HEPATITIS-G VIRUS-RNA IN THE SERUM OF PATIENTS WITH ELEVATED GAMMA-GLUTAMYL-TRANSPEPTIDASE AND ALKALINE-PHOSPHATASE - A SPECIFIC LIVER-DISEASE

We tested the sera of 67 consecutive patients for hepatitis G virus (H GV) RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). T hese patients (42 males and 25 females, median age 35 years, range 13- 64 years) had liver disease of unknown aetiology and were without mark ers of hepatitis (A-E) viruses or signs of genetically determined, aut oimmune, alcoholic or drug-induced liver disease. The controls in this study were 110 patients (50 females and 60 males, median age 45 years , range 9-65 years) with chronic hepatitis E virus (HBV) infection (19 patients) or hepatitis C virus (HCV) infection (91 patients). Ten of 67 (14.9%) patients with cryptogenic disease were positive for HGV RNA by at least three separate tests; HGV RNA was also detected in one of 19 (5.3%) hepatitis B surface antigen (HBsAg) carriers and in nine of 91 (16.6%) patients with antibody to HCV. These data suggest that HGV occurs as frequently in HCV-infected patients as in those with crypto genic disease. Elevated serum gamma glutamyl transpeptidase (gamma-GT) (higher than twice the normal value) and alkaline phosphatase levels were found in eight of 10 (80%) HGV RNA positive patients and in six o f 57 (10.5%) HGV RNA negative patients (P < 0.0001). five (50%) HGV RN A positive patients had non-specific inflammatory bile duct lesions. A statistically significant difference was observed between HGV RNA pos itive and negative patients with chronic HBV or HCV infections (P < 0. 029). Therefore, the spectrum of liver disease associated with HGV is wide, but a characteristic lesion of the bile duct leading to elevatio n of cholestatic enzymes might be specific for this virus.