Transmission of hepatitis G virus in patients with angioedema treated with steam-heated plasma concentrates of C1 inhibitor.
BACKGROUND
Hepatitis G virus (HGV) is a blood-borne flavivirus that may cause acute and chronic transfusion-transmitted infections. Patients with complement component 1 (C1) inhibitor (C1-INH) deficiency may acquire blood-borne infections through infusion of plasma concentrates.


METHODS
Serum samples from 84 patients with C1-INH deficiency (19 who received unmodified C1-INH concentrates, 23 who received steam-heated concentrates, and 42 untreated patients) were tested for HGV RNA and hepatitis C virus (HCV) RNA by a nested polymerase chain reaction (PCR). The samples were also tested for antibodies to the E2 envelope protein of HGV (anti-HGV) and to HCV with enzyme-linked immunosorbent assays.


RESULTS
Nine (11%) patients had serum HGV RNA; that is, 7 (17%) of 42 patients previously treated with C1-INH concentrates and 2 of 42 previously untreated patients. HGV RNA was as common in the 19 patients treated with unmodified concentrates as in the 23 given steam-heated concentrates (16 vs. 17%, p = 0.60). Anti-HGV was more common among the recipients of unmodified concentrates than among those given steam-heated concentrates (26 vs. 0%, p = 0.014). HCV RNA was more frequently detected in treated patients than in untreated patients (33 vs. 7%, p = 0.005) and in the 19 recipients of unmodified concentrates than in the 23 treated with steam-heated concentrates (58 vs. 16%, p = 0.003). Only one HGV RNA-seropositive patient had elevated serum aminotransferase activity, compared to 11 with HCV RNA.


CONCLUSIONS
HGV was transmitted by both unmodified and steam-heated concentrates, but it caused persistent viremia in a minority of the cases and was rarely associated with liver disease.
De Filippi
F
F
Angela Maria e Antonio Migliavacca Center for Liver Disease, Department of Internal Medicine, Istituto di Ricovero é Cura a Carattere Scientifico Maggiore Hospital, University of Milan, Italy.
Castelli
R
R
Cicardi
M
M
Soffredini
R
R
Rumi
M G
MG
Silini
E
E
Mannucci
P M
PM
Colombo
M
M
D000328:Adult; D000368:Aged; D000799:Angioedema / Q000188:drug therapy*; D003174:Complement C1 Inactivator Proteins / Q000008:administration & dosage* / Q000172:deficiency; D005260:Female; D018067:Flaviviridae; D006508:Hepatitis Antibodies / Q000032:analysis; D006526:Hepatitis C; D006525:Hepatitis, Viral, Human / Q000235:genetics / Q000276:immunology / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D013227:Steam
D003174:Complement C1 Inactivator Proteins; D006508:Hepatitis Antibodies; D012367:RNA, Viral; D013227:Steam