Persistence and clinical outcome of hepatitis G virus infection in pediatric bone marrow transplant recipients and children treated for hematological malignancy.
The natural course and the clinical significance of hepatitis G virus (HGV) infection were investigated in 106 pediatric patients who received chemotherapy for hematological malignancy or underwent bone marrow transplantation (BMT) using HGV-RNA and antibodies to the HGV-E2 protein (anti-E2). HGV markers were detected in 21 patients (19.8%; HGV-RNA in 19 and anti-E2 in 2). Longitudinal analysis of these HGV-infected patients showed that 1 had anti-E2 before the initial blood transfusion, 14 had persistent viremia, and 6 became clear of circulating HGV-RNA after completion of therapy, although 5 of the 6 HGV-cleared patients never developed anti-E2. Reactivation of HGV infection during chemotherapy was observed in two anti-E2-positive, HGV-RNA-negative patients; the reappearance of the same HGV strain was confirmed by phylogenetic analysis. Among BMT survivors without other known causes of liver dysfunction, HGV-RNA-positive patients had a higher peak serum alanine amino transferase (ALT) value than negative patients. Contrary to previous reports, immunosuppressed patients can apparently recover from HGV infection without detectable anti-E2 and some patients who supposedly recovered from HGV infection can nonetheless suffer exacerbation when subsequently immunosuppressed.
Yamada-Osaki
M
M
Department of Pediatrics, University of Tsukuba, Tsukuba, Japan.
Sumazaki
R
R
Tsuchida
M
M
Koike
K
K
Fukushima
T
T
Matsui
A
A
D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D018067:Flaviviridae / Q000235:genetics / Q000276:immunology; D019337:Hematologic Neoplasms / Q000188:drug therapy* / Q000821:virology*; D006525:Hepatitis, Viral, Human / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007223:Infant; D008099:Liver / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D012367:RNA, Viral / Q000097:blood; D012008:Recurrence; D014766:Viremia
D000914:Antibodies, Viral; D012367:RNA, Viral