellular caIcinoma. 5. These was no slatistically significant difference in sex, age, history of transfusion, serum ALT level, etiologies and status of liver diseases between HGV RNA positve and negative group. CONCLUSIONS: the prevalence of HGV infection is quite high among the patients who have no specific cause of acute or chronic liver diseases and HGV can be coinfected with HBV and/ar HCV infection in Korea.