VIREMIA, GENETIC-HETEROGENEITY, AND IMMUNITY TO HEPATITIS-G GB-C VIRUS IN MULTIPLY TRANSFUSED PATIENTS WITH THALASSEMIA

BACKGROUND: Thalassemia patients are at high risk for posttransfusion hepatitis. Hepatitis G virus (HGV) has been suspected of being respons ible for acute and chronic hepatitis. STUDY DESIGN AND METHODS: The pr evalence of HGV infection, its possible association to liver disease, the genetic heterogeneity among the various HGV isolates, and immunity to HGV were studied in 36 thalassemia patients with reverse transcrip tase-polymerase chain reaction assay and sequence analysis. RESULTS: H GV RNA was detected in seven patients (19.4%) only two of whom had evi dence of hepatitis C virus infection as well. Sequence analysis of the NS3 gene from isolates of the five patients infected with HGV alone r evealed 84.7 to 90.9 percent homology at the nucleotide level. Prolong ed HGV viremia was not associated with significant liver enzyme elevat ion. All five patients were chronically infected with the same viral s train. E2 antibodies were detected in 57 percent of the HGV-nonviremic patients and in only 1 of 7 viremic patients.CONCLUSION: HGV is assoc iated with persistent viremia but not with significant biochemical evi dence of liver damage. There is some genetic heterogeneity among HGV i solates from thalassemia patients in Israel.