title: Epidemiological and clinical aspects of hepatitis G virus infection in blood donors and immunocompromised recipients of HGV-contaminated blood.
abstract: OBJECTIVE
  The infectiousness and clinical relevance of the newly discovered blood-borne Flaviviridae-like agent, termed hepatitis G virus (HGV), are not well understood.
  
  
  METHODS
  Twenty-three transfusion recipients of two HGV-affected long-term blood donors were studied for HGV genome and antibodies to the putative envelope 2 glycoprotein (anti-E2) of HGV. Nine recipients had nonhematological disorders and 14 suffered from severe hematological diseases and 7 of them received allogeneic bone marrow or blood stem cell transplantation. The molecular epidemiology of the observed HGV infection was studied by direct sequencing of parts of the 5'-noncoding region, NS3, and NS5 region of HGV in the 2 long-term donors and in their 6 recipients who became HGV RNA positive. Additionally, 549 individuals-homologous (n = 254) and autologous blood donors (n = 202), and medical staff (n = 89)--were investigated for the presence of HGV RNA.
  
  
  RESULTS
  HGV RNA in serum was found in 15 of the 23 (65%) transfusion recipients with known exposure of HGV-contaminated blood. Seven of the remaining 8 recipients showed only an anti-E2 response, indicating previous HGV infection with spontaneous clearance of the virus. In one recipient neither HGV RNA nor anti-E2 could be detected. Molecular evidence for HGV transmission by the 2 donors was found in 3 of the 6 recipients studied. The alanine aminotransferase levels were not significantly different in the HGV RNA positive and negative recipients, and none of the 23 recipients developed posttransfusion hepatitis. Persistent HGV infection was observed especially in recipients with severe hematological disorders or in those in whom intensive immunosuppressive treatment was necessary. Of the 549 individuals studied, 10 (1.8%) were healthy carriers of HGV RNA.
  
  
  CONCLUSIONS
  The persistence of transfusion-acquired HGV infection is not associated with acute or chronic hepatitis, but may be influenced by the recipient's underlying disease.
authors.affiliation: Virchow-Clinic, Department of Internal Medicine, Hematology/Oncology, Humboldt University, Germany.
authors.forename: H G
authors.initials: HG
authors.lastname: Heuft
authors.forename: T
authors.initials: T
authors.lastname: Berg
authors.forename: E
authors.initials: E
authors.lastname: Schreier
authors.forename: U
authors.initials: U
authors.lastname: Künkel
authors.forename: M
authors.initials: M
authors.lastname: Tacke
authors.forename: N
authors.initials: N
authors.lastname: Schwella
authors.forename: U
authors.initials: U
authors.lastname: Hopf
authors.forename: A
authors.initials: A
authors.lastname: Salama
authors.forename: D
authors.initials: D
authors.lastname: Huhn
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001483:Base Sequence; D001782:Blood Donors; D001804:Blood Transfusion, Autologous; D005260:Female; D018067:Flaviviridae / Q000235:genetics / Q000302:isolation & purification; D005858:Germany / Q000453:epidemiology; D006282:Health Personnel; D019337:Hematologic Neoplasms / Q000097:blood / Q000150:complications; D006508:Hepatitis Antibodies / Q000097:blood*; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood*; D016415:Sequence Alignment; D012689:Sequence Homology, Nucleic Acid; D065227:Transfusion Reaction; D014759:Viral Envelope Proteins / Q000276:immunology*
chemical_list: D006508:Hepatitis Antibodies; D012367:RNA, Viral; D014759:Viral Envelope Proteins; C107619:glycoprotein E2, GB virus C; D000410:Alanine Transaminase