The clinical significance of simultaneous infection with hepatitis G virus in patients with chronic hepatitis C

D. J. Brandhagen, J. B. Gross, J. J. Poterucha, M. R. Charlton, J. Detmer, J. Kolberg, A. A. Gossard, K. P. Batts, W. R. Kim, J. J. Germer, R. H. Wiesner, D. H. Persing

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Abstract

OBJECTIVES: Hepatitis G virus (HGV) is a recently discovered member of the flavivirus family that has been associated with acute and chronic hepatitis. HGV infection has been reported to coexist in 10-20% of patients with chronic hepatitis C. The significance of simultaneous infection with HGV and hepatitis C virus (HCV) remains to be clarified, as do the effects on HGV of therapeutic interventions such as interferon treatment or liver transplantation. The aims of our study were: 1) to examine the frequency of HGV infection in the settings of liver transplantation and interferon therapy for hepatitis C; and 2) to compare HGV RNA levels before and after liver transplantation or interferon treatment. METHODS: Pre-treatment sera were available in 65 patients with chronic hepatitis C treated with interferon; pretransplant sera were available in 49 patients transplanted for end stage liver disease associated with chronic hepatitis C. Information collected included age, sex, risk factors for hepatitis, concurrent liver disease, patient and allograft survival, biochemical response to interferon, histological activity index, and degree of fibrosis/cirrhosis. HCV genotyping was performed by sequencing the NS-5 region. HGV quantitation was performed using a research-based branched DNA (bDNA) assay with a set of probes directed at the 5' untranslated region. RESULTS: HGV was detected in 10 of 49 patients (20%) before transplant and in 13 of 65 patients (20%) treated with interferon. There was a female predominance among HGV-positive compared with HGV-negative transplant patients (80% vs 20%; p < 0.01), but such a difference was not observed in the interferon-treated group. Hepatic iron concentration was lower in hepatic explants from patients who were HGV- positive than in those who were HGV-negative (318 ± 145 μg/g dry weight vs 1497 ± 2202 μg/g dry weight; p = 0.02). HCV exposure after 1980 was more common in the HGV-positive patients than in those who were HGV-negative for the entire study population (10 of 20 [50%] vs 16 of 66 [24%]; p = 0.03), as well as for the nontransplant subgroup (8 of 12 [67%] vs 12 of 39 [31%]; p = 0.03). HGV RNA levels declined at 1 yr after transplant in seven of eight patients. Among nine patients tested during or after interferon treatment, HGV RNA levels declined from pretreatment levels in all and disappeared in three. CONCLUSIONS: Among patients with chronic hepatitis C treated with either interferon or liver transplantation, the frequency of coinfection with HGV is about 20%. HGV may be a more recent virus in the US than HCV. Coinfection with HGV does not appear to affect the likelihood of response to interferon in patients with hepatitis C. Finally, HGV RNA levels appear to decline after both liver transplantation and interferon therapy, suggesting possible suppression by increased HCV replication in the former case, and a possible drug treatment effect in the latter.

Original languageEnglish (US)
Pages (from-to)1000-1005
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume94
Issue number4
DOIs
StatePublished - Apr 1999

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GB virus C
Chronic Hepatitis C
Interferons
Infection
Hepacivirus
Liver Transplantation
RNA
Virus Diseases
Therapeutics
Hepatitis C
Coinfection
Transplants
Fibrosis
Branched DNA Signal Amplification Assay

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Brandhagen, D. J., Gross, J. B., Poterucha, J. J., Charlton, M. R., Detmer, J., Kolberg, J., ... Persing, D. H. (1999). The clinical significance of simultaneous infection with hepatitis G virus in patients with chronic hepatitis C. American Journal of Gastroenterology, 94(4), 1000-1005. https://doi.org/10.1016/S0002-9270(99)00058-1

The clinical significance of simultaneous infection with hepatitis G virus in patients with chronic hepatitis C. / Brandhagen, D. J.; Gross, J. B.; Poterucha, J. J.; Charlton, M. R.; Detmer, J.; Kolberg, J.; Gossard, A. A.; Batts, K. P.; Kim, W. R.; Germer, J. J.; Wiesner, R. H.; Persing, D. H.

In: American Journal of Gastroenterology, Vol. 94, No. 4, 04.1999, p. 1000-1005.

Research output: Contribution to journalArticle

Brandhagen, DJ, Gross, JB, Poterucha, JJ, Charlton, MR, Detmer, J, Kolberg, J, Gossard, AA, Batts, KP, Kim, WR, Germer, JJ, Wiesner, RH & Persing, DH 1999, 'The clinical significance of simultaneous infection with hepatitis G virus in patients with chronic hepatitis C', American Journal of Gastroenterology, vol. 94, no. 4, pp. 1000-1005. https://doi.org/10.1016/S0002-9270(99)00058-1
Brandhagen, D. J. ; Gross, J. B. ; Poterucha, J. J. ; Charlton, M. R. ; Detmer, J. ; Kolberg, J. ; Gossard, A. A. ; Batts, K. P. ; Kim, W. R. ; Germer, J. J. ; Wiesner, R. H. ; Persing, D. H. / The clinical significance of simultaneous infection with hepatitis G virus in patients with chronic hepatitis C. In: American Journal of Gastroenterology. 1999 ; Vol. 94, No. 4. pp. 1000-1005.
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abstract = "OBJECTIVES: Hepatitis G virus (HGV) is a recently discovered member of the flavivirus family that has been associated with acute and chronic hepatitis. HGV infection has been reported to coexist in 10-20{\%} of patients with chronic hepatitis C. The significance of simultaneous infection with HGV and hepatitis C virus (HCV) remains to be clarified, as do the effects on HGV of therapeutic interventions such as interferon treatment or liver transplantation. The aims of our study were: 1) to examine the frequency of HGV infection in the settings of liver transplantation and interferon therapy for hepatitis C; and 2) to compare HGV RNA levels before and after liver transplantation or interferon treatment. METHODS: Pre-treatment sera were available in 65 patients with chronic hepatitis C treated with interferon; pretransplant sera were available in 49 patients transplanted for end stage liver disease associated with chronic hepatitis C. Information collected included age, sex, risk factors for hepatitis, concurrent liver disease, patient and allograft survival, biochemical response to interferon, histological activity index, and degree of fibrosis/cirrhosis. HCV genotyping was performed by sequencing the NS-5 region. HGV quantitation was performed using a research-based branched DNA (bDNA) assay with a set of probes directed at the 5' untranslated region. RESULTS: HGV was detected in 10 of 49 patients (20{\%}) before transplant and in 13 of 65 patients (20{\%}) treated with interferon. There was a female predominance among HGV-positive compared with HGV-negative transplant patients (80{\%} vs 20{\%}; p < 0.01), but such a difference was not observed in the interferon-treated group. Hepatic iron concentration was lower in hepatic explants from patients who were HGV- positive than in those who were HGV-negative (318 ± 145 μg/g dry weight vs 1497 ± 2202 μg/g dry weight; p = 0.02). HCV exposure after 1980 was more common in the HGV-positive patients than in those who were HGV-negative for the entire study population (10 of 20 [50{\%}] vs 16 of 66 [24{\%}]; p = 0.03), as well as for the nontransplant subgroup (8 of 12 [67{\%}] vs 12 of 39 [31{\%}]; p = 0.03). HGV RNA levels declined at 1 yr after transplant in seven of eight patients. Among nine patients tested during or after interferon treatment, HGV RNA levels declined from pretreatment levels in all and disappeared in three. CONCLUSIONS: Among patients with chronic hepatitis C treated with either interferon or liver transplantation, the frequency of coinfection with HGV is about 20{\%}. HGV may be a more recent virus in the US than HCV. Coinfection with HGV does not appear to affect the likelihood of response to interferon in patients with hepatitis C. Finally, HGV RNA levels appear to decline after both liver transplantation and interferon therapy, suggesting possible suppression by increased HCV replication in the former case, and a possible drug treatment effect in the latter.",
author = "Brandhagen, {D. J.} and Gross, {J. B.} and Poterucha, {J. J.} and Charlton, {M. R.} and J. Detmer and J. Kolberg and Gossard, {A. A.} and Batts, {K. P.} and Kim, {W. R.} and Germer, {J. J.} and Wiesner, {R. H.} and Persing, {D. H.}",
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T1 - The clinical significance of simultaneous infection with hepatitis G virus in patients with chronic hepatitis C

AU - Brandhagen, D. J.

AU - Gross, J. B.

AU - Poterucha, J. J.

AU - Charlton, M. R.

AU - Detmer, J.

AU - Kolberg, J.

AU - Gossard, A. A.

AU - Batts, K. P.

AU - Kim, W. R.

AU - Germer, J. J.

AU - Wiesner, R. H.

AU - Persing, D. H.

PY - 1999/4

Y1 - 1999/4

N2 - OBJECTIVES: Hepatitis G virus (HGV) is a recently discovered member of the flavivirus family that has been associated with acute and chronic hepatitis. HGV infection has been reported to coexist in 10-20% of patients with chronic hepatitis C. The significance of simultaneous infection with HGV and hepatitis C virus (HCV) remains to be clarified, as do the effects on HGV of therapeutic interventions such as interferon treatment or liver transplantation. The aims of our study were: 1) to examine the frequency of HGV infection in the settings of liver transplantation and interferon therapy for hepatitis C; and 2) to compare HGV RNA levels before and after liver transplantation or interferon treatment. METHODS: Pre-treatment sera were available in 65 patients with chronic hepatitis C treated with interferon; pretransplant sera were available in 49 patients transplanted for end stage liver disease associated with chronic hepatitis C. Information collected included age, sex, risk factors for hepatitis, concurrent liver disease, patient and allograft survival, biochemical response to interferon, histological activity index, and degree of fibrosis/cirrhosis. HCV genotyping was performed by sequencing the NS-5 region. HGV quantitation was performed using a research-based branched DNA (bDNA) assay with a set of probes directed at the 5' untranslated region. RESULTS: HGV was detected in 10 of 49 patients (20%) before transplant and in 13 of 65 patients (20%) treated with interferon. There was a female predominance among HGV-positive compared with HGV-negative transplant patients (80% vs 20%; p < 0.01), but such a difference was not observed in the interferon-treated group. Hepatic iron concentration was lower in hepatic explants from patients who were HGV- positive than in those who were HGV-negative (318 ± 145 μg/g dry weight vs 1497 ± 2202 μg/g dry weight; p = 0.02). HCV exposure after 1980 was more common in the HGV-positive patients than in those who were HGV-negative for the entire study population (10 of 20 [50%] vs 16 of 66 [24%]; p = 0.03), as well as for the nontransplant subgroup (8 of 12 [67%] vs 12 of 39 [31%]; p = 0.03). HGV RNA levels declined at 1 yr after transplant in seven of eight patients. Among nine patients tested during or after interferon treatment, HGV RNA levels declined from pretreatment levels in all and disappeared in three. CONCLUSIONS: Among patients with chronic hepatitis C treated with either interferon or liver transplantation, the frequency of coinfection with HGV is about 20%. HGV may be a more recent virus in the US than HCV. Coinfection with HGV does not appear to affect the likelihood of response to interferon in patients with hepatitis C. Finally, HGV RNA levels appear to decline after both liver transplantation and interferon therapy, suggesting possible suppression by increased HCV replication in the former case, and a possible drug treatment effect in the latter.

AB - OBJECTIVES: Hepatitis G virus (HGV) is a recently discovered member of the flavivirus family that has been associated with acute and chronic hepatitis. HGV infection has been reported to coexist in 10-20% of patients with chronic hepatitis C. The significance of simultaneous infection with HGV and hepatitis C virus (HCV) remains to be clarified, as do the effects on HGV of therapeutic interventions such as interferon treatment or liver transplantation. The aims of our study were: 1) to examine the frequency of HGV infection in the settings of liver transplantation and interferon therapy for hepatitis C; and 2) to compare HGV RNA levels before and after liver transplantation or interferon treatment. METHODS: Pre-treatment sera were available in 65 patients with chronic hepatitis C treated with interferon; pretransplant sera were available in 49 patients transplanted for end stage liver disease associated with chronic hepatitis C. Information collected included age, sex, risk factors for hepatitis, concurrent liver disease, patient and allograft survival, biochemical response to interferon, histological activity index, and degree of fibrosis/cirrhosis. HCV genotyping was performed by sequencing the NS-5 region. HGV quantitation was performed using a research-based branched DNA (bDNA) assay with a set of probes directed at the 5' untranslated region. RESULTS: HGV was detected in 10 of 49 patients (20%) before transplant and in 13 of 65 patients (20%) treated with interferon. There was a female predominance among HGV-positive compared with HGV-negative transplant patients (80% vs 20%; p < 0.01), but such a difference was not observed in the interferon-treated group. Hepatic iron concentration was lower in hepatic explants from patients who were HGV- positive than in those who were HGV-negative (318 ± 145 μg/g dry weight vs 1497 ± 2202 μg/g dry weight; p = 0.02). HCV exposure after 1980 was more common in the HGV-positive patients than in those who were HGV-negative for the entire study population (10 of 20 [50%] vs 16 of 66 [24%]; p = 0.03), as well as for the nontransplant subgroup (8 of 12 [67%] vs 12 of 39 [31%]; p = 0.03). HGV RNA levels declined at 1 yr after transplant in seven of eight patients. Among nine patients tested during or after interferon treatment, HGV RNA levels declined from pretreatment levels in all and disappeared in three. CONCLUSIONS: Among patients with chronic hepatitis C treated with either interferon or liver transplantation, the frequency of coinfection with HGV is about 20%. HGV may be a more recent virus in the US than HCV. Coinfection with HGV does not appear to affect the likelihood of response to interferon in patients with hepatitis C. Finally, HGV RNA levels appear to decline after both liver transplantation and interferon therapy, suggesting possible suppression by increased HCV replication in the former case, and a possible drug treatment effect in the latter.

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