High prevalence, low pathogenicity of hepatitis G virus in kidney transplant recipients.
BACKGROUND
Prevalence and pathogenicity of hepatitis G virus infection in long-term renal transplant recipients, are not fully known.


OBJECTIVE
To evaluate long-term impact of HGV infection on liver disease of renal transplanted patients.


METHODS
A total of 155 hepatitis B surface antigen negative kidney transplant recipients, followed for a mean of 11 years after renal transplantation, were studied. Of these 48 (31%) patients had persistently elevated serum aminotransferase values. Frozen serum samples were tested for HGV-RNA and HCV-RNA by nested reverse transcribed polymerase chain reaction, and for anti-hepatitis G virus and anti-hepatitis C virus by enzyme-linked immunosorbent assay Hepatitis C virus-RNA was typed by a line probe assay and quantified by a branched DNA signal amplification assay


RESULTS
Hepatitis G virus-RNA was detected in 37 (24%) patients and anti-hepatitis G virus in another 26 (17%). Seventy (45%) patients had serum anti-hepatitis C virus and 63 of these (90%) had serum hepatitis C virus-RNA. Hepatitis G virus-RNA positive and negative patients were similar in terms of age, sex, duration of dialysis, rate of transfusion, chronic liver disease, rate of hepatitis C virus infection and immunosuppressive therapy. Fifteen (41%) hepatitis G virus-RNA seropositive patients were hepatitis C virus co-infected. Hepatitis C virus-RNA levels were significantly lower in the 15 hepatitis C virus/hepatitis G virus co-infected patients than in the 48 patients with hepatitis C virus infection only (2.2 vs 10.8 MEq/ml, p = 0.02). Only 3 hepatitis G virus carriers had persistently elevated alanine aminotransferase compared to 29 hepatitis C virus carriers (14% vs 60%, p < 0.001), 10 patients co-infected with both hepatitis G virus and hepatitis C virus, and in 6 patients with neither infection (67% vs 8%, p < 0.001).


CONCLUSIONS
Hepatitis G virus infection is common among kidney transplant patients, it carries a low risk of chronic liver disease even in long-term follow-up. Low levels of hepatitis C virus-RNA found in hepatitis G virus carriers suggest an interaction between these two viruses in immunosuppressed patients.
De Filippi
F
F
Angela Maria e Antonio Migliavacca Center for Liver Disease, Department of Internal Medicine, IRCCS Maggiore Hospital, University of Milan, Italy.
Lampertico
P
P
Soffredini
R
R
Rumi
M G
MG
Lunghi
G
G
Aroldi
A
A
Tarantino
A
A
Ponticelli
C
C
Colombo
M
M
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D005260:Female; D018178:Flaviviridae Infections / Q000175:diagnosis / Q000453:epidemiology*; D005500:Follow-Up Studies; D029407:GB virus C / Q000302:isolation & purification* / Q000472:pathogenicity*; D006526:Hepatitis C / Q000453:epidemiology; D006525:Hepatitis, Viral, Human / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D012367:RNA, Viral / Q000097:blood; D016036:Seroepidemiologic Studies; D013997:Time Factors
D012367:RNA, Viral; D000410:Alanine Transaminase