Detection of TT virus DNA in patients with liver disease and recipients of liver transplant.
TT virus (TTV) is transfusion-transmissible but its involvement in post-transfusion hepatitis is uncertain. To investigate the potential association of TTV with liver diseases, the prevalence of TTV DNA was tested by semi-nested PCR in 113 carriers of hepatitis C virus (HCV), 10 patients with acute liver failure, 11 patients with cryptogenic cirrhosis and 200 control blood donors. Thirty-seven of these patients underwent liver transplantation and were tested pre- and post-transplantation. TTV DNA was semi-quantified in serial samples from seven patients with unexplained post-transplant hepatitis. TTV genotyping was performed on samples from 28 patients by sequence analysis. The prevalence of TTV DNA in blood donors was 1.5% and 17% in HCV infected haemophiliacs. In patients with acute or chronic liver disease or hepatitis, 6 to 27% prevalence was observed. After liver transplantation, the prevalence of TTV DNA increased from 16 to 46% (P < 0.01). In patients who developed unexplained hepatitis post-transplantation, TTV viraemia did not parallel ALT levels. TTV DNA either increased in titre or became detectable shortly after transplantation, suggesting that either TTV was transfusion-transmitted, or, more likely, that immunosuppression caused a recurrence of low level or undetectable TTV viraemia. TTV had considerable genomic diversity in the N22 region, corresponding to at least 4 genotypes. Genotype 2 was found in 14/28 patients.
Shang
D
D
Department of Haematology, Division of Transfusion Medicine, East Anglia Blood Centre, Cambridge, United Kingdom.
Lin
Y H
YH
Rigopoulou
I
I
Chen
B
B
Alexander
G J
GJ
Allain
J P
JP
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001782:Blood Donors; D004267:DNA Viruses / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D005838:Genotype; D006526:Hepatitis C / Q000097:blood / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000821:virology; D008107:Liver Diseases / Q000097:blood / Q000601:surgery / Q000821:virology*; D017114:Liver Failure, Acute / Q000097:blood / Q000139:chemically induced / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D065227:Transfusion Reaction; D019562:Viral Load
D000410:Alanine Transaminase