Long-term liver function of recipients with hepatitis G virus infection after bone marrow transplantation

To clarify the role of hepatitis G virus (HGV) infection in liver dysfuncti on following allogeneic BR-IT, we examined cryopreserved serum samples from 33 patients who had a history of blood transfusions before BMT and whose s erum samples had been stored periodically, before BMT, on day 100, and ther eafter for the presence of HGV-RNA and hepatitis C virus (HCV)-RNA by rever se transcription polymerase chain reaction. Nineteen patients (58%) out of 33 were positive for HGV-RNA before BMT and 10 for HCV-RNA, All patients po sitive for HCV-RNA were also positive for HGV-RNA. Patients were divided in to three groups according to their viral status before BMT; namely, the G+C + group (n = 10), the G+C- group (12 = 9) and the G-C- group (n = 14). Two patients in the G-C- group became positive for HGV-RNA after BMT, One patie nt in the G+C- group suffered an acute exacerbation of hepatitis, with GPT levels reaching over 1000 IU/l, 2 and 3 years after BMT, showing quite a di fferent clinical course from those in the G+C- group. Excluding these three patients, GPT levels of the patients in the G+C+ group were significantly higher after day 100 and remained higher than those of patients in the G+C- and G-C- groups for at least 4 years. There were no significant difference s in post-transplant GPT levels between the G+C- group and the G-C- group a t any time point. Of the seven patients followed-up for 5 to 10 years, thre e patients became HGV-RNA-negative, while four remained positive. Ln the ab sence of HCV co-infection, the behavior of GPT values post transplant in pa tients with HGV infection did not differ from those without HGV infection, With respect to the patient who was G+C- and showed high values of GPT 2 an d 3 years post transplant, we suspect that his liver dysfunction might have been caused by some unknown virus or etiology.