title: HGV/GBV-C infection in liver transplant recipients: antibodies to the viral E2 envelope glycoprotein protect from de novo infection.
abstract: OBJECTIVE
  Liver transplantation for endstage liver cirrhosis provides a useful model to investigate the pathogenetic role of hepatotropic viral agents. Recently, a new member of the Flaviviridae family, provisionally named HGV/GBV-C virus, has been associated with acute and chronic non A-E hepatitis. We studied 136 patients with cirrhosis consecutively transplanted at our institution for evidence of hepatitis G virus infection and correlation with the patients' clinical course.
  
  
  METHODS
  All patients survived for at least 6 months after transplantation (median follow-up 44 months) and underwent routine liver biopsies. Hepatitis G virus infection was studied using both direct viral RNA identification by RT-PCR and indirect detection of antibodies to the E2 glycoprotein.
  
  
  RESULTS
  There was a high frequency of the hepatitis G virus among patients undergoing liver transplantation, with HGV RNA and anti-E2 prevalence rates of 18.4% and 26.5%, respectively. HGV RNA prevalences significantly increased after transplantation (47.8%), with 47.3% rate of new infections in susceptible subjects. Anti-E2 antibodies were significantly more prevalent among patients transplanted for HCV-related cirrhosis and represented a strong protective factor against hepatitis G virus reinfection or recurrent infection. No correlation was found between HGV RNA or anti-E2 prevalences and survival after transplantation or rates of recurrent liver damage.
  
  
  CONCLUSIONS
  All available evidence suggests that, although liver transplant patients are heavily exposed to hepatitis G virus both before and after transplantation, hepatitis G virus does not induce liver disease in this setting. Most infections appear to be self-limited and induce a protective immunity which is marked by the presence of anti-E2 antibodies.
authors.affiliation: Department of Pathology and Infectious Diseases, University of Pavia and IRCCS Policlinico S. Matteo, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Silini
authors.forename: L
authors.initials: L
authors.lastname: Belli
authors.forename: A B
authors.initials: AB
authors.lastname: Alberti
authors.forename: M
authors.initials: M
authors.lastname: Asti
authors.forename: A
authors.initials: A
authors.lastname: Cerino
authors.forename: M
authors.initials: M
authors.lastname: Bissolati
authors.forename: G
authors.initials: G
authors.lastname: Rondinara
authors.forename: L
authors.initials: L
authors.lastname: De Carlis
authors.forename: D
authors.initials: D
authors.lastname: Forti
authors.forename: M U
authors.initials: MU
authors.lastname: Mondelli
authors.forename: G
authors.initials: G
authors.lastname: Ideo
mesh_terms: D000328:Adult; D005260:Female; D018067:Flaviviridae / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000097:blood*; D006526:Hepatitis C / Q000209:etiology; D006525:Hepatitis, Viral, Human / Q000209:etiology* / Q000276:immunology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012008:Recurrence; D014759:Viral Envelope Proteins / Q000276:immunology*
chemical_list: D006508:Hepatitis Antibodies; D012367:RNA, Viral; D014759:Viral Envelope Proteins