HIGH PREVALENCE OF INFECTION WITH HEPATITIS-G VIRUS IN PATIENTS WITH HEPATIC AND EXTRAHEPATIC MALIGNANCIES

Background/Aims: The pathogenic role of hepatitis G virus, the recentl y discovered blood-borne agent, is controversial. Our aim was to ascer tain the prevalence of hepatitis G virus infection in hepatic and in e xtrahepatic malignancies. Methods: We studied 166 Italian patients (11 2 male, 54 female, mean age 61.8 +/- 9.3, mean +/- SD, range 34-85). O ne hundred and eighteen had cirrhosis, which was complicated by hepato cellular carcinoma in 66 cases. Forty-eight patients had extra-hepatic malignancies. Circulating HGV RNA was detected by reverse transcripta se-polymerase chain reaction (RT-PCR) of both the nonstructural-3 and 5' noncoding regions of the hepatitis G virus genome, Antibodies to th e E2 protein of hepatitis G virus were detected by means of an enzyme- linked immunosorbent assay. Results: Ongoing HGV infection was detecte d in 30/66 (46%) patients with hepatocellular carcinoma, 12/52 (23%) p atients with cirrhosis, and 14/48 (29%) patients with extrahepatic mal ignancies (p<0.05), Evidence of exposure to hepatitis G virus (detecti on of either HGV RNA or anti-E2 antibodies) was found in 46% of patien ts with cirrhosis, 66% of patients with hepatocellular carcinoma, and 39% of patients with extrahepatic malignancies, Serum HGV RNA positivi ty was associated with a hematocrit value less than or equal to 0.35 a nd with history of exposure to blood products (p<0.005). Conclusions: Ongoing hepatitis G virus infection is detected at a very high rate in patients with hepatocellular carcinoma, but is also fairly common in extrahepatic malignancies, Hepatitis G virus infection in these patien ts is likely to originate from exposure to blood products, and to pers ist because of deficient immune surveillance.