Higher detection rate of hepatitis G and C virus RNA in liver tissue than in serum of deceased injection drug users

To examine the prevalence of hepatitis G virus (HGV) and hepatitis C virus (HCV) infections in deceased injection drug users and for comparison of the detection rates of HGV and HCV RNA in liver tissue with detection rates in postmortem serum samples, RT-PCR was performed in 50 drug abuse-related fa talities. HGV RNA was detectable in liver tissue samples from 17/50 suddenl y deceased drug abusers (34%). In 16 of these 17 positive cases, serum samp les were also available but HGV RNA was detected in only 10. From 29/50 ant i-HCV positive individuals, HCV RNA was detected in 23/50 liver tissue samp les (46%), but HCV RNA was detectable in only 6/22 of the corresponding ser um samples. In 12 anti-HCV positive cases (10 being also positive for HCV R NA in the liver), the examinations revealed a coinfection with HGV by detec tion of HGV RNA in the liver tissue samples. A significant association betw een the detection of HCV RNA in the liver and the occurrence of antibodies against the HCV NS4 protein, but not against HCV core antigen or NS3 protei n was observed. The probability of anti-HCV and HCV RNA positivity increase d with the age of the individuals. No HGV or HCV infection was detected in a control group of 50 persons who died suddenly by violent impact. The prev alence of active HCV and HGV infections in injection drug users detected by RT-PCR in liver tissue is in good accordance with data obtained from sera from living injection drug users. In contrast, the detection rate in postmo rtem serum samples was clearly lower. Possible reasons for this observation are discussed and the use of liver tissue for postmortem detection of hepa titis virus RNA is recommended.