HEPATITIS-G VIRUS-RNA AND HEPATITIS-G VIRUS E2 ANTIBODIES IN DUTCH HEMOPHILIA PATIENTS IN RELATION TO TRANSFUSION HISTORY

The prevalence of hepatitis G virus (HGV)-RNA and HGV-E2 antibodies wa s studied in a cohort of Dutch hemophilia patients in relation to clot ting products used, age, and coinfection with hepatitis C. Between 199 1 and 1995, blood samples were taken from 294 patients with hemophilia A, B, or von Willebrand disease. From each patient one fresh frozen s ample was tested for HGV cDNA polymerase chain reaction (PCR) and HCV cDNA PCR. Alanine aminotransferase (ALT) tests were performed on plasm a samples of all patients. The presence of HGV-E2 antibodies was teste d on plasma samples from a subset of 169 patients representing all age groups. Based on the origin and viral safety of the products used, th ree subgroups of patients were distinguished. Group A: patients who us ed viral noninactivated factors derived from small and large donor poo ls; group B: patients who used factors prepared with inadequate viral inactivation techniques derived from small and large donor pools; and group C: patients treated only with optimally viral inactivated large pool clotting factor or recombinant clotting factor concentrate. The p revalence of HGV-RNA was 18%. In group A patients the prevalence was 7 1%, in group B 50%, and in group C 6%. When related to age, the highes t prevalence of HGV-RNA (35%) was seen in patients born between 1980 a nd 1989. The prevalence of HGV-E2 antibodies increased with age. Of HG V-RNA-negative patients born before 1950, 96% tested positive. HGV vir emia did not affect ALT levels, neither in HCV-RNA positive nor in HCV -RNA negative patients. HGV infection is frequently seen in patients w ith hemophilia. In older age groups a lower rate of HGV-RNA positivity is seen coinciding with a higher rate of antienvelope antibodies. (C) 1998 by The American Society of Hematology.