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A prospective study of transfusion-transmitted GB virus C infection: similar frequency but different clinical
1Department of Bacteriology, School of Medicine, College of Medicine, National Taiwan University, Taipei.
Insights
GB virus C (GBV-C) infection is transmitted via blood transfusions in about 9% of cardiac surgery patients. This GBV-C RNA virus rarely causes hepatitis, even when persisting for years.
Area of Science:
- Virology
- Hepatology
- Transfusion Medicine
Background:
- GB virus C (GBV-C) is a flavivirus that can be transmitted through blood transfusions.
- The clinical significance and transmission dynamics of GBV-C in transfusion recipients remain incompletely understood.
Purpose of the Study:
- To determine the incidence and clinical outcomes of GBV-C infection in adult blood recipients undergoing cardiac surgery.
- To assess the risk of GBV-C transmission per donor and the long-term viral persistence.
Main Methods:
- Prospective study analyzing serum samples from 400 adult cardiac surgery patients.
- Detection of GBV-C RNA using nested polymerase chain reaction (PCR).
- Coinfection analysis with hepatitis C virus (HCV) and testing for hepatitis G virus (HGV) sequences.
Main Results:
- GBV-C RNA was detected in 40 (10%) of 400 patients; transmission risk was estimated at 0.46% per donor.
- GBV-C viremia was detectable within 1 week post-transfusion and persisted up to 8 years.
- Most GBV-C infected patients (25/32) showed no evident symptoms or significant elevation in alanine aminotransferase (ALT) levels; coinfection with HCV did not alter hepatitis course.
Conclusions:
- GBV-C transfusion transmission occurs in approximately 9% of cardiac surgery patients.
- GBV-C infection is generally asymptomatic and does not appear to cause classic hepatitis in most recipients.
- High concordance between GBV-C and HGV RNA detection suggests they are the same virus.
Abstract:
To study the incidence and outcome of GB virus C (GBV-C) infection in blood recipients. Serum samples collected in a prospective study were examined for GBV-C RNA by a nested polymerase chain reaction assay. Among the 400 adults who underwent cardiac surgery, 40 were positive for GBV-C RNA, including six whose pretransfusion sera were already positive and seven coinfected with hepatitis C virus (HCV) during transfusion. The risk of transmission was estimated to be approximately 0.46% per donor. GBV-C viremia was detectable 1 week after transfusion and could persist for 8 years. However, no evident symptoms or signs were noted in the 25 patients infected by GBV-C alone, and the average peak serum alanine aminotransferase activity was 31 IU/L only (range, 12 to 123), with persistently normal levels in 20 patients. In the seven patients coinfected with HCV, the clinical courses of posttransfusion hepatitis were similar to those infected by HCV alone. In eight patients with posttransfusion non-A approximately E hepatitis, only one was positive for GBV-C RNA. Sixty samples were chosen to test hepatitis G virus (HGV) sequences, 26 of the 30 GBV-C positives were positive for HGV RNA in contrast to none of the 30 GBV-C negative samples. In conclusion, GBV-C can be transmitted by transfusion in approximately 9% of patients who underwent cardiac surgery. Nevertheless, this virus does not seem to cause classic hepatitis in most instances.