TT-VIRUS INFECTION IN NORTH-AMERICAN BLOOD-DONORS, PATIENTS WITH FULMINANT HEPATIC-FAILURE, AND CRYPTOGENIC CIRRHOSIS

A novel DNA virus, TT-virus (TTV), has been reported in patients with non-A-G posttransfusion hepatitis in Japan. We sought to determine whe ther TTV infection occurs in North American blood donors and to furthe r determine the prevalence of TTV infection in several groups of patie nts with liver disease, including patients with cryptogenic cirrhosis and idiopathic fulminant hepatic failure. TTV infection was sought by detection of TTV DNA in serum by polymerase chain reaction (PCR) using primers generated from a conserved region of the TTV genome. Blood do nors, patients with cryptogenic cirrhosis, idiopathic fulminant hepati c failure, and patients with other forms of advanced liver disease wit h and without a history of parenteral exposures were studied. TTV infe ction was present in 1% (1 of 100) of blood donors, 15% (5 of 33) of p atients with cryptogenic cirrhosis, 27% (3 of 11) of patients with idi opathic fulminant hepatic failure, 18% (2 of 11) of patients with a hi story of exposure to blood products, and 4% (1 of 25) of patients with out parenteral risk factors. For all patients tested, a history of pri or exposure to blood products was associated with an increased risk of TTV infection (relative risk, 4.5; 90% confidence intervals, 0.6-43.9 ). We conclude that TTV infection is present among North American bloo d donors and is common in patients with liver disease, including crypt ogenic cirrhosis and fulminant hepatic failure. Further studies are re quired to determine the role of TTV in the pathogenicity of acute and/ or chronic liver disease.