PATTERNS OF HEPATITIS-G VIREMIA AND LIVER-DISEASE IN HEMOPHILIACS PREVIOUSLY EXPOSED TO NON-VIRUS INACTIVATED COAGULATION-FACTOR CONCENTRATES

Hepatitis G virus (HGV), a novel flavivirus, has been implicated as a cause of posttransfusion hepatitis. We have performed a longitudinal s tudy in a cohort of haemophiliacs (n = 68) who previously received non -virus inactivated coagulation factor concentrates to assess both patt erns of HGV viraemia and any associated liver disease. Hepatitis C vir us (HCV) RNA was present in 58/68 and co-infection with human immunode ficiency virus (HIV) was present in 15/68. HGV RNA was detected in 17/ 68 (25%) samples from the mid-1980s. There was no association between either HIV infection (p = 0.74) or co-infection with a particular HCV genotype (p = 0.62). However, there was a relationship between HGV vir aemia and the severity of haemophilia (p = 0.0004) with HGV RNA detect ed in 5/19, 9/16 and 3/32 patients with mild, moderate and severe haem ophilia respectively. A longitudinal study was performed in 15/17 haem ophiliacs with HGV viraemia using stored serum samples from the 1980s and 1990s. HGV viraemia persisted in 8/15 and cleared in 7/15 over a v ariable period of time. A Weibull model was constructed to estimate th e duration of HGV viraemia in the study group. The 75th and 90th perce ntiles for the duration of HGV were estimated to be 8.7 years (95%, co nfidence interval 4.8-15.7) and 23.6 years (95% confidence interval 11 .8-47.1) respectively. Laparoscopic liver inspection/biopsy was perfor med in 25/68. There was no association between severity of liver disea se and HGV viraemia (p = 0.43). This study demonstrates considerable v ariation in patterns of HGV viraemia in haemophiliacs. We found little evidence to implicate HGV as a major cause of chronic liver disease i n haemophiliacs.