High prevalence but low pathogenicity of hepatitis G virus infection in Italian patients with genetic haemochromatosis

Background. Various environmental factors have been shown to hasten cirrhos is and hepatocellular carcinoma in patients with genetic haemochromatosis. Aim. To assess the prevalence and the role of the recently identified hepat itis G virus in 70 patients with genetic haemochromatosis in comparison wit h 40 patients with cryptogenic chronic hepatitis and 200 regular blood dono rs. Patients, Six patients with genetic haemochromatosis (9%) had serum hepatit is B surface antigen, 14 (20%) had serum hepatitis C virus RNA. A liver bio psy was available in 66 patients with genetic haemochromatosis (43 with cir rhosis) and 40 with cryptogenic hepatitis (4 with cirrhosis). Methods. Serum HGV-RNA was detected by a reverse transcriptase polymerase c hain reaction using primers derived from the 5'-non-coding and non-structur al-5A regions of the viral genome. Sen lm IgG antibodies against HGV were d etected by enzyme-linked immunosorbent assay using a recombinant E-2 protei n of the virus envelope. Results, The prevalence of serum HGV-RNA was higher in patients with crypto genic hepatitis (n = 6,15%) and genetic haemochromatosis (n=6, 9%) than in donors (n=3, 1.5%) (p=0.0008 and p=0.01, respectively). The corresponding f igures for serum anti-HGV were 4 (10%), 16 (23%) and 10 (5%). The sir haemo chromatotic patients with serum HGV-RNA more often had parenteral exposure to blood (50% vs 5%, p<0.001), and persistently elevated serum aminotransfe rases (100% vs 31%, p<0.001) than the 64 non-viraemic patients. The six HGV -RNA seropositive patients with cryptogenic hepatitis were older than the 3 4 non-viraemic patients (56 vs 34 years, p<0.05). Conclusions. The prevalence of serum markers of HGV infection in patients w ith genetic haemochromatosis is higher than in blood donors, but similar to that of patients with cryptogenic chronic hepatitis. However, HGV is not a cofactor of morbidity in patients with genetic haemochromatosis.