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GB hepatitis agent in cadaver organ donors and their recipients
B V Murthy1, A S Muerhoff, S M Desai
1Division of Nephrology, Department of Medicine, New England Medical Center, Boston, Massachusetts 02111, USA.
Insights
Hepatitis GB virus-C (GBV-C) RNA was detected in 8.3% of organ donors, and while transmission occurred, it did not significantly impact post-transplant outcomes in this study. Further research is needed to confirm transmission risks.
Area of Science:
- Virology
- Hepatology
- Transplantation Immunology
Background:
- The emergence of Hepatitis GB virus-C (GBV-C) necessitates understanding its prevalence and clinical impact.
- This study investigates GBV-C infection in cadaver organ donors and recipients, examining clinical and laboratory characteristics.
Purpose of the Study:
- To determine the prevalence of GBV-C RNA in cadaver organ donors.
- To assess the clinical and laboratory characteristics associated with GBV-C infection in donors.
- To evaluate the transmission of GBV-C to organ recipients and its impact on post-transplantation outcomes.
Main Methods:
- Stored sera from cadaver organ donors across the US were tested for GBV-C RNA using RT-PCR.
- Donors were previously screened for Hepatitis C Virus (HCV) infection.
- Pre- and post-transplantation clinical data were collected for recipients from GBV-C RNA-positive and -negative donors.
Main Results:
- GBV-C RNA prevalence was 8.3% in organ donors, higher than HCV RNA (2.4%).
- Factors associated with GBV-C infection included high blood alcohol levels and positive anti-HCV tests.
- While GBV-C transmission to recipients occurred, post-transplantation liver disease, graft, and patient survival rates were not significantly different.
Conclusions:
- GBV-C can be transmitted through organ transplantation, but definitive conclusions on its impact require further investigation.
- Additional studies are necessary to fully understand the risks of GBV-C transmission and its role in post-transplant liver disease.
Background:
The cloning of yet another hepatitis virus, GB virus-C (GBV-C), has provided the opportunity to study the prevalence, and clinical and laboratory characteristics, associated with GBV-C infection among cadaver organ donors and recipients of organs from infected donors.
Methods:
Stored sera from a cohort of cadaver organ donors from eight organ procurement organizations, representing different geographic regions of the United States previously screened for hepatitis C virus (HCV) infection, were tested for GBV-C RNA by polymerase chain reaction using degenerate primers derived from the NS3 helicase and 5'-untranslated regions of the GBV-C genome. Pre- and posttransplantation clinical data, and prevalence of GBV-C RNA among recipients of organs from GBV-C RNA-positive and -negative donors, were studied at one of the organ procurement organizations.
Results:
Twenty-one of 76 (27.6%) anti-HCV ELISA1-positive donors tested positive for GBV-C RNA compared with 6 of 82 (7.3%) ELISA1-negative donors (P=0.001). The prevalence of GBV-C RNA, extrapolated to all cadaver organ donors, was 8.3% (95% confidence interval [CI]: 5.6-11.1%) and was higher than the prevalence of HCV RNA (2.4%). Among ELISA1-positive donors, GBV-C RNA was present in 13 of 35 (37%) donors with HCV RNA, compared with 8 of 41 (20%) donors without HCV RNA (odds ratio [OR]=2.44, P=0.09). Blood alcohol level of more than 100 mg/dl (OR=9.43, P=0.05) and a positive anti-HCV ELISA2 (OR=4.58, P=0.001) were significantly associated with GBV-C infection. In addition, there was a trend toward an association between history of drug abuse (OR=5.23, P=0.06) and younger age (OR=0.97/year, P=0.06) with GBV-C infection. Organs from four GBVC-positive donors and 47 GBV-C-negative donors procured by the New England Organ Bank (Newton, MA) were transplanted into 6 and 79 recipients, respectively. Among recipients of organs from GBV-C RNA. positive donors, the posttransplantation prevalence of GBV-C RNA (25%) was not significantly higher than among recipients of organs from GBV-C RNA-negative donors (23%). Among recipients in whom both pre- and posttransplantation sera were available, one of three (33%) recipients of kidneys from GBV-C RNA-positive donors acquired GBV-C RNA after transplantation, compared with 4 of 40 (10%) recipients of kidneys from GBV-C RNA-negative donors. After a median follow up of 6 years, the posttransplantation prevalence of liver disease, and graft and patient survival, were not significantly different between recipients of organs from GBV-C RNA-positive and -negative donors.
Conclusions:
Although GBV-C could be transmitted by organ transplantation, the results of this study preclude definitive conclusions. Further studies are required to determine the risk of transmission of GBV-C by organ transplantation and its role in posttransplantation liver disease.