HEPATITIS-G VIRUS-INFECTION IN PATIENTS TRANSPLANTED FOR CRYPTOGENIC CIRRHOSIS - RED FLAG OR RED HERRING

Background The significance of hepatitis G (HGV) infection in liver tr ansplant recipients is not known, We set out to determine the pre-orth otopic liver transplantation (OLT) prevalence, the pre-and postoperati ve viral titers of HGV, and the allograft histology in patients infect ed with HGV who underwent OLT for cryptogenic cirrhosis, Methods, HGV RNA was measured using a research-based branched DNA assay, The assay used a target-specific probe set that was based on the 5'-untranslated region of the HGV genome, Allograft histology was assessed with proto col liver biopsies in all patients who survived longer than 6 months, Results, The preoperative prevalence of HGV infection in recipients tr ansplanted for cryptogenic cirrhosis was 26%, Thirty-seven percent (12 of 33) of recipients who had serum available in the first postoperati ve month had HGV infection, Mean HGV RNA levels were 9.8 (+/-4.2) (vir al molecular equivalents/mlx10(6)) before OLT and 37.5 (+/-10.7) at 1 year after OLT, In 4 of the 11 cryptogenic recipients in whom HGV RNA was detectable in the first postoperative month, HGV RNA fell to undet ectable levels at the most recent follow-up (mean 70 months), Of the f ive cryptogenic recipients who continue to have measurable HGV RNA, th ree have unexplained hepatitis histologically, Conclusions, These find ings suggest the following: 1) The prevalence of HGV infection in pati ents undergoing OLT for cryptogenic cirrhosis is about 25%, 2) In reci pients persistently infected with HGV, mean HGV RNA titers increase af ter OLT, 3) HGV RNA becomes undetectable in about one third of recipie nts who had detectable HGV RNA in the first month after OLT, 4) Hepati tis of uncertain etiology occurs in 60% (3 of 5) of persistently HGV-i nfected cryptogenic recipients.