Hepatitis C is a major health problem and at present, interferon-alpha is the only therapy of proven use. Two viral factors, namely HCV genotype and viraemia levels, have been studied extensively for their possible role in the clinical management of patients with chronic hepatitis C virus infection. This review attempts to summarize our current understanding of these two viral factors and provide recommendations as to how these two parameters should be used by general practitioners, practising gastroenterologists/hepatologists, and investigators in 1997.

To determine the prevalence and clinical significance of hepatitis G virus (HGV)/GB virus C (GBV-C) infection in renal transplant recipients, prospectively collected serum samples from a cohort of cadaveric renal transplant patients were studied for the presence of HGV RNA using a sensitive reverse transcription 'nested'-polymerase chain reaction (RT-PCR) based on primers derived from the 5' untranslated region. All positive PCR amplicons were sequenced bidirectionally and aligned. The nucleotide substitution rate was estimated by the 6-parameter method, and a phylogenetic tree was constructed using the Neighbour-joining method. HGV RNA was detected in 11/93 (12%) patients pretransplant and in 15/90 (17%) patients 1-4 years post-transplant. All PCR amplicons were confirmed to be specific for HGV by sequencing. Phylogenetic tree construction revealed that 17 PCR amplicons had sequences related to HGV and one had a sequence related to GBV-C. Two HGV RNA-positive patients pretransplant became HGV RNA negative post-transplant, and seven HGV RNA-negative patients pretransplant became HGV RNA positive post-transplant. There was no relationship between hepatitis C virus (HCV) and HGV infection. There were also no differences in age, gender distribution, ethnic origin, the total number of blood units transfused and either graft or patient survival between patients who were positive or negative for HGV RNA. We conclude that HGV infection is common among renal transplant candidates and recipients. Most of the isolates had sequences related to the HGV prototype. HGV infection does not appear to adversely affect clinical outcome in renal transplant recipients during early follow-up.

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