Abstract
The association of GB virus type C (GBV-C) virus and clinical disease is uncertain. The role of GBV-C and (Envelope) E2 antibody in children with liver transplants has not been determined. This study's aim is to examine the prevalence of GBV-C in children with liver transplants, to assess the relationship of GBV-C to posttransplant hepatitis, and to determine the role of E2 antibodies. Sera from 34 children, preliver and postliver transplant, between 1989-1996 were tested for GBV-C (Ribonucleic acid) RNA by the automated Abbott LCx PCR assay. Anti-E2 antibodies were detected by an Abbott immunoassay. Recent posttransplant liver biopsies were examined for hepatitis. The results of the study determined that pretransplant, four children (12%) were GBV-C RNA positive. Posttransplant, 14 (42%) children were GBV-C RNA positive. The GBV-C RNA positive conversion rate was 33% (CI 17.2-55.7%). Patients received blood products from a mean of 68 ± 34 donors, which correlated with GBV-C acquisition. There was no difference in the incidence (32% versus 36%; p = 0.726) or severity (grade 2.00 versus 0.68; p = 0.126) of posttransplant hepatitis in the liver biopsies of GBV-C RNA negative and/or positive children, respectively. Pretransplant, nine of 32 children were anti-E2 positive. Posttransplant, eight of 32 children were anti-E2 positive, including five children who were anti-E2 positive pretransplant. Of nine children who were anti-E2 positive and GBV-C RNA negative pretransplant, three became GBV-C RNA positive posttransplant. The results of this study conclude that the prevalence of GBV-C infection in children postliver transplantation is high and that blood product transfusions correlate with GBV-C acquisition. Also, no correlation was found between GBV-C RNA and the incidence or severity of posttransplant hepatitis. Finally, E2 antibody presence before transplantation failed to provide complete protection from GBV-C acquisition.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Abbreviations
- GBV-C:
-
GB virus type C
- HGV:
-
hepatitis G virus
- E2 Ab:
-
envelope antibody
- NANBNC:
-
non-A, non-B, non-C
References
Alter M 1989 Non-A, non-B hepatitis: sorting through a diagnosis of exclusion. Ann Intern Med 110: 583–585.
Koretz R, Abbey H, Coleman E, Gitnick G 1993 Non-A non-B post transfusion hepatitis. Looking back in the second decade. Ann Intern Med 119: 110–115.
Gonzalez A, Esteban J, Madoz P. Viladomiu L, Genesca J, Muniz E, Enriquez J, Torras X, Hemandez JM, Quer J, Vidal X, Alter HJ, Shih JW, Esteban R, Guardia J 1995 Efficacy of screening donors for antibodies to the hepatitis C virus to prevent transfusion-associated hepatitis: final report of a prospective trial. Hepatology 12: 439–445.
Alter MJ, Gallagherr M, Morris TT, Moyer LA, Meeks EL, Krawczynski K, Kim JP, Margolis HS 1997 Acute non A-E hepatitis in the US and the role of HGV. N Engl J Med 346: 741–746.
Linnen J, Wages J, Zhang-Keck ZY, Fry KE, Krawczynski KZ, Alter H, Koonin E, Gallagher M, Alter M, Hadziyannis S, Karayiannis P, Fung K, Nakatsuji Y, Shih JW, Young L, Piatak M, Hoover C, Fernandez J, Chen S, Zou JC, Morris J, Hyams KC, Ismay S, Lifson JD, Hess G, Foung SKH, Thomas H, Margolis H, Kim JP 1996 Molecular cloning and disease association of hepatitis G virus: a transfusion-transmissible agent. Science 271: 505–508.
Simons JN, Leary TP, Dawson GJ, Pilot-Matias TJ, Muerhoff AS, Schlauder GG, Desai SM, Mushahwar IK 1990 Isolation of novel virus like sequences associated with human hepatitis. Nat Med 1: 564–569.
Simons JN, Pilot-Matias TJ, Leary TP, Dawson GJ, Desai SM, Schlauder GG 1995 Identification of two flavivirus-like genomes in the GB hepatitis agent. Proc Natl Acad Sci USA 92: 3401–3405.
Balistreri WF 1997 "G" another form of viral hepatitis?. J Pediatr 131: 503–506.
Ohba K, Mizokami M, Lau JYN 1996 Evolutionary relationship of hepatitis C, pesti-, flavi- plantviruses, and newly discovered GB hepatitis agents. FEBS Lett 378: 232–234.
Leary TP, Muerhoff AS, Simons JN, Pilot-Matias TJ, Erker JC, Chalmers ML, Schlauder GG 1996 Sequence and genomic organization of GBV-C: a novel member of the Flaviviridae associated with human non A-E hepatitis. J Med Virol 48: 600–67.
Fiordalisi G, Zanella I, Mantero G, Bettinardi A, Stellini A, Paraninfo G, Cadedo G 1996 High prevalence of GBV-C infection in a group of Italian patients with hepatitis of unknown etiology. J Infect Dis 174: 181–183.
Moriyama M, Miyauchi I, Naki K, Shimizu T, Matsumura H, Segawa T, Tanaka N, Okubo H, Arakawa Y, Abe K 1996 HGV infection in Japanese patients with various forms of liver disease. Hepatology 24: 550
Fukushima S, Hyashi S, Abe K, Masaki N, Shimizu K, Isu N, Isuu N, Ohhara H, Yamasshina S, Akiyama J, Sekigawa K, Matsukawa M, Yamato S, Muraoko A, Shoda R, Matsueda K, Shimijo E, Umeda N 1996 Clinical features of acute hepatitis G. Hepatology 24: 1148
Saiz M, Sans Olmedo, Lopez-Labrador FX, Resterop JC, Rimola A, Ohara H, Yamasshina S, Akiyama J, Sekigawa K, Matsukawa M, Yamato S, Muraoko A, Shoda R, Matsueda K, Shimijo E, Umeda N 1996 Hepatitis G virus infection in fulminant hepatitis. Hepatology 24: 663
Monuz S, Alter H, Liang TJ, Nakatzuji Y, Shin J, Jeffers Reid, Marrone K, Rothstein TJ, Manzarbieta C 1996 Hepatitis G virus is present in serum of patients with fulminant hepatitis of unknown ethiology. Hepatology 24: 665
Pessoa MG, Terrault NA, Detmer J, Kolberg J, Wright TL 1997 Hepatitis G virus in patients with cryptogenic liver disease undergoing liver transplantation. Hepatology 25: 1266–1270.
Hoofnagle JH, Lombardoo M, Wei Y, Everhart J, Weisner R, Zetterman R, Yun AJ, Yang L, Kim JP 1997 Hepatitis G virus infection before and after liver transplantation. Liver Transpl Surg 3: 578–585.
Hagsma Eb, Cuypres HT, Ouw AS, Sjerps MC, Huizenga JR, Slooff MJ, Yun AJ, Yang L, Kim JP 1997 High prevalence of hepatitis G virus after liver transplantation without apparent influence on long-term graft function. J Hepatol 2: 921–925.
Kallinowski B, Buhrmann C, Seipp S, Arnold JC, Goeser T, Stremmel W, Otto G, Theilman L 1996 Infection with Hepatitis GBV-C virus after orthotopic liver transplantation. Hepatology 24: 289
Belli LS, Silini E, Ideo G 1995 HGV and post transplantation hepatitis. N Engl J Med 335: 1394–1395.
Belli LS, Silini E, Alberti AB, Asti A, Asti L, Bellati G, Rondinaara L, De Carlis, Forti D, Ideo G 1997 HGV infection and liver transplantation: virological, serological and clinical course. Hepatology 26: 1408
Fischer L, Sternecck M, Schuhmacher C, Feucht H, Malago M, Laufs R, Broelch CE 1997 HGV infection after liver transplantation has no impact on graft survival. Hepatology 26: 1513
Colombatto P, Randonr A, Civitico G, Monti G, Dolci L, Medaina N, Calleri G, Oliveri F, Baldi M, Tappero G, David E, Brunetto MR 1997 A new hepatitis G virus-like flavivirus in patients with cryptogenic liver disease associated with elevated GGT and alkaline phosphatase serum levels. J Viral Hepat 1: 55–60.
Kutdo T, Morishima T, Tsuzuki K, Orito E, Mizokami M 1996 HGV in immunosuppressed pediatric allograft recipients. [letter] Lancet 348: 751
Davidson SM, Skidmore SJ, Collingham KE, Irving WL, Hubscher SS, Kelly DA 1998 Chronic hepatitis in children after liver transplant: role of hepatitis C virus and hepatitis G virus infections. J Hepatol 28: 764–770.
Dille BJ, Surowy TK, Gutierrez RA, Coleman PF, Knigge MF, Carrich RJ, Aach RD, Hollinger F, Stevens C, Barbosa L, Memo Mosley, Dawson G, Mushahwar I 1997 An ELISA for detection of antibodies to the E2 protein of GBV-C. J Infect Dis 175: 458–461.
Hassoba HM, Terrault NA, El-Gohary AM, Scheffel C, Joe C, Brackett J, Hunt J, Lou SC, Wright TL 1997 Antibody to GBV-C second envelope glycoprotein (anti-GBV-C E2): is it a marker for immunity?. J Med Virol 53: 354–360.
Hassoba MH, Passoa MG, Terrault NA, Wright TL 1997 Anti-envelope antibodies are protective against further GBV-C infection: evidence from the transplant model. Hepatology 26: 776
Tacke M, Schmolke S, Schelueter V, Sauleda S, Tanaka E, Engel AM 1997 Humoral immune response to the E2 protein of hepatitis G virus is associated with long term recovery from infection and reveals a high frequency of hepatitis G virus exposure among healthy blood donors. Hepatology 26: 1626–1633.
Marshall RL, Cockerill J, Friedman P, Hayden M, Hodges S, Holas C, Jennings C, Jou CK, Kratochvil J, Laffler T, Lewis N, Scheffel C, Traylor D, Wang L, Solomon N 1998 Detection of GB Virus C by the RT-PCR LCx® System. J Virol Methods 73: 99–107.
Lou S, Qiu X, Tegtmeier G, Leitza S, Brackeett J, Cousineau K, Varma A, Seballos H, Kundu S, Hunt JC 1997 Immunoassay to study prevalence of antibody against GBV-C in blood donors. J Virol Methods 68: 45–55.
Scheuer P 1991 Classification of chronic viral hepatitis: a need for reassessment. J Hepatol 13: 372–374.
Dickson RC, Qian KP, Lau JY 1997 High prevalence of GBV-C infection in liver transplant recipients. Transplantation 63: 1695–1697.
Alter HJ, Nakatsuji Y, Melpolder J, Wages J, Wesley R, Shin JW-K, Shin JW, Kim JP 1997 The incidence of transfusion associated HGV infection and its relation to liver disease. N Engl J Med 336: 747–754.
Shimizu M, Osada K, Okamoto H 1996 Transfusion transmitted hepatitis G virus following open-heart surgery. [letter] Transfusion 366: 937
Huey LC, Mei-Hwei C, Yen-Hsuan N, Hong-Yuan HSU, JIA-Horng K, Pei-Jeer C 1997 HGV infection in normal and prospectively followed post-transfusion children. Pediatr Res 42: 784–787.
Ishikawa K, Hasegawa S, Hayashi N 1996 HGV is rare but possible causative agent of non A-C fulminant Hepatitis. Hepatology 24: 527
Matsui A, Momoya T, Ishikawa T, Sasaki N, Okamato 1996 GBV-C genome in two children with fulminant hepatic failure and chronic active hepatitis. Hepatology 24: 545
Tatsuoo K, Osamu Y, Toshiki Yasushi, Fumio I, Hiromitsu S 1997 Detection of GBV-C RNA in patients with non-A-E fulminant hepatitis by PCR. Hepatology 25: 1261–1265.
Yoshiba M, Okamoto H, Mishiri S 1995 Detection of GBV-C hepatitis virus genome in serum from patients with fulminant hepatitis of unknown etiology. Lancet 346: 1131–1132.
Feucht HH, Zollner B, Polywka S, Laufs R 1996 Vertical transmission of hepatitis G virus. Lancet 347: 615–616.
Berg T, Woelfle J, Schrier J, Hopf U, Lentze MJ 1997 HGV can persist in children after neonatal blood transfusion for more then 15 years without evidence of hepatitis. Hepatology 26: 785
Chen HL, Ni YH, Kao H, Wang JT, Chen DS 1997 Failure of hepatitis G virus anti-E2 response in infants: more persistent infection after mother to infant transmission?. Hepatology 26: 774
Acknowledgements
Materials and equipment for performing reverse-transcription polymerase chain reaction for GBV-C were provided by Abbott Laboratories (Abbott Park, IL). The immunoassay for detection of human antibodies elicited against GBV-C was performed at Abbott Laboratories.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Elkayam, O., Hassoba, H., Ferrell, L. et al. GB Virus C (GBV-C/HGV) and E2 Antibodies in Children Preliver and Postliver Transplant. Pediatr Res 45, 795–798 (1999). https://doi.org/10.1203/00006450-199906000-00002
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/00006450-199906000-00002
