title: The clinical significance of the detection of hepatitis GBV-C RNA in the serum of patients with fulminant, presumed viral, hepatitis.
abstract: In a significant number of cases of fulminant (presumed viral) hepatitis worldwide, no aetiological agent has been identified. Recently, it has been suggested that a newly described flavivirus, GBV-C, is responsible for some of these cases. This study aimed to assess the clinical significance of GBV-C RNA, demonstrated by reverse transcriptase-polymerase chain reaction (RT-PCR), in the serum of patients with fulminant non-A to E hepatitis. Twenty-three consecutive cases of non-A to E fulminant hepatitis were included in the study. GBV-C RNA was reverse transcribed and amplified using two RT-PCR based detection methods. Medical records were examined to assess clinical history, duration and mode of infection, transfusion history, liver histology and clinical outcome. Five (three female, two male; mean age 21.2 years) of 23 patients had GBV-C RNA detected in their serum by RT-PCR: all five patients were RT-PCR positive following amplification by primers specific for the 5' non-coding region (NCR), whilst four were positive by primers for the NS3 region. Prior to the onset of illness, two patients had risk factors for transmission of an infectious agent; however, all five patients had been transfused during their illness, prior to testing for GBV-C. Of these, two (of two in whom serum was available) were negative for GBV-C after the onset of fulminant hepatitis but before their first transfusion. This study does not support the hypothesis that the detection of hepatitis G virus (HGV)/GBV-C RNA in the serum of patients with fulminant hepatitis indicates a causal association. However, it does demonstrate that a careful transfusion history and screening of blood products is vital before the importance of GBV-C in the aetiology of fulminant hepatitis can be established.
authors.affiliation: Department of Medicine, University of Edinburgh, UK.
authors.forename: G H
authors.initials: GH
authors.lastname: Haydon
authors.forename: L M
authors.initials: LM
authors.lastname: Jarvis
authors.forename: K J
authors.initials: KJ
authors.lastname: Simpson
authors.forename: P C
authors.initials: PC
authors.lastname: Hayes
authors.forename: P
authors.initials: P
authors.lastname: Simmonds
mesh_terms: D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D002648:Child; D005260:Female; D018067:Flaviviridae / Q000235:genetics / Q000302:isolation & purification*; D006501:Hepatic Encephalopathy / Q000097:blood / Q000503:physiopathology / Q000821:virology*; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood*; D014158:Transcription, Genetic
chemical_list: D012367:RNA, Viral