Blood, Vol. 93 No. 2 (January 15), 1999:
pp. 721-727
Persistence and Clinical Outcome of Hepatitis G Virus Infection
in Pediatric Bone Marrow Transplant Recipients and Children Treated
for Hematological Malignancy
Maki Yamada-Osaki,
Ryo Sumazaki,
Masahiro Tsuchida,
Kazutoshi Koike,
Takashi Fukushima, and
Akira Matsui
From the Department of Pediatrics, University of Tsukuba, Tsukuba,
Japan; and the Department of Pediatrics, Ibaraki Children's Hospital,
Ibaraki, Japan.
The natural course and the clinical significance of hepatitis G
virus (HGV) infection were investigated in 106 pediatric patients who
received chemotherapy for hematological malignancy or underwent bone
marrow transplantation (BMT) using HGV-RNA and antibodies to the HGV-E2
protein (anti-E2). HGV markers were detected in 21 patients (19.8%;
HGV-RNA in 19 and anti-E2 in 2). Longitudinal analysis of these
HGV-infected patients showed that 1 had anti-E2 before the initial
blood transfusion, 14 had persistent viremia, and 6 became clear of
circulating HGV-RNA after completion of therapy, although 5 of the 6 HGV-cleared patients never developed anti-E2. Reactivation of HGV
infection during chemotherapy was observed in two anti-E2-positive,
HGV-RNA-negative patients; the reappearance of the same HGV strain was
confirmed by phylogenetic analysis. Among BMT survivors without other
known causes of liver dysfunction, HGV-RNA-positive patients had a
higher peak serum alanine amino transferase (ALT) value
than negative patients. Contrary to previous reports, immunosuppressed
patients can apparently recover from HGV infection without detectable
anti-E2 and some patients who supposedly recovered from HGV infection
can nonetheless suffer exacerbation when subsequently immunosuppressed.
