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.     

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.     

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.     

GBV-C/HGV, a new virus as one possible cause of hepatitis of unknown etiology

For etiologically obscure (some 4%) viral hepatitis agents are sought and tested to make elucidation of their cause possible. One of the candidates is since 1995 the newly discovered virus GBV-C/HGV. Despite intense research its relationship to viral hepatitis of obscure origin (VHN) has not been elucidated so far. In the submitted paper the authors attempted to contribute to the elucidation of etiological associations of GBV-C/HGV infection and VHN by comparing the dynamics of markers of the infection in a group of 59 patients with VHN, two control groups exposed to a high risk of parenteral operations and a third comparative group. The first control group comprised 64 patients in a long-term haemodialyzation programme (HD), the second group was formed by 82 patients with haematooncological disease (BD). The third comparative group comprised 22 patients coinfected (CI) with virus of hepatitis C (VHC), or possibly hepatitis B (VHB). The patients with VHN were HBsAg, anti HCV and anti HEV negative. In the majority in the first blood sample transaminases were elevated which was one of the main reasons for examination of GBV-C/HGV RNA. Prevalence of GBV-C/HGV infection, proved by the presence of at least one of the two markers of current or past infection (GBV-C/HGV RNA, antiGBV-C/HGV) was in the compared VHN, HD and BD groups as follows: 88.1%, 59.4% and 43.9%. The frequency of GBV-C/HGV positivity was highest in VHN-76.3%. In control groups HD and BD GBV-C/HGV RNA positivity was substantially lower, 18.8% and 25.6% resp. Long-term continuous viraemia was recorded in patients with VHN in 18.6%. In groups HD and BD it was half that value: 9.3% and 9.18%. In patients with VHN surprisingly after 6.5 months a marked rise of negative findings occurred (5.6x) without the expected increase of antibodies. A similar finding was recorded also in the other groups (HD and BD), incl. CI patients. Disappearance of viraemia was observed most frequently in VHN (55.9%). In groups HD and BD GBV-C/HGV RNA disappeared only in 7.8% and 12.1% resp. In treated patients of the CI group viral RNA was present in 45.5% and it disappeared in 36.4%. On the other hand, seroconversion to antibodies was comparable in VHN, HD and BD (11.9%, 9.4%, 8.5%), only in group CI it was higher (18.2%), obviously in conjunction with treatment of concurrent HCV or HBV infection. Disappearance of viraemia without subsequent seroconversion occurs in GBV-C/HGV infection frequently, the highest rate was observed by the authors in patients with VHN. Disappearance of viraemia does not necessarily imply clearance of GBV-C/HGV but may be due to a change of GBV-C(HGV into a state of persistence without positive laboratory markers of the infection. Persistence of the virus could also be the reason of the assumed conditioned pathogenicity of the virus, and the effect of frequent disappearance of both markers could explain some controversial epidemiological observations when in studies only static data without dynamic associations were used.     

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.     

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.     

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。     

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.     

HAV and HEV infection in hospitalised hepatitis patients in Alexandria, Egypt

A total of 202 serum and stool samples from acute hepatitis patients attending the Fever Hospital of Alexandria, Egypt, have been studied to reveal markers of hepatitis virus infection. Anti-HAV IgM were detected in 21 out of 202 sera (10.4%), whereas 201 sera (99.5%) had anti-HAV IgG. The first age attack was in the class-age 0–9 years with 64.7% of anti-HAV IgM positive sera. Among 202 patients, anti-hepatitis E IgG (sample/over cut off>1.0) was identified in 90 patients (44.5%). The anti-HEV seropositivity ranged from 17.6% to 60.0% in the different age groups, with the highest level in the class-age 20–29 years. Anti-hepatitis E IgM were identified in 49 patients with the first age attack in the class-age 10–19 years (39.4%). HAV RNA was identified by nested PCR in 7 samples out of 15, whereas HEV RNA was present in 4 out of 75 stool samples. Direct DNA sequence of the latter PCR products confirmed the presence of the HEV genome; comparison of the sequences of the isolates from Egypt with those in data banks revealed the highest homology to the Burma strain. Our data confirm that HAV and HEV are common causes of acute sporadic hepatitis in Alexandria but with different peak age positivity. Occasionally, but not infrequently, dual infections (HAV–HEV and HEV-enteric viruses) were also found. The risk analysis indicates that patients living in rural areas are exposed to a higher risk of hepatitis E infection compared to the urban population, whereas the presence of anti-HEV IgG was significantly associated with consumption of common village water and use of indoor dry pit and oral therapy for schistosomiasis.     

HGV在HIV阳性人群的调查

目的：调查HIV流行地区庚型肝炎（HGV）在HIV阳性人群的感染率，并探讨其对HIV疾病进展的影响。方法：对某HIV流行地区人们作病史询问及血清实验室检测。结果：328名HIV－Ab阳性人群检测出210名（64％）合并感染HGV者；合并HGV的HIV感染人群艾滋病人或艾滋病死亡者所占比率较低（10．5％）。结论；合并感染瘐型肝炎似乎能延缓HIV感染者疾病的进展。     

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。     

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。     

广西部分不同人群庚型肝炎感染状况调查

目的 了解广西不同人群ＨＧＶ感染情况及探讨ＨＧＶ的传播途径。方法 采集不同人群血清并以ＥＬＩＳＡ法检测血清中的抗ＨＧＶ。结果 抗ＨＧＶ阳性率在静脉吸毒人群为２．８６％,慢性肝炎病人为２７．７１％,急性病毒性肝为病人为１８．６０％;肝癌病人为６．６７％,健康孕妇和献血员分别为３．３３％和１．６１％。急性病毒性肝炎病人中,以非Ａ－Ｅ型肝炎和丙型肝炎抗ＨＧＶ阳性率高,分别为２６．６９％和２４．４４％;乙     

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。     

Seroepidemiological survey of Q fever in León Province, Spain

A seroepidemiological survey, using an indirect immunofluorescence test against Coxiella burnetii (antigenic phase II), was carried out in León province, north-western Spain. A total of 406 serum samples was collected from people (from 15 to more than 65 years old) living in a rural environment during the winter and spring of 1994. The overall prevalence was 40.6%, titres ranged from 1:80 to 1:640, and a titre of 1:80 was encountered among 60.6% of positive samples. A significant higher prevalence was observed among males globally, as well as among those aged 15–44 and 45–64 years old; however, no difference was encountered among males and females older than 64 years. In the same way, a significant higher Q fever prevalence was observed among individuals having occupations related to agriculture and among those having close relationship with animals.     

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.     

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。     

Detection of bovine herpesvirus-1 infection in breeding bull semen by virus isolation and polymerase chain reaction

Serum samples from 51 apparently healthy breeding bulls were screened for bovine herpesvirus-1 (BHV-1) antibodies using an avidin-biotin enzyme-linked immunosorbent assay, revealing a sero-positive prevalence rate of 45.09%. Semen samples were then collected from 12 of the sero-positive and 12 of the sero-negative bulls and tested for BHV-1 antigen using both a virus isolation assay and a polymerase chain reaction (PCR) assay; PCR was applied to detect BHV-1 deoxyribonucleic acid by using primers selected from the relatively conserved sequence of the gl glycoprotein gene to amplify a 468 base pair fragment. The PCR-amplified products were confirmed as BHV-1 by restriction enzyme, Dde 1, which produced fragments of predictable sizes, namely 340 and 128 base pairs. Positive virus isolation test results, confirmed by virus neutralisation, found BHV-1 antigen in the semen of five sero-positive and six sero-negative bulls. In comparison, positive PCR results found BHV-1 genome in the semen of six sero-positive and eight sero-negative bulls. From the 24 semen samples tested, 14 were shown to be positive by PCR and 11 by virus isolation. The sensitivity and specificity of virus isolation were 57.14% and 70% respectively, and were significantly lower than PCR. In the semen samples taken from sero-negative bulls, BHV-1 was detected more often by PCR methods than by virus-isolation, suggesting that PCR is a more sensitive method for BHV-1 screening in bulls.