Impact of hepatitis G virus co-infection on the course of hepatitis C virus infection before and after liver transplantation

Background/Aims: Hepatitis G virus (HGV), a new RNA virus that is parentera lly transmitted, has frequently been found in patients with chronic hepatit is C (HCV) infection but its role in chronic liver disease is unknown, The purpose of this study was to determine the prevalence of HGV infection in t ransplantation patients infected with hepatitis C and to assess the impact of HGV co-infection on the course of HCV infection after liver transplantat ion. Methods: Eighty-nine liver transplantation recipients with persistent hepat itis C viremia detected by polymerase chain reaction (PCR) were evaluated, Serum samples were tested before and after liver transplantation for HGV RN A by two different PCR methods: LCTM assay (Abbott Laboratories) and an RT- PCR procedure which we developed using the silica gel technique for extract ion of the HGV RNA, E2 antibodies were detected before orthotopic liver tra nsplantation by an EIA-test, HCV RNA was quantified by branched DNA assay, and HCV genotype was determined, A mean of nine liver biopsy specimens were examined for each patient and the severity of the lesions was compared in HCV-positive patients with or without HGV co-infection. Results: The concordance between the two HGV RNA detection methods was exce llent and the reproducibility of our RT-PCR procedure was confirmed, The pr evalence of pretransplantation and posttransplantation HGV infection was 11 % and 19%, respectively, Pretransplantation HGV infection was positively co rrelated with posttransplantation HGV infection (p < 0.001). Before transpl antation the E2 antibodies seroprevalence was 34%, Seven patients became HG V RNA positive after transplantation, but all of them were negative for E2 antibodies. Among the patients who remained RNA negative after liver transp lantation, 40% were positive for E2 antibodies (p = 0.04), Pretransplantati on clinical features (except AST mean value) were not different in patients with HCV and HGV co-infection and those with HCV only, After a mean follow -up of 34 months (range: 6 to 70), 67/89 (75%) patients developed histologi cal features of recurrent hepatitis but the frequency of the occurrence of graft hepatitis was not different between HGV/HCV co-infected patients and those with HCV alone (p = 0.89), The mean interval from orthotopic liver tr ansplantation to recurrence was 12.2 months (range: 3-63), which was not di fferent for HVG/HVC-co-infected patients and HCV-infected patients, The his tological severity of posttransplantation liver disease, and the graft and patient survival were not different for patients with and without HGV co-in fection. Conclusions: Our results suggest the general persistence of HGV infection a fter liver transplantation, but HGV co-infection did not appear to influenc e the posttransplantation course of HCV infection, Before transplantation t he prevalence of E2 antibodies was 34%, and our data clearly indicate that E2 antibodies were protective against HGV infection.