Infection with an unenveloped DNA virus (TTV) in patients with acute or chronic liver disease of unknown etiology and in those positive for hepatitisC virus RNA

Background/Aims: An unenveloped single-stranded DNA virus (TTV) has been re ported in association with elevated transaminase levels in patients with po sttransfusion hepatitis and in those with acute or chronic liver disease of unknown etiology. To further evaluate the association of TTV with liver di sease, TTV DNA was searched for in patients with acute or chronic liver dis ease of various etiologies. Methods: TTV DIVA was determined by polymerase chain reaction with hemi-nes ted primers in 64 patients with acute or chronic liver disease of unknown e tiology and in 100 with acute or chronic liver disease positive for antibod y to hepatitis C virus (HCV) as well as HCV RNA. Results: TTV DNA was detected in two of the seven (29%) patients with acute hepatitis of unknown etiology, but in none of the four patients with acute HCV-associated hepatitis. It was detected in 27 of the 57 (47%) patients w ith chronic liver disease of unknown etiology at a frequency significantly higher (p<0.001) than that in 17 of the 96 (18%) patients with chronic HCV- associated liver disease. By contrast, RNA of hepatitis G virus was detecte d in none of the patients with acute hepatitis, and only in one of the 57 ( 2%) patients with chronic liver disease of unknown etiology as well as in s ix of the 96 (6%) patients with chronic HCV-associated liver disease. Conclusions: Based on the obtained results, TTV has a role in the developme nt of acute and chronic liver disease of unknown etiology.