PREVALENCE AND CLINICAL AND HISTOLOGICAL MANIFESTATION OF HEPATITIS-GGBV-C INFECTIONS IN PATIENTS WITH ELEVATED AMINOTRANSFERASES OF UNKNOWN ETIOLOGY

Background/Aims: Hepatitis G virus (HGV) and hepatitis GB virus-C (GBV -C) are recently identified non-A-E hepatitis-associated viruses. The prevalence of HGV/GBV-C in the general population is high (1.0-1.7%), but data on the clinical and histological manifestations of the new vi ruses are sparse. In the present study we investigated the prevalence and clinical and histological manifestation of HGV/GBV-C infections in patients with elevated aminotransferase levels of unknown etiology. M ethods: In 52 of 630 consecutive patients referred for evaluation of e levated aminotransferases the underlying liver disease remained unknow n. Serum samples of these 52 patients with elevated aminotransferase l evels of unknown etiology were tested for HGV/GBV-C RNA by reverse tra nscription-polymerase chain reaction (RT-PCR) using primers deduced fr om nonstructural regions. Cloned PCR products were sequenced and compa red by phylogenetic analysis. Results: HGV/GBV-C RNA was consistently detected in 7 of the 52 patients (13%). Sequence and phylogenetic anal ysis revealed the presence of only one subtype, with nucleotide sequen ce homologies between 86 and 91%. All seven patients had persistent vi remia for at least 9 months. In six patients liver function test resul ts normalized, and alanine aminotransferase levels remained persistent ly elevated in only one patient. Four HGV/GBV-C positive and ten HGV/G BV-C negative patients consented to a liver biopsy, which revealed sim ilar results with minimal to mild chronic hepatitis and mild portal fi brosis. Conclusions: The prevalence of HGV/GBV-C infections in patient s with elevated aminotransferases of unknown etiology is low. Since cl inical, biochemical and histomorphologic features of patients with ele vated aminotransferases of unknown etiology with and without HGV/GBV-C infection are indistinguishable, the role of HGV/GBV-C in the pathoge nesis of chronic liver disease appears insignificant.