Incidence and clinical presentation of posttransfusion TT virus infection in prospectively followed transfusion recipients: emphasis on its relevance to hepatitis.
BACKGROUND
A novel transfusion-transmissible human DNA virus, TT virus (TTV), has been discovered recently. An attempt was made to determine the incidence and clinical outcome of TTV infection in recipients of blood transfusion.


METHODS
Serial serum samples collected as part of a prospective study of posttransfusion hepatitis were examined for TTV DNA by a nested PCR assay.


RESULTS
Among 150 adults undergoing cardiac surgery, posttransfusion specimens from 59 individuals were positive for TTV DNA. Pretransfusion sera were found to be positive in 13 of these individuals. Therefore, 46 (33.6%) of the 137 previously uninfected patients developed new TTV viremia after transfusion. Among the 46 patients, 3 were coinfected with HCV, 5 were coinfected with HGV, and 38 were infected with TTV alone. No apparent symptoms or signs were noted in the 38 patients infected by TTV alone or the 5 infected with HGV plus TTV. The average peak serum ALT activity was 31 IU per L, with persistently normal levels in 34 of the 38 patients with TTV infection alone. In 8 other patients who subsequently developed well-documented non-A-G hepatitis, 3 were positive for TTV (3/8 vs. 46/137, p = 0.8). In 12 patients followed for more than 1 year, TTV viremia persisted in every case.


CONCLUSIONS
In this population, TTV is transmitted by transfusion to approximately 30 percent of patients who undergo cardiac surgery. Most of the infections appear to become persistent. Despite the high prevalence rate, TTV does not appear to cause hepatitis on its own.
Wang
J T
JT
Department of Bacteriology, College of Medicine, National Taiwan University, Taipei. wangjt@ccms.ntu.edu.tw
Lee
C Z
CZ
Kao
J H
JH
Sheu
J C
JC
Wang
T H
TH
Chen
D S
DS
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D004266:DNA Virus Infections / Q000453:epidemiology* / Q000635:transmission*; D004267:DNA Viruses / Q000235:genetics; D004279:DNA, Viral / Q000097:blood; D005260:Female; D018067:Flaviviridae / Q000235:genetics; D016174:Hepacivirus / Q000235:genetics; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D065227:Transfusion Reaction
D004279:DNA, Viral; D000410:Alanine Transaminase