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Hepatitis G virus infection in normal and prospectively followed posttransfusion children
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Republic of China.
Insights
Hepatitis G virus (HGV) poses a high risk for children undergoing open heart surgery, with young age increasing chronic infection likelihood. Transfusion-transmitted HGV infection is a significant concern in this pediatric population.
Area of Science:
- Virology
- Hepatology
- Pediatric Infectious Diseases
Background:
- Hepatitis G virus (HGV) is an emerging RNA virus implicated in non-A-E hepatitis.
- The prevalence and clinical significance of HGV infection in pediatric populations require further investigation.
Purpose of the Study:
- To determine the frequency and clinical outcomes of hepatitis G virus infection in children.
- To assess the risk of transfusion-transmitted HGV infection and chronicity in pediatric patients undergoing open heart surgery.
Main Methods:
- Nested reverse transcription-polymerase chain reaction (RT-PCR) was used to detect HGV RNA in serum samples.
- Study included 200 healthy children and 90 children post-open heart surgery.
- Follow-up assessments were conducted up to 1 year post-surgery.
Main Results:
- HGV RNA viremia was detected in 1% of healthy children and 30% of post-surgery patients.
- 28% of children who underwent surgery became viremic within 6 months, with 65% developing persistent infection at 1 year.
- No elevated alanine aminotransferase levels or co-infections with HCV/HBV were observed in HGV-infected children. Younger age was associated with higher rates of chronic carriage.
Conclusions:
- Children undergoing open heart surgery face a high risk of transfusion-transmitted HGV infection and subsequent chronicity.
- Younger age is a significant risk factor for developing persistent HGV infection in this cohort.
- Current anti-HCV screening did not impact HGV infection prevalence, highlighting the need for specific HGV surveillance in at-risk pediatric groups.
Abstract:
A recently identified RNA virus, hepatitis G virus (HGV), has been investigated for its role in causing non-A-E hepatitis. The frequency and clinical outcome of HGV infection in children was studied. Two hundred apparently healthy children aged 6 mo to 12 y, and 90 children who had undergone open heart surgery in a prospective study for posttransfusion hepatitis were included in this study. The serum samples were tested for HGV RNA by nested reverse transcription-PCR with primers from the 5'-untranslated region. The HGV RNA viremic rate was found to be 1% (2/200) in apparently healthy children, 30% in children after open heart surgery. Among the 90 children, three were HGV-infected before the surgery. Twenty-four (28%) of the remaining 87 children tested positive for HGV RNA within 6 mo after the surgery. Sixty-five percents of these viremic children eventually became persistently infected at 1 y after surgery. No HGV RNA-positive children exhibited elevated alanine aminotransferase levels during the follow-up period. No coinfections of HGV with the hepatitis C virus or hepatitis B virus were found. Patients of younger age appeared more likely to become chronic carriers. Anti-HCV screening did not reduce the prevalence of HGV infection. In conclusion, in children with open heart surgery, the risk of transfusion-transmitted HGV infection and the chronicity rate have been found to be high. Young age is a risk factor of persistent infection.