HEPATITIS-G VIRUS-INFECTION IN ACUTE FULMINANT-HEPATITIS - PREVALENCEOF HGV INFECTION AND SEQUENCE-ANALYSIS OF A SPECIFIC VIRAL STRAIN

Hepatitis G virus (HGV) is a recently discovered RNA virus, which belo ngs to the Flaviviridae family, Although HGV infection is usually not associated with elevated serum transaminases. some recent studies have reported that HGV infection is found in a significant number of patie nts with fulminant hepatitis and may play a role in its etiopathogenes is. In this study the prevalence of HGV infection was determined in 50 0 healthy blood donors and in 24 patients admitted to hospital because of acute liver failure caused by fulminant hepatitis, The presence of HGV RNA was tested in sera, obtained at admission and before any tran sfusion was given, by a sensitive seminested reverse transcriptase-pol ymerase chain reaction (RT-PCR) assay specific for detection of the no n-structural (NS) 5 region. Nine of the 500 blood donors (1.8%) and tw o of the 24 patients (8.3%) were found to be HGV RNA positive. One pat ient was co-infected with HCV and was known to be an intravenous (i,v. ) drug user. After intensive supporting treatment, this patient recove red completely. The second patient had no serological markers of known viral hepatitis infection, including hepatitis A virus (HAV), hepatit is B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV), Epst ein-Barr virus (EBV) and herpes simplex virus (HSV). This patient was successfully transplanted. From both patients, from HGV RNA-positive h ealthy blood donors and from other patients coinfected with HCV a part of the HGV NS3 region (nucleotides 4191-345, EMBL entry U45966) was c loned and sequenced, Sequence comparison revealed that the NS3 region of HGV in patients with fulminant hepatitis contained three nucleotide substitutions as part of the six substitutions described in previous work. These nucleotide substitutions were not found in the tested bloo d donors or in patients with HCV co-infection. Our findings therefore support the concept of the association of fulminant hepatitis with inf ection of a specific HGV strain.