Prevalence of hepatitis G virus and its strain variant, the GB agent, in blood donations and their transmission to recipients

Abstract

Background: Hepatitis G virus (HGV) and its strain variant, the GB agent (GBV-C) are independent isolates of a recently identified non-A through -E hepatitis virus. Prevalence in United States volunteer blood donors is 1.5 to 1.9 percent, but no data on European blood donors are available. Epidemiologic data suggest a preferred parenteral transmission route. The prevalence of HGV/GBV-C in European blood donors and the efficiency of transmission to transfusion recipients were investigated.

Study design and methods: Plasma samples from unpaid volunteer German blood donors were tested for HGV/GBV-C by in-house reverse transcription-polymerase chain reaction. Positive donors were independently retested and interviewed for parenteral transmission risks. Amplification products were sequenced and subjected to phylogenetic analysis. Recipients of reverse transcription-polymerase chain reaction-positive donations were traced and tested for HGV/GBV-C infection.

Results: A total of 14 (1.34%) of 1048 donors (alanine aminotransferase < 45 IU/L) were repeatedly positive for HGV/GBV-C with 9 (2.18%) of 413 urban and 5 (0.78%) of 635 rural donors (chi 2-test; p = 0.04). Isolates differed in nucleotide sequence homology over a range of 12.5 to 19.6 percent. All but one positive donor reported parenteral transmission risks. Transmission of HGV/GBV-C was detected in 4 of 9 transfusion recipients. The prevalence of HGV/GBV-C in donors with an alanine aminotransferase level > 45 IU per L was 3 percent (3/100). Two mother/child pairs were identified with highly homologous isolates.

Conclusion: A significantly greater prevalence of HGV/GBV-C was detected in urban volunteer blood donors than in rural donors. The high prevalence in urban donors (2.18%) suggests specific transmission risks for this group. The less than 50-percent efficiency of HGV/GBV-C transmission via blood components may indicate the presence of defective viruses with reduced infectivity. There is evidence for vertical transmission.