HUMAN PAPILLOMAVIRUS (HPV)-ASSOCIATED NEONATAL GIANT-CELL HEPATITIS (NGCH)

Neonatal giant cel hepatitis (NGCH) is a clinicopathological syndrome that has bee related to perinatal infections and metabolic disorders. In a great number of cases no apparent etiology has been found. To cha racterize the possible relationship between human papillomavirus (HPV) and idiopathic NGCH (INGCH) we analyzed paraffin-embedded hepatic bio psies from seven cases of INGCH for the presence of both HPV and cytom egalovirus (CMV) DNA. Clinically, jaundice, detected within the first 3 days of life (except in one case), and raised levels of serum transa minases and bilirubin, mainly th direct fraction, were recorded in all . Follow-up of six patients revealed complete recovery. In a ''blind'' experiment, samples were studied along with appropriate controls [2 c ases of CMV hepatitis, one case of postinfantile GCH, 12 cases of juve nile laryngeal papillomatosis (JLP), and 5 normal neonatal liver sampl es] by polymerase chain reaction (PCR). All DNA samples from INGCH con sistently showed positive HPV DNA amplification. This was also found i n the samples from postinfantile GCH and JLP. In addition, a second bi opsy performed 11 months later in one of the cases of INGCH revealed s cattered multinucleated hepatocytes and was still positive for HPV DNA . CMV-DNA was detected only in the cases of CMV hepatitis. All five no rmal livers were negative for HPV and CMV-DNA. These data seem to indi cate that HPV may be closely related to a subset of ''idiopathic'' NGC H with good outcome.