RESUMO
BACKGROUND: Prevalence of transfusion-transmitted virus (TTV) infection among blood donors and in patients with liver diseases in China was studied. METHODS: DNA was extracted from serum and amplified by seminested polymerase chain reaction with reported primer sets from a conserved region of the TTV genome. RESULTS: TT Virus DNA was detected in 55 of 196 blood donors (28%); 31% (40 of 127) in the north and 22% (15 of 69) in the south. TT Virus DNA was also detected in 14 of 31 patients (45%) with non-A-non-G fulminant hepatitis and in eight of 25 patients (32%) with non-A-non-G chronic hepatitis. The rate of TTV viraemia in these patients with liver disease was comparable to that in blood donors. TT Virus DNA sequencing of 12 isolates showed that the prevalence of genotype 2 was significantly higher than that reported in Japan (66.7 vs 2.6%, P < 0.001). Furthermore, genotyping assays based on restriction fragment length polymorphism were carried out on all 88 TTV DNA-positive samples. It was found that 42 isolates (47.7%) belonged to genotype 1 and 40 (45.5%) to genotype 2. It was of particular interest that the prevalence of genotype 1 in patients with non-A-non-G fulminant hepatitis was significantly higher than that in blood donors (10/14 vs 22/55, P < 0.05). CONCLUSIONS: The data indicate that TTV infection is common in China and that the pathogenic potential of TTV toward the liver (if any) may differ between genotypes.
Assuntos
Doadores de Sangue , Transfusão de Sangue , Infecções por Vírus de DNA/transmissão , Vírus de DNA/isolamento & purificação , Hepatopatias/virologia , Adulto , China/epidemiologia , Infecções por Vírus de DNA/epidemiologia , Infecções por Vírus de DNA/virologia , Vírus de DNA/genética , DNA Viral/análise , Feminino , Humanos , Hepatopatias/sangue , Hepatopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , RNA Viral/análise , Estatísticas não ParamétricasRESUMO
The natural course and the clinical significance of hepatitis G virus (HGV) infection were investigated in 106 pediatric patients who received chemotherapy for hematological malignancy or underwent bone marrow transplantation (BMT) using HGV-RNA and antibodies to the HGV-E2 protein (anti-E2). HGV markers were detected in 21 patients (19.8%; HGV-RNA in 19 and anti-E2 in 2). Longitudinal analysis of these HGV-infected patients showed that 1 had anti-E2 before the initial blood transfusion, 14 had persistent viremia, and 6 became clear of circulating HGV-RNA after completion of therapy, although 5 of the 6 HGV-cleared patients never developed anti-E2. Reactivation of HGV infection during chemotherapy was observed in two anti-E2-positive, HGV-RNA-negative patients; the reappearance of the same HGV strain was confirmed by phylogenetic analysis. Among BMT survivors without other known causes of liver dysfunction, HGV-RNA-positive patients had a higher peak serum alanine amino transferase (ALT) value than negative patients. Contrary to previous reports, immunosuppressed patients can apparently recover from HGV infection without detectable anti-E2 and some patients who supposedly recovered from HGV infection can nonetheless suffer exacerbation when subsequently immunosuppressed.
Assuntos
Transplante de Medula Óssea/efeitos adversos , Flaviviridae , Neoplasias Hematológicas/tratamento farmacológico , Neoplasias Hematológicas/virologia , Hepatite Viral Humana/virologia , Adolescente , Anticorpos Antivirais/sangue , Criança , Pré-Escolar , Estudos Transversais , Feminino , Flaviviridae/genética , Flaviviridae/imunologia , Hepatite Viral Humana/fisiopatologia , Humanos , Terapia de Imunossupressão/efeitos adversos , Lactente , Fígado/fisiopatologia , Estudos Longitudinais , Masculino , RNA Viral/sangue , Recidiva , ViremiaAssuntos
Infecções por Vírus de DNA/etiologia , Hemofilia A/virologia , Reação Transfusional , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Infecções por Vírus de DNA/virologia , Feminino , Hemofilia A/terapia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Viremia/virologiaAssuntos
Infecções por Vírus de DNA/transmissão , Vírus de DNA/isolamento & purificação , Reação Transfusional , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Infecções por Vírus de DNA/epidemiologia , Feminino , Humanos , Lactente , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da PolimeraseRESUMO
The natural course of hepatitis G virus (HGV) infection was clarified in 70 haemophiliacs by testing for HGV RNA and antibodies against HGV envelope protein (anti-E2). None of 12 patients treated with only virus-inactivated coagulation factors were infected with HGV. Of 58 patients who received non-inactivated products, 28 (48%) were positive for HGV RNA and/or anti-E2. Of 16 patients with anti-E2, 14 were negative for the viral RNA, and had recovered from HGV infections. HCV antibodies were detected in 59 patients, and eight patients were successively negative for HCV RNA. Thus, the recovery rate of HGV infection (14/28, 50%) was higher than that of HCV (8/59, 14%) (P<0.001). Longitudinal study revealed that anti-E2 developed either during viraemia or some years after seronegativity for HGV RNA. Hence the antibody response itself seemed not to play a major role in the clearance of HGV though anti-E2 was associated with the clearance of HGV RNA. In conclusion, HGV and HCV are prevalent in patients treated with unsterilized coagulation factor concentrates. However, in contrast to HCV, spontaneous recovery is frequently observed in HGV infections.
