Anti-hepatitis G E2 Antibody Detection and Its Relation to Serum HGV-RNA in Patients with Clotting Disorders: High Prevalence of HGV Infection and Spontaneous Remission

L. Sheng; A. Soumillion; K. Peerlinck; C. Verslype; R. Schelstraete; F. Gyselinck; M.-P. Emonds; G. Hess; J. Vermylen; J. Desmyter; S. H. Yap

doi:10.1055/s-0037-1615059

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1998; 79(04): 752-755
DOI: 10.1055/s-0037-1615059

Rapid Communication

Schattauer GmbH

Anti-hepatitis G E2 Antibody Detection and Its Relation to Serum HGV-RNA in Patients with Clotting Disorders: High Prevalence of HGV Infection and Spontaneous Remission

L. Sheng

¹From the Division of Liver and Pancreatic Diseases

,

A. Soumillion

¹From the Division of Liver and Pancreatic Diseases

,

K. Peerlinck

²From the Division of Bleeding and Vascular Diseases, Department of Medicine

,

C. Verslype

¹From the Division of Liver and Pancreatic Diseases

,

R. Schelstraete

⁵From the Blood Transfusion Center, Rode Kruis Vlaanderen, Leuven, Belgium

,

F. Gyselinck

¹From the Division of Liver and Pancreatic Diseases

,

M.-P. Emonds

⁵From the Blood Transfusion Center, Rode Kruis Vlaanderen, Leuven, Belgium

,

G. Hess

⁴From the Boehringer Mannheim, Germany

,

J. Vermylen

²From the Division of Bleeding and Vascular Diseases, Department of Medicine

,

J. Desmyter

³From the Department of Microbiology Rega Institute and University Hospitals

,

S. H. Yap

¹From the Division of Liver and Pancreatic Diseases

› Author Affiliations

Abstract

Summary

In a previous study, we have determined the prevalence of serum HGV-RNA in patients with congenital clotting disorders. Twenty-six (15%) of 175 patients investigated were serum HGV-RNA positive. In addition, HGV-RNA was detectable in peripheral blood mononuclear cells (PBMC) in ten percent of the cases, three of these patients were serum HGV-RNA negative.

In the present study, we have determined the prevalence of anti-HGV-E2 antibodies in the same patient population. Anti-HGV-E2 as determined by ELISA was detected in 45 patients (25.7%). Forty of these patients were serum HGV-RNA negative.

Ninety-two percent of the 26 HGV viremic patients and all but one patient (44 patients) with detectable anti-HGV-E2 had coinfection with the hepatitis C virus (HCV). Of these coinfected patients, 62.5% of HGV viremic patients and 53% of anti-HGV-E2 positive patients showed elevated serum ALT levels. Anti-HGV-E2 seroconversion is thus not associated with HCV infection. Two patients who were solely infected with HGV had normal serum ALT levels. In a retrospective longitudinal study, we have observed in 15 patients that serum HGV-RNA persisted during one to 19 years of follow-up, while anti-HGV-E2 was repeatedly negative. Five additional patients who were anti-HGV-E2 positive with concomitant detectable HGV-RNA (4 patients in serum and 1 patient in PBMC) became HGV-RNA negative during follow-up, ranging from 1 to 8 years after the first detection of anti-HGV-E2 antibodies. Two patients had lost anti-HGV-E2 antibodies 3 to 6 years after the seroconversion without the re-appearance of serum HGV-RNA. From these findings, it is clear that the prevalence rate of HGV infection in patients with clotting disorders as determined by PCR assay for HGV-RNA and anti-HGV-E2 by ELISA is actually higher than the prevalence of HGV viremia. Although HGV viremia may persist for longer than 19 years, most of the patients infected with HGV may clear the viremia spontaneously. The clearance of viremia is usually associated with seroconversion to anti-HGVE2. In addition, anti-HGV-E2 may be lost during years of follow-up without the reappearance of the HGV-RNA. Although HGV infection does not seem to influence the fate of HCV infection and does not induce increased levels of serum ALT, the clinical significance of long-term infection remains to be established.

Full Text

References

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