TT virus (TTV) was recently identified as a candidate for a new hepatitis v
irus. In the present study, the clinical features and transmission routes o
f TTV infection were analyzed in an area highly endemic for hepatitis C vir
us (HCV) infection, and compared to those in an area not endemic. A total o
f 400 inhabitants were selected randomly from those who were medically scre
ened for liver disease in 1993; 200 were from the high-endemicity area, and
the other 200 were from the control area, TTV DNA in serum was tested by a
semi-nested polymerase chain reaction. The prevalence of TTV DNA was 58% (
116/200) in the high-endemicity area, and was significantly (P = 0.0083) hi
gher than that in the control area (43%, 85/200). Age specific prevalence o
f TTV DNA was significantly (P = 0.0007) higher in individuals over 60 year
s old (68.8%) than in those under 60 (45.1%) in the high-endemicity area, b
ut was similar among the age groups in the control area. TTV infection was
not associated with neither HCV and hepatitis G virus (HGV) infections nor
histories of surgical operation, blood transfusion and folk remedies in bot
h areas. In the high-endemicity area, the prevalence of TTV DNA was signifi
cantly (P = 0.0311) lower in individuals with any HCV markers (25%) than in
those without it (39%). The elevation of liver enzymes in serum was depend
ent on HCV viremia but not on TTV viremia. In conclusion, the prevalence of
TTV infection was as high as 58% in the high-endemicity area for HCV infec
tion. The infection pattern for TTV was different from that of HCV and HGV.
TTV infection showed a reciprocal association with HCV infection, and had
limited pathogenetic effect on hepatitis. (C) 1999 Elsevier Science Ireland
Ltd. All rights reserved.