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Blood, Vol. 94 No. 12 (December 15), 1999:
pp. 4333-4336
TT Virus Is Present in a High Frequency of Italian Hemophilic Patients
Transfused With Plasma-Derived Clotting Factor Concentrates
Benjamin P. Chen,
Maria Grazia Rumi,
Massimo Colombo,
Yu-Huei Lin,
Latha Ramaswamy,
Jac Luna,
Jen-Kuei Liu,
Daniele Prati, and
Pier
Mannuccio Mannucci
From Sentinel BioSciences, Inc, Palo Alto, CA; the Department of
Internal Medicine, Blood Transfusion and Transplant Immunology Center,
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Maggiore
Hospital, University of Milan, Milan, Italy.
The prevalence of the blood-borne TT virus (TTV) in Italian
hemophiliacs treated with different preparations of factor VIII was
determined. Of the 178 hemophilic patients (mean age, 29 years), TTV-DNA was found in 123 (69%), in comparison to 22 of 100 (22%) blood donors (P < .0001). Of the 123 patients who tested
positive for TTV, significant numbers were also infected with human
hepatitis viruses and/or human immunodeficiency virus (HIV): 31% had
TTV and hepatitis C virus (HCV), 22% had TTV, and at
least 2 of the 4 known human blood-borne viruses tested, whereas 15%
had TTV alone. The risk of acquiring TTV alone was only slightly higher in recipients of unmodified plasma factor concentrates (78%, odds ratio, 1.24; 95% confidence interval [CI], 0.27 to
5.79) than in patients treated with virus inactivated concentrates
(67%), whereas the risk was significantly lower in recipients of
recombinant factors (11%, odds ratio, 0.09; 95% CI, 0.01 to 0.52).
Serum alanine aminotransferase (ALT) levels were elevated in 2 of 27 patients (7%) with TTV alone compared with 43 of 56 patients (77%)
coinfected with TTV and HCV and compared with 16 of 21 patients (76%)
with HCV alone. Taken together, these results indicate that TTV
frequently infects Italian hemophiliacs treated with plasma-derived
factor VIII concentrates, both unmodified and virus-inactivated. Our results do not suggest a causal effect of TTV on chronic liver disease
in these patients.
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