Dynamics of GB Virus C viremia early after orthotopic liver transplantation indicates extrahepatic tissues as the predominant site of GB virus C replication

Abstract

The principal site of GB virus C (GBV-C) replication is unknown. To determine whether hepatic GBV-C replication is important for the maintenance of a measurable viremia level in GBV-C infection, the influence of hepatectomy followed by liver transplantation on GBV-C viremia was investigated. GBV-C RNA levels were determined by a quantitative TaqMan polymerase chain reaction (PCR) in 12 patients with pretransplantation GBV-C infection before and daily after orthotopic liver transplantation (OLT) for 25 to 28 days. Compared with the pretransplantation values (mean, 12.4 ؎ 3.9 ؋ 10 7 copies/mL), mean GBV-C RNA levels declined significantly by 1 log by day 1 after OLT (mean, 3.5 ؎ 1.6 ؋ 10 7 copies/mL), but subsequently remained relatively stable on this high level for the entire observation period, indicating ongoing high-level virus replication (mean GBV-C RNA levels on days 7 and 28 were: 1.7 ؎ 0.5 ؋ 10 7 and 2.8 ؎ 0.7 ؋ 10 7 copies/mL; P ‫؍‬ ns). Thus, at the end of the follow-up, mean GBV-C RNA levels were not significantly different from that of the 1st and 7th postoperative day and remained significantly lower compared with the pretransplantation values. However, in 2 of the 12 patients, different kinetics were observed. Both already had low-level viremia pre-OLT (0.02 and 0.002 ؋ 10 7 copies/mL) and became persistently GBV-C RNAnegative 2 days after OLT. In 5 patients, liver tissues were collected 6 to 9 days after OLT and investigated for GBV-C RNA. All but 1 were GBV-C RNA-negative in the liver, although 2 of them had rather high serum GBV-C RNA levels at this time. The kinetics of GBV-C viremia observed in our study were neither influenced by the immunosuppressive therapy nor by the number of blood and blood product transfusions given after OLT. In addition, they were quite different from those observed in patients with chronic hepatitis C in whom early reinfection of the graft could be demonstrated by a steady increase in HCV RNA levels starting 3 days after OLT and exceeding preoperative levels by day 8. From our data, one can conclude that the liver is certainly not the major site of GBV-C replication in most patients. However, one cannot exclude that host or viral factors exist that predispose GBV-C replication predominantly in the liver. (HEPATOLOGY 1999;29:245-249.)While the epidemiology and clinical aspects of the GB virus C (GBV-C) and hepatitis G virus infection have been extensively studied, little is known about the site of infection, and the hepatotropism of GBV-C/hepatitis G virus has also been questioned.

Molecular epidemiology of GB virus C/hepatitis G virus in Athens, Greece

“…This finding is not surprising given that GBV-C/HGV may not be primarily hepatotropic, at least in a significant proportion of patients [Berg et al, 1999;Laras et al, 1999]. However, studies by other investigators reported the detection of antigenomic strand of GBV-C/HGV RNA in the human liver, a finding presumably compatible with hepatotropism of the virus [Madejon et al, 1997;Saito et al, 1997;Seipp et al, 1999].…”

“…The primary tropism of GBV-C/HGV [Madejon et al, 1997;Saito et al, 1997;Berg et al, 1999;Laras et al, 1999;Seipp et al, 1999] and, consequently, the clinical relevance of infections with the virus remain unclear [Alter et al, 1997;Enomoto et al, 1998;Mushahwar and Zuckerman, 1998]. …”

Major risk of blood transfusion in hemolytic anemia patients

“…Samples were overlaid with mineral oil and transferred to a Biometra Thermal Cycler (Esco Micro Pte Ltd, Singapore City, Singapore), then subjected to 34 cycles of denaturation (948C for 1 min), annealing (508C for 1 min) and extension (728C for 2 min). The sequence of the primers (PS000c, DiaSorin) used for HCV-RNA estimation was as follows: [12]). The expected product sizes were 266 bp.…”

“…The expected product sizes were 266 bp. The PCR products (5 ml) were loaded on a 2% agarose gel ethidium bromide and visualized by ultraviolet fluorescence [12].…”

Diagnostic Value of Serum Level of Soluble Tumor Necrosis Factor Receptor IIα in Egyptian Patients with Chronic Hepatitis C Virus Infection and Hepatocellular carcinoma

“…In addition, the following laboratory parameters were evaluated: liver function tests including serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, albumin (Alb), prothrombin time (PT), and prothrombin concentration, complete blood count (CBC), HBsAg ,anti-HCV Abs (by third generation ELISA), qualitative assessment of HCV-RNA in serum by nested RT-PCR assay (20), AFP by ELISA (21), and serum sTNFR-IIα.…”