Hepatitis GBV-C sequences in patients infected with HCV contaminated anti-D immunoglobulin and among i.v. drug users in Germany

doi:10.1016/S0168-8278(96)80126-7

Journal of Hepatology

Volume 25, Issue 3, September 1996, Pages 385-389

https://doi.org/10.1016/S0168-8278(96)80126-7 Get rights and content

Abstract

Background/Aims: A novel virus, GB virus-C (GBV-C), with a genome organization similar to those of the Flaviviridae family was identified in sera of patients diagnosed with hepatitis. Up to now little has been known about the prevalence of GBV-C sequences in German hepatitis C virus infected patients.

Methods: We investigated two groups of patients chronically infected with hepatitis C virus: (i) Women infected in 1978/79 with HCV-contaminated anti-D immunoglobulin batches in former Eastern Germany, and (ii) I.v. drug users infected with different HCV subtypes. Nested polymerase chain reaction products amplified with GBV-C specific primer pairs within the helicase region were sequenced directly and compared with the GBV-C sequences reported recently.

Results: GBV-C sequences of the putative NS 3 gene region were shown to occur in two randomly selected anti-D immunoglobulin batches of 1978 (GI and GII) and two sera of HCV-infected women drawn in 1979. In patient 3, the HCV-infected erythrocyte donor in 1978, specific GBV-C sequences were also evident in serum drawn in 1990. In the high-risk group of i.v. drug users, 49% were GBV-C RNA positive. Among the 21 GBV-C positive samples, 11 were coinfected with HCV subtype 3a and 10 with subtype 1 b. All isolates showed an overall homology to the GBV-C sequence reported by Simons of 75–81% at the nucleotide level and 94–100% at the amino acid level.

Conclusion: GBV-C sequences are detectable in the anti-D immunoglobulin batches which caused a hepatitis C virus outbreak in 1979, and a first hint of its transmission to recipients was shown. The detection of GBV-C in patient serum drawn 12 years after the onset of chronic liver disease confirms the persistence of the novel virus described here. In the group of i.v. drug users a high frequency of GBV-C sequences (49%) was shown, and the considerable variability of the nucleotide sequences indicates the existence of different GBV-C genotypes/subtypes.

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Citation Excerpt :
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Between Sept 1, 1987, and Jan 31, 2001, 2010 adults who had bariatric surgery and 2037 who were treated conventionally were enrolled into the SOS study. In this study, we followed up 4030 patients (2836 who were euglycaemic; 591 who had prediabetes; 603 who had diabetes). Drug costs did not differ between the surgery and conventional treatment groups in the euglycaemic subgroup (surgery US$10 511 vs conventional treatment $10 680; adjusted mean difference –$225 [95% CI −2080 to 1631]; p=0·812), but were lower in the surgery group in the prediabetes ($10 194 vs $13 186; –$3329 [–5722 to −937]; p=0·007) and diabetes ($14 346 vs $19 511; –$5487 [–7925 to −3049]; p<0·0001) subgroups than in the conventional treatment group. Compared with the conventional treatment group, we noted greater inpatient costs in the surgery group for the euglycaemic ($51 225 vs $25 313; $22 931 [19 001–26 861]; p<0·0001), prediabetes ($58 699 vs $32 861; $27 152 [18 736–35 568]; p<0·0001), and diabetes ($61 569 vs $47 569; 18 697 [9992–27 402]; p<0·0001) subgroups. We noted no differences in outpatient costs. Total health-care costs were higher in the surgery group in the euglycaemic ($71 059 vs $45 542; $22 390 [17 358–27 423]; p<0·0001) and prediabetes ($78 151 vs $54 864; $26 292 [16 738–35 845]; p<0·0001) subgroups than in the conventional treatment group, whereas we detected no difference between treatment groups in patients with diabetes ($88 572 vs $79 967; $9081 [–1419 to 19 581]; p=0·090).
Total health-care costs were higher for patients with euglycaemia or prediabetes in the surgery group than in the conventional treatment group, but we detected no difference between the surgery and conventional treatment groups for patients with diabetes. Long-term health-care cost results support prioritisation of patients with obesity and type 2 diabetes for bariatric surgery.
US National Institutes of Health, AFA Försäkring, and Swedish Scientific Research Council.
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The GB virus (GBV)/hepatitis G virus is a member of the Flaviviridae family and belongs to the hepatitis group of viruses transmitted parenterally, common among intravenous drug users. The strong association between GBV and HIV infection suggests that the two viruses may share similar epidemiological and transmission features. GBV infection is widely believed to prolong HIV disease progression as well as decreasing the HIV viral load and increasing the CD4⁺ T-cell level. GBV-driven anti-E2 antibodies have been shown to inhibit HIV replication in vitro. Preliminary studies also suggest that GBV infection of peripheral blood mononuclear cells leads to increased production of β-chemokines, which may explain the in vitro inhibitory effects and warrants further studies. With sufficient knowledge of resistance patterns studied in tropical south India, researchers are now keen to study the competitive interactions between GBV-induced chemokines and HIV ligands to bind CCR5.
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We detected GBV-C/HGV sequences in the sera from 64 out of a total of 324 subjects in the south of China. In agreement with findings of others, we noted an especially high rate of infection among intravenous drug addicts and patients with chronic hepatitis C virus infection. The detection was achieved by nested PCR to amplify the 5′ noncoding region (5′NCR) of the viral genome. Sequence analysis of the resulting 234 bp product revealed a total of 26 different sequences of which 25 were found to belong to the genotype G3, which is the most prevalent genotypes among Asian isolates, and one belonged to genotype G1, common among African isolates. The sequence divergence between the genotypes was largely clustered in a short variable region (V2) within the 5′NCR, and we showed that genotyping may be achieved equally well by analysis of this variable region as by the more detail analysis of the entire 5′NCR or of the entire viral genome.
Does HGV-HIV co-infection exist?
2000, International Journal of Antimicrobial Agents
Hepatitis G virus (HGV) is a recently discovered virus belonging to the Flaviviridae family. Prevalence of HGV active infection (presence of HGV-RNA) in HIV-1-infected patients has been reported in various categories of patients. Our study aimed to find out its prevalence in our cohort of HIV-1-infected children. No investigated child presented with signs of HGV active infection notwithstanding the presence of many risk factors for HGV infection. Prevalence of HGV active infection in our cohort was <2.7%.
Hepatitis G virus infection in Chinese patients with chronic hepatitis B, C or non-A-E: Clinical and molecular aspects
1999, Hepatology Research
In the present study we investigated the epidemiology, clinical significance and molecular characteristics of hepatitis G virus (HGV) infection in Chinese patients with chronic hepatitis B, C or non-A-E. Based on the detection of HGV RNA by reverse transcription polymerase chain reaction, 17 of 70 patients (24%) with chronic post-transfusion hepatitis C were coinfected with HGV. In contrast, none of 21 patients with non-A-E hepatitis had detectable HGV RNA. Among nine patients with severe chronic hepatitis caused by HBV/HCV coinfection, two were HGV RNA positive without affecting the outcome. Sustained biochemical response to interferon-alpha was similar in patients with HCV infection only (22/51, 43%) and in patients with HCV/HGV coinfection (7/17, 41%). Among ten Chinese HGV isolates, the nucleotide sequence homology in the 5′-UTR was 91–100% as compared to 84–95% between the Chinese HGV isolates and those from other countries. No core gene was found in the Chinese HGV isolates examined. In conclusion, about 20% of Chinese patients with chronic hepatitis C are coinfected with HGV. Coinfection did not affect the natural course of chronic hepatitis C or the response to antiviral therapy. Sequence analyses revealed a high degree of homology among Chinese HGV isolates. HGV infection does not appear to play a major clinical role in Chinese patients with chronic hepatitis B, C or non-A-E.
Hepatitis G virus: Relevance to oral health care
1999, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
Objective. To review the current literature on the hepatitis G virus (HGV) infection, with particular attention to the aspects of interest for the dental staff. Material And Methods. The authors searched for original research and review articles on specific aspects of the HGV infection including virology, epidemiology, transmission, natural history, and dental zaspects of HGV infection. The relevant articles were evaluated and reviewed. Results. HGV is a parenterally transmitted RNA virus that may cause acute, chronic, and fulminant liver disease; however, the real pathogenic potential of this virus and its possible effect on other hepatitic infections is still to be clarified. Preliminary studies have failed to demonstrate strong relationships between HGV infection and any oral disease. At present, data on the prevalence of HGV infection among health care workers are scarce. Nevertheless, in view of the potential transmission rates of HGV and the lack of effective immunization, HGV should be regarded as a potential occupational hazard for medical and dental staff. Conclusion. Many virological, medical, and oral aspects of HGV infection need to be further investigated; nevertheless, until related data are available, HGV should be considered to be an infection that may be transmitted during dental care. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:568-72)

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Rapid PublicationHepatitis GBV-C sequences in patients infected with HCV contaminated anti-D immunoglobulin and among i.v. drug users in Germany

Abstract

J Hepatol

Lancet

Isolation of novel virus-like sequences associated with human hepatitis

Nature Med

Sequence and genomic organization of GBV-C: a novel member of the Flaviviridae associated with human non-A–E hepatitis

J Med Virol

Molecular cloning and disease association of hepatitis G virus: a transfusion-transmissible agent

Science

Rapid Publication
Hepatitis GBV-C sequences in patients infected with HCV contaminated anti-D immunoglobulin and among i.v. drug users in Germany