title: Toga virus-like particles in acute liver failure attributed to sporadic non-A, non-B hepatitis and recurrence after liver transplantation.
abstract: Toga virus-like particles (typically 60-70 nm: enveloped with small surface spikes) were detected in the native hepatectomy specimens in 7 of 18 patients grafted for acute liver failure attributed to sporadic non-A, non-B hepatitis and in 2 patients grafted for fulminant hepatitis attributed to anti-epileptic drug hepatotoxicity. These particles were not detected in the hepatectomies from 12 other patients grafted for other causes of acute liver failure, 12 for various chronic liver diseases, and 2 histologically normal livers. Acute hepatic failure, characterized histologically by severe haemorrhagic necrosis, developed 7 days after grafting in 5 patients, all in the non-A, non-B group with toga virus-like particles in native liver. Similar virus-like particles were detected in all grafts and were in greater abundance than in the native livers. The agent may be novel because pre- and post-grafting sera were negative for antibodies against representative panels of arboviruses and in first and second generation antibody tests for hepatitis C virus.
authors.affiliation: Institute of Liver Studies, King's College Hospital, London, England, UK.
authors.forename: E A
authors.initials: EA
authors.lastname: Fagan
authors.forename: D S
authors.initials: DS
authors.lastname: Ellis
authors.forename: G M
authors.initials: GM
authors.lastname: Tovey
authors.forename: G
authors.initials: G
authors.lastname: Lloyd
authors.forename: H M
authors.initials: HM
authors.lastname: Smith
authors.forename: B
authors.initials: B
authors.lastname: Portmann
authors.forename: K C
authors.initials: KC
authors.lastname: Tan
authors.forename: A J
authors.initials: AJ
authors.lastname: Zuckerman
authors.forename: R
authors.initials: R
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D006526:Hepatitis C / Q000382:microbiology; D006801:Humans; D017114:Liver Failure, Acute / Q000382:microbiology*; D016031:Liver Transplantation; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D012008:Recurrence; D014035:Togaviridae / Q000302:isolation & purification* / Q000648:ultrastructure; D014036:Togaviridae Infections / Q000175:diagnosis*; D014771:Virion / Q000302:isolation & purification / Q000648:ultrastructure*
chemical_list: D006508:Hepatitis Antibodies