Antibodies against the GB virus C envelope 2 protein before liver transplantation protect against GB virus C de novo infection.
GB virus C (GBV-C) is a newly discovered RNA virus related to the Flaviviridae family. Although GBV-C is not yet associated with any cause of liver disease, a humoral immune response against the GBV-C envelope 2 (E2) protein has been observed. Therefore, we studied the prevalence and clinical relevance of GBV-C RNA and anti-E2 antibodies in patients undergoing orthotopic liver transplantation (OLT). In addition, we tested whether the prevalence of anti-E2 antibodies may protect against GBV-C infection. Of the 182 liver recipients included in this study, 117 of these were evaluated for GBV-C recurrence or de novo infection. GBV-C RNA was detected in sera or plasma using single-tube, reverse-transcriptase polymerase chain reaction, and anti-E2 antibody was detected by enzyme immunoassay (EIA). Cumulative patient and graft survival was tested by using Kaplan-Meier analysis. The independence of prognostic values was assessed by using Cox regression analysis. Before OLT, GBV-C RNA and anti-E2 were detected in 4.0% to 28.6% and 10.0% to 68.8%, respectively, of patients suffering from different forms of chronic liver diseases. GBV-C reinfection after OLT was determined in 85.7%. Of the patients without evidence of exposure to GBV-C before OLT, 30 of 65 (46.2%) became GBV-C RNA positive after OLT. None of the 38 patients who were anti-E2 antibody positive before OLT became GBV-C RNA positive after OLT. Neither patient nor graft survival was significantly affected by the presence of either GBV-C RNA or anti-E2 antibody before OLT. Our data indicate that 1) GBV-C RNA positive patients have a high risk of reinfection after OLT, and 2) the presence of anti-E2 antibodies before OLT is associated with an absence of GBV-C infection after OLT, which may indicate a protective role of anti-E2 antibodies.
Department of Gastroenterology and Hepatology, Medizinische Hochschule Hannover, Germany.
H L
HL
Tillmann
S
S
Heringlake
C
C
Trautwein
D
D
Meissner
B
B
Nashan
H J
HJ
Schlitt
J
J
Kratochvil
J
J
Hunt
X
X
Qiu
S C
SC
Lou
R
R
Pichlmayr
M P
MP
Manns
D000328:Adult; D005260:Female; D018067:Flaviviridae / Q000235:genetics / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000032:analysis*; D006525:Hepatitis, Viral, Human / Q000276:immunology* / Q000517:prevention & control*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012367:RNA, Viral / Q000032:analysis; D016019:Survival Analysis; D014759:Viral Envelope Proteins / Q000276:immunology*
D006508:Hepatitis Antibodies; D012367:RNA, Viral; D014759:Viral Envelope Proteins