Polymerase chain reaction analysis for viral nucleic acids in acute sporadic hepatitis patients negative for serum hepatitis B surface antigen and antibodies to hepatitis C virus.
BACKGROUND
Polymerase chain reaction (PCR) is both very sensitive and very valuable in the clarification of the pathogenesis of viral hepatitis from type A to E (HAV to HEV).


METHODS
This study was aimed to detect viral nucleic acids with PCR in 33 consecutive, acute sporadic hepatitis patients who were seronegative for hepatitis B surface antigen and antibody to hepatitis C virus by conventional radioimmununoassay or enzyme-linked immunoassay.


RESULTS
Of the totals, 10 (30.3%) had detectable viral genomes. HBV DNA and HCV RNA were each detected in 2 (7.4%) of 27 patients with a self-limiting course. By contrast, HBV DNA was detected in the two (33.3%, p = 0.14) and HCV RNA in the three (50%, p = 0.03) of the six patents who became chronic; another one who had subsequent multiple exacerbations of hepatitis was positive for both HBV DNA and HCV RNA. HDV RNA was not detectable in all subjects. Although four (12.1%) were positive for antibody against HEV, none had detectable HEV RNA. Spontaneous disease resolution predominantly occurred in patients without detectable hepatitis B and hepatitis C genomes (100% of 23 patients vs 40% of 10 patients, p < 0.01).


CONCLUSIONS
These results demonstrate that a combination of serological and molecular tests is mandatory for the appraisal of acute sporadic non-B non-C hepatitis and its clinical prognosis, they also raise the possibility of a hepatotrophic agent other than HAV to HEV. Recent documentation of the new GBV-C (hepatitis G virus) suggests the necessity of studying the unidentified pathogenesis in patients with non-A to E hepatitis.
Huo
T I
TI
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Wu
J C
JC
Yen
F S
FS
Sheen
I J
IJ
Lee
S D
SD
D000208:Acute Disease; D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006518:Hepatitis Viruses / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood*
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral