Infection with hepatitis G-virus and viral hepatitis in India

Association of a new non-A-E hepatitis virus designated as hepatitis G virus (HGV) or GBV-C with acute and chronic hepatitis, particularly with fulminant hepatic failure is not clearly understood. In view of paucity of data on the prevalence of HGV in India where viral hepatitis is a major public health problem, we have examined the presence of HGV infection in patients with acute viral hepatitis (AVH), fulminant hepatic failure (FHF) and in normal healthy blood donors. HGV-RNA sequences were detected in patient's serum by reverse transcription plus nested polymerase chain reaction (RT-PCR) using primer sequences located in the conserved NS3 helicase region of the HGV genome. Serum samples collected from 36 acute viral hepatitis, 16 fulminant hepatic failure and 50 healthy voluntary blood donors who did not have symptoms of viral infection or liver disease were recruited for the study. HGV-RNA was detected in 6 (37.5%) of 16 patients with fulminant hepatic failure, in 7 (19.4%) of 36 acute viral hepatitis, and two (4%) in 50 control blood donors. Of the 6 HGV positive FHF patients, only one (1/6; 16.6%) was in non A-E category while 5 (20.0%) patients were HGV positive out of the 25 non A-E AVH cases. In both AVH and FHF, HGV was more frequently detected in (8/13; 61.5%) patients co-infected with other hepatotropic viruses and the most common co-infections were found to be HEV (6/8; 75%) and HBV (5/8; 62.5%). The frequency of hepatitis G virus is found to be certainly higher (37.5%) in fulminant hepatic failure than that in any other type of viral hepatitis in India. But since the virus is often detected in co-infection with either hepatitis B or E virus, which are known potential hepatitis agents, the role of HGV as an independent hepatitis agent is uncertain