Iatrogenic GB virus C/hepatitis G virus infection in an area endemic for hepatitis C virus

GB virus C/hepatitis G virus (GBV-C/HGV) is reported to be transmitted by blood products. This study reports infection with GBV-C/HGV from Area-O of town T, an area of high prevalence of antibody to hepatitis C virus (anti-HCV). Four hundred and thirty-five inhabitants of Area-O in town T were examined. Three hundred and forty-three inhabitants of Area-H in town T (where differences of age or sex are not markedly different to Area-O) were studied as controls. We investigated the virus markers and conducted a survey of life history in both areas. The seroprevalence of anti-HCV and GBV-C/HGV markers in Area-O was 17.7% and 11.7%, significantly higher than in Area-H (1.5% and 4.4%). The prevalence of GBV-C/HGV markers was significantly higher in the anti-HCV-positive group than in the sero-negative group. Anti-HCV- or GBV-C/HGV positive subjects tended to have a history of intravenous medications at hospital C in town T, suggesting iatrogenic infection through insufficient sterilization of needles and/or syringes.     

维持性血液透析患者庚型肝炎病毒感染的研究

目的 了解血液透析患者庚型肝炎病毒(HGV)感染情况，探讨其危险因素。方法 采用酶联免疫法(ELISA)和逆转录—套式PCR法分别检测44例血透患者的抗—HGV抗体和HGVRNA。结果 血透患者HGV感染率为13．6％，HGV阳性组与阴性组相比输血次数较多、透析时间较长，但差异无显著性；而单独HGV阳性组与全阴性组相比透析时间明显延长，HGV感染与年龄、HBV感染、HCV感染及肝功能损害无显著相关。结论 血透患者HGV感染率明显高于普通人群，严格消毒措施、预防交叉感染、减少输血、血源中HGV筛查，对减少透析中庚型肝炎病毒感染至关重要。     

HCV and GBV-c/HGV infection in HIV positive patients in southern Italy

Flaviviridae–hepatitis C virus (HCV) and GB virus C/hepatitis G virus (GBV-C/HGV) – and human immunodeficiency virus (HIV) frequently show similar modes of transmission. HCV and GBV-C/HGV infection was assessed in 134 consecutive patients with evidence of HIV infection, living in Campania, Italy. Data obtained from this cohort were compared with those obtained from 252 age- and sex-matched HCV infected patients without evidence of HIV infection (HCV control group). Following enzymatic immunoassays, samples were tested for the presence of HCV-RNA by RT-PCR. The HCV-RNA positive sera were genotyped by LiPA procedure. The prevalence of HCV infection in HIV patients was 19.40% and the largest group of HIV–HCV co-infected patients (84.62%) was represented by intravenous drug users (IVDU). The distribution of HCV genotypes in HIV–HCV patients was different, compared to that observed in HCV control group. HCV genotypes 1a (50%) and 3a (23.08%) were more frequently detected in HIV–HCV patients, compared to HCV control group (5.16 and 5.56% for 1a and 3a, respectively). Conversely, HCV genotypes 1b (55.70%) and 2a/2c (30.26%) were more represented in HCV control group, compared to HIV–HCV patients (15.38 and 0% for 1b and 2a/2c, respectively). GBV-C/HGV seroprevalence was 41.04% in HIV patients and 6.54% in healthy control individuals. Differently from HCV, GBV-C/HGV infection did not correlate to a preferential risk behaviour in the HIV cohort. Comparative analysis of HCV and GBV-C/HGV infection indicates that the use of injecting drugs might play a key role in the epidemiology of HCV and, in particular, of 1a and 3a HCV genotypes, in HIV patients.     

The prevalence of TT virus and GB virus C/hepatitis G virus infection in individuals with raised liver enzymes but without HBV or HCV infection in Taiwan

The prevalence of TT virus (TTV) and GB virus-C/hepatitis G virus (GBV-C/HGV) infection and the association with raised liver function tests in 546 Taiwanese with negative HBsAg, anti-HCV and HCV RNA was elucidated. They were tested for serum alanine aminotransferase (ALT), GBV-C/HGV RNA, anti-envelope protein 2 antibody (anti-E2) and TTV DNA. Direct sequencing and phylogenetic analyses were performed on 58 isolates for TTV genotype determination. The prevalence of TTV DNA, GBV-C/HGV RNA, anti-E2 and over all GBV-C/HGV exposure was 24.9, 3.4, 8.2 and 11.1%, respectively. Using uni- and multi-variate analyses, male gender and TTV viremia were associated significantly with raised ALT values. Sixty-nine percent of TTV isolates were deduced to be TTV genotype 1 and they had significantly lower mean age than genotype non-1 isolates. In the population, raised ALT may be related to male gender and be attributable to TTV infection but not to GBV-C/HGV among individuals with no evidence of current HBV and HCV infection. TTV genotype 1 is the most prevalent genotype and associated with younger age.     

庚型肝炎病毒在肝炎及肝癌患者中感染情况

为研究庚型肝炎病毒在乙型肝炎、丙型肝炎、非甲—戊型肝炎及原发肝癌患者中的感染情况 ,选择临床肝炎患者血清及肝癌手术病人的术前血清、肝癌组织及癌旁组织。采用HGV RT PCR法检测标本中HGVRNA。结果 ,在临床乙型肝炎、丙型肝炎、非甲—戊型肝炎及肝癌手术病人中庚型肝炎感染率分别为 9% ( 12 / 130 )、10 % ( 3/ 30 )、17% ( 4 / 2 4 )、0 % ( 0 / 2 4 )。证明庚型肝炎是普遍存在的一种肝炎病毒 ,并与乙型肝炎、丙型肝炎有较高的重叠感染率 ,而与肝癌的相关性不大。     

Viral co-infections in hepatitis C: HBV, HBV-C/HGV and TTV studies

BACKGROUND/AIMS: The prevalence of co-infections with hepatitis B virus (HBV) and novel hepatitis viruses GBV-C (Hepatitis G virus, HGV) and TT virus (TTV) in chronic hepatitis C (HCV) infection has been studied. In patients with chronic hepatitis C and in asymptomatic healthy HCV carriers, the influence of these agents on the course of HCV infection was assessed. METHODS: a total of 110 HCV-positive individuals, among them 77 patients with chronic hepatitis C--50 of them treated with interferon (IFN)--and 33 HCV carriers with normal alanine aminotransferase have been investigated. HBV-DNA, HGV RNA and TTV DNA were detected by PCR, to determine HBsAg and anti-HBc ELISA technic has been used. RESULTS: In the healthy population, the prevalence of anti-HCV was 0.3%, HBsAg 0.09%, anti-HBc 2.5%, HGV RNA 8.0% and TTV DNA 18.5%, respectively. In chronic hepatitis C HBsAg (accompanied with HBV-DNA) occurred in 1.29%, anti-HBc 25.97%, HGV RNA in 9.09% and TTV DNA in 40.25% of cases. In IFN-treated patients with sustained remission, the frequency of TTV was 20% vs. 45.7% found in non-responders. Among asymptomatic HCV-carriers, the prevalence of anti-HBc was 27.27%, HGV RNA 9.09% and TTV DNA 75.7% respectively. CONCLUSIONS: Neither previous HBV infection, nor HGV RNA and TTV DNA had apparent effect on the course of chronic HCV infection. TTV was detected with the lowest frequency in persons with sustained remission due to IFN, suggesting antiviral effect of IFN on TTV.     

Hepatitis G virus/GBV-C in serum,peripheral blood mononuclear cells and bone marrow in patients with hematological malignancies

BackgroundHGV/GBV-C is highly prevalent in the general population but its significance remains unclear. It is known that HGV/GBV-C is not primary hepatotropic and its replication was reported in PBMC, bone marrow and other tissues. To investigate a possible role of HGV/GBV-C 115 consecutive patients with hematological malignancies were analyzed for virus RNA presence and quasispecies composition in three compartments: serum, PBMC and bone marrow.MethodsRT-PCR was used to amplify 5′UTR HGV/GBV-C in serum, PBMC and bone marrow. Viral sequences obtained from three compartments were subjected for comparative molecular analysis performed by single strand conformational polymorphism (SSCP) and pyrosequencing.ResultsHGV/GBV-C RNA was detected in 23 out of 115 (20.0%) patients, most often in bone marrow (18 patients), followed by PBMC (11 patients) and serum (10 patients). Differences in SSCP bands distribution corresponding to different viral variants and confirmed by direct sequencing were observed in three patients.ConclusionHGV/GBV-C infection is frequent in patients with hematological malignancies. Common detection of HGV/GBV-C in bone marrow supports the hypothesis that it is a major replication site of this virus.     

乙型肝炎患者重叠感染丙型肝炎、庚型肝炎病毒的研究

[目的 ]了解乙型肝炎患者重叠感染丙型肝炎病毒 (HCV)、庚型肝炎病毒 (HGV)的情况。 [方法 ]应用 EL ISA法分别对 86 8例乙肝患者、5 17例乙肝病毒携带者检测血清抗 - HCV和抗 - HGV,应用逆转录聚合酶链反应法分别对HCV、HGV感染者进行血清 HCV- RNA、HGV- RNA检测 ,并与乙肝病毒携带者比较。 [结果 ]乙肝患者与乙肝病毒携带者 HCV感染率分别为 14.5 %、2 .3% ,HGV感染率分别为 15 .6 %、3.9% ,HCV和 HGV的重叠感染率分别为 2 .3%、0 .2 % ,两组间 HCV、HGV合并感染率均有非常显著性差异 (P<0 .0 1)。乙肝患者中 HCV感染者 HCV- RNA阳性率14.3% ,HGV感染者 HGV- RNA阳性率 11.9%。 [结论 ]乙型肝炎、丙型肝炎、庚型肝炎可以重叠感染。急慢性乙型肝炎患者的 HCV、HGV重叠感染率不同。     

沈阳地区重型肝炎血清中庚型肝炎病毒核酸的检测

为调查重型肝炎的庚型肝炎病毒 ( HGV)的感染状况。我们应用逆转录 -巢式聚合酶链反应 ( Rt- nested PCR)检测了 4 9例重型肝炎患者血清中的庚型肝炎病毒核酸 ( HGV RNA)。结果显示 :8例 HGV RNA阳性 ( 16.3% ) ,其中 6例死亡 ( 75% ) ;8例 HGV感染的重型肝炎患者中 7例重叠感染乙型肝炎病毒 ( HBV)或丙型肝炎病毒 ( HCV) ,1例为单纯 HGV感染。提示 :HGV与其它肝炎病毒重叠感染及单纯 HGV感染均可引起重型肝炎 ;而且其临床表现较重 ,病死率高。     

Detection of HGV in serum and peripheral blood mononuclear cells of maintenance haemodialysis patients.

The aim of the present study was to investigate the prevalence of hepatitis G virus (HGV) and also hepatitis C virus (HCV) infections in maintenance haemodialysis patients, and to identify extrahepatic sites as HGV reservoirs. HGV RNA was detected in the serum of 6/61 (10%) patients and in the peripheral blood mononuclear cells of 2/61 (3%) patients (one of whom was serum negative). These findings suggest that lymphoid cells constitute an extrahepatic HGV reservoir. HCV RNA was detected in 7/61 (11%) patients. Five of these patients (71%) were identified as carrying HCV genotype 1b. Co-infection with HCV and HGV was detected only in one patient. Haemodialysis patients are at risk for HGV infection, by nosocomial routes or via transfusions. HGV itself does not seem to be an important cause of hepatitis since all six HGV RNA positive patients not co-infected by HCV or HBV showed normal ALT values.     

Investigation of saliva, faeces, urine or semen samples for the presence of GBV-C RNA

GBV-C/HGV has been demonstrated to be distributed worldwide with a prevalence in blood donors higher than HCV. This distribution in the general population probably requires an effective non-parenteral route of transmission. A previous study was performed to evaluate the presence of GBV-C/HGV in serum. Saliva, faeces and urine samples of 30 patients (15 males and 15 females) and 15 semen samples from patients whose serum gave a GBV-C/HGV RNA positive result were then tested by a sensitive polymerase chain reaction (PCR) test. Five semen supernatant samples (33.3%) tested positive – four of them belonged to HIV positive patients – and two saliva samples contained GBV-C/HGV sequences (6.6%) – one from a HIV-positive patient. An internal control was used to detect PCR non-specific inhibitors in the samples. The data suggest possible non-parenteral routes of transmission from this virus. Its presence in body fluids other than serum has clinical implications other than possible hepatic damage that remain to be investigated.     

深圳市一般人群庚型肝炎病毒感染状况分析

目的：探讨深圳市一般人群中庚型肝炎病毒（HGV）感染情况及其影响因素，方法：采用随机抽样法选取研究对象，并用酶联免疫反应法（ELISA）检测该人群中抗－HGV抗体。对其中抗体阳性用逆转录PCR（RT－PCR）检测血清中HGV RNA。结果：一般人群中抗－HGV阳性率为9．33％，HGV RNA阳性为2．33％，男女HGV RNA阳性率分别为2．45％和2．20％，年龄组间HGV RNA阳性率差异无显。单因素和logistic回归分析未显示肝炎病史，近期手术史、注射史，拔牙史及乙型肝炎疫苗接种史等因素与HGV感染有关，HBsAg，抗－HBs和抗－HBc与HGV感染无统计学意义。不同职业人员中以中学生及教师的HGV RNA阳性率较高，结论：深圳市一般人群中HGV感染率较高，但其流行因素尚待进一步研究。     

血液透析肾病患者GBV-C感染的分析

目的 探讨血液透析病人中GBV-C(GBV-C／HGV)感染情况及GBV-C的致病性。方法 对北京地区67例因肾功能衰竭而进行血液透析的患血清，用PCR法检测HCVRNA，GBV-C RNA和HBV DNA。同时应用ELISA法检测HBsAg和抗-HCV。结果 67例患血清GBV-C RNA的检出率为16．42％。HBV DNA的检出率为26．87％，HCV RNA的检出率为22．39％，GBV-C和HCV的感染率随透析次数的增多而增高。在单独感染GBV-C的血液透析患中未发现血清ALT或AST异常。结论 GBV-C的感染率随透析时间的延长而增高，提示血液透析可能是GBV-C的传播途径之一。未发现经血液透析获得单独GBV-C感染的血清转氨酶异常．证明GBV-C很可能不具有嗜肝致病性。     

输血传播庚型肝炎的前瞻性观察

目的了解庚型肝炎（ＨＧ）在我国输血后肝炎中的发生率及其与输血后乙型肝炎（ＨＢ）、丙型肝炎（ＨＣ）的关系。方法检测１３８例因手术输血病人在输血前后的ＨＢｓＡｇ、抗－ＨＢｓ，ＨＢｅＡｇ、抗－ＨＢｅ、抗－ＨＢｃ、抗－ＨＣＶ、ＨＣＶＲＮＡ和ＨＧＶＲＮＡ。结果５３例发生输血后肝炎病毒感染，其中丙型肝炎病毒感染４８例；乙型肝炎病毒感染２例（含１例两型混合感染）。７例输血后可用巢式ＲＴ－ＰＣＲ法查到庚型肝炎病毒感染，３例合并丙型肝炎病毒感染者均有ＡＬＴ增高。４例单纯ＨＧＶ感染者，ＡＬＴ均正常。ＨＧＶＲＮＡ持续１个月至半年不等。５例输血后ＨＧＶ感染的病人可查到供血，其中３例病人至少有１份供血ＨＧＶＲＮＡ阳性。结论单纯ＨＧＶ感染的献血员和输血后感染者均无病毒性肝炎的临床表现和ＡＬＴ改变，与ＨＧＶ作为一种重要肝炎病毒的观点不相符。     

Manifestations extrahépatiques au cours de l’infection par le GBV-C/HGV

The GBV-C/HGV virus has clearly established transmission modes, mainly blood contamination, and occasionally sexual transmission. It is frequently found among transfused patients, intravenous drug abusers, and hemodialysis patients and often associated with HCV. Its hepatic pathogenicity is very weak, marked by a moderate and transitory cytolysis. Chronic carriage is possible, but does not lead to chronic hepatitis. Carriage can be maintained before the virus disappears. The authors report the case of a patient presenting with pleuropericarditis after a blood transfusion without any other etiology than infection by GBV-C/HGV virus. The possible extrahepatic pathogenicity of the virus is suggested. This hypothesis was rarely put forward.     

乙型、丙型、庚型肝炎病毒多重感染研究

目的探讨庚型肝炎感染患者是否存在双重感染和多重感染。方法应用庚型肝炎病毒（ＨＧＶ）ＮＳ３区逆转录聚合酶链反应技术检测了ＨＧＶ系列稀释的质控血清及ＡｂｂｏｔＧＢＶ－Ｃ参比样品中ＨＧＶＲＮＡ，并对９０例丙型肝炎病毒（ＨＣＶ）ＲＮＡ阳性和１２例乙型肝炎、丙型肝炎双重感染献血员进行了ＨＧＶＲＮＡ的检测。结果ＨＧＶ系列稀释质控血清１０－１～１０－５均为阳性；１０－６为阴性。２份ＡｂｂｏｔＧＢＶ－Ｃ样品均为ＨＧＶＲＮＡ阳性。９０例ＨＣＶＲＮＡ阳性样品中，８例ＨＧＶＲＮＡ阳性（１７．８％）；１２例乙、丙双重感染者中４例（４／１２）ＨＧＶＲＮＡ阳性。结论不仅存在ＨＣＶ及ＨＧＶ双重感染，也存在多重感染。     

北京铁路部分人群散发性急性非甲非乙非丙型肝炎病原学分析

对北京铁路地区部分人群５８例散发性急性非甲非乙非丙型肝炎进行了ＨＥＶ和ＨＧＶ血清学调查。结果如下,抗－ＨＥＶ阳性２２例（３７．９３％）,抗－ＨＧＶ和ＨＧＶＲＮＡ阳性共１２例（２０．６８％）,其中３例为戊型和庚型肝炎病毒混合感染。戊肝、庚肝病毒感染均以３１～４０岁发病最多,且男多于女;戊肝主要发生在冬春季,多有肠道暴露史;庚型肝炎病毒感染无明显季节性,有肠道外暴露史。ＨＧＶ可单独感染,提示它可能有一定的致病性。     

The risk of hospital-acquired GB virus C infection: a pilot case-control study

The risk of hospital-acquired infection with GB virus C (GBV-C) was explored among 42 patients. The factors independently associated with detection of GBV-C RNA in serum were bronchoscopic examination [adjusted odds ratio (OR)=18.1 (95% confidence interval 1.3-255.3), P=0.03] and a history of illicit drug use [OR=14.5 (1.0-218.7), P=0.05]. In this cohort of patients, invasive procedures appear to be associated with GBV-C infection but not with hepatitis C virus (HCV) infection.     

Gbv-C RNA presence in several high-risk groups of Spain

GB virus C subtype (GBV-C) seems to share the same routes of transmission as other parenteral transmitted viruses. We have evaluated the prevalence of GBV-C in 247 patients with potential risk for GBV-C infection and in 91 healthy blood donors. The presence of GBV-C RNA was examined by polymerase chain reaction in serum samples. The 23.6% of parenteral drug users were GBV-C positive, 36.3% of them were also HIV infected. Moreover, 22.5 and 19% of sera from patients with HBV and HCV chronic hepatitis, respectively, but without apparent risk factors seemed GBV-C infected. Finally, the 6% of patients on hemodialysis were also positive. Therefore, these results suggest that GBV-C is transmitted by parenteral routes but other non-parenteral routes shared with HBV or HCV must be considered.     

抗—HCV阳性单采浆供血员HGV感染随访研究

为了解单采浆供血员庚型肝炎病毒（ＨＧＶ）感染及其转归，对１０２名抗－ＨＣＶ阳性单采浆供血员冻存血清进行抗－ＨＧＶ和ＨＧＶＲＮＡ检测，对抗－ＨＧＶ和（或）ＨＧＶＲＮＡ阳性者作３年随访研究。采用ＥＩＡ法检测抗－ＨＧＶ，包被抗原来自ＨＧＶ不同功能区的合成肽。应用ＲＴ－ＰＣＲ法检测ＨＧＶＲＮＡ，引物选自ＨＧＶＮＳ３区。结果表明，抗－ＨＣＶ阳性单采浆供血员ＨＧＶＲＮＡ阳性率为１９．６１％（２０／１０２），抗－ＨＧＶ阳性率为１７．６５％（１８／１０２），ＨＧＶ感染率（抗ＨＧＶ和／或ＨＧＶＲＮＡ阳性）为２４．５１％（２５／１０２），而对照组仅为０．９４％（１／１０６）。提示单采血浆是ＨＧＶ感染的重要危险因素。ＨＧＶＲＮＡ和抗－ＨＧＶ的３年阴转率分别为３５．００％（７／２０）和１１．１１％（２／１８），说明ＨＧＶ感染有慢性携带趋势