Hepatitis G virus (HGV) infection in voluntary and commercial blood donors in India

Review of human pegivirus: Prevalence, transmission, pathogenesis, and clinical implication

Human pegivirus (HPgV-1), previously known as GB virus C (GBV-C) or hepatitis G virus (HGV), is a single-stranded positive RNA virus belonging to the genus Pegivirus of the Flaviviridae family. It is transmitted by percutaneous injuries (PIs), contaminated blood and/or blood products, sexual contact, and vertical mother-to-child transmission. It is widely prevalent in general population, especially in high-risk groups. HPgV-1 viremia is typically cleared within the first 1–2 years of infection in most healthy individuals, but may persist for longer periods of time in immunocompromised individuals and/or those co-infected by other viruses. A large body of evidences indicate that HPgV-1 persistent infection has a beneficial clinical effect on many infectious diseases, such as acquired immunodeficiency syndrome (AIDS) and hepatitis C. The beneficial effects seem to be related to a significant reduction of immune activation, and/or the inhabitation of co-infected viruses (e.g. HIV-1). HPgV-1 has a broad cellular tropism for lymphoid and myeloid cells, and preferentially replicates in bone marrow and spleen without cytopathic effect, implying a therapeutic potential. The paper aims to summarize the natural history, prevalence and distribution characteristics, and pathogenesis of HPgV-1, and discuss its association with other human viral diseases, and potential use in therapy as a biovaccine or viral vector.

Human pegivirus type 1 infection in Asia-A review of the literature

The human pegivirus type 1 (HPgV-1)-as known as hepatitis G virus and GB virus C-is a common single-stranded RNA flavivirus. Because few studies have demonstrated an association between HPgV-1 infection and disease, screening for HPgV-1 is not performed routinely. Nonetheless, a beneficial impact of HPgV-1 infection on HIV disease progression has been reported in multiple studies. Given the burden of HIV in Asia and the complex interactions between viral co-infections and the host, we provide a comprehensive overview of the existing data from Asia on HPgV-1 infection, including the prevalence and circulating genotypes in all Asian countries with data reported. This review highlights the research conducted thus far and emphasizes the need for additional studies on HPgV-1 across the Asian continent.

Global prevalence of human pegivirus-1 in healthy volunteer blood donors: a systematic review and meta-analysis

BACKGROUND AND OBJECTIVES

The local prevalence of HPgV-1 has been reported from different countries worldwide, but the global prevalence of HPgV-1 remains unknown. The aim of this systematic review and meta-analysis was to gather data from the literature to estimate the prevalence of HPgV-1 in healthy volunteer blood donors in the world.

MATERIALS AND METHODS

We searched PubMed, EMBASE, Scopus and Google Scholar databases for records up to January 2019 and included studies reporting HPgV-1 virus prevalence amongst healthy volunteer blood donors based on the detection of HPgV-1 RNA.

RESULTS

In all, we included 79 studies for the systematic review and 63 for the meta-analysis. Based on the random effect meta-analysis of 35 468 volunteer blood donors, we found the global prevalence of HPgV-1 to be 3·1% (95% CI, 2·4-4·1). The pooled prevalences of HPgV-1 were 1·7% (95% CI, 1·1-2·6) in North America, 9·1% (95% CI, 6·4-12·7) in South America, 2·3% (95% CI, 2%, 2·8) in Europe and 2·4% (95% CI, 1·4-4) in Asia. Subgroup analyses based on age, gender or risk factors were not possible.

CONCLUSION

Approximately 3 in 100 blood donations worldwide are positive for HPgV-1 increasing the risk of infection from transfusion of their components to subsequent recipients. Further research on virus pathogenicity is required before recommending routine screening of HPgV-1 for healthy volunteer blood donors.

Emerging infectious threats to the blood supply: seroepidemiological studies in iran - a review

SUMMARY

The risk of transfusion-transmitted infections has been greatly reduced by improvements in donor screening and testing. However, newly recognized blood-borne infectious agents can be threats to blood safety. In order to evaluate the prevalence some of these agents in blood donors, a systematic review was conducted. Data were obtained from published papers related to HGV, Torque Teno virus (TTV), HTLV, West Nile virus (WNV) and SEN virus (SEN-V). Based on these studies, the prevalence of HGV varied from 1 to 8.6% for anti-E2 and from 0 to 4.8% for HGV RNA. The prevalence of TTV DNA and HTLV-I varied from 2.7 to 79.5% and from 0.013 to 2.3%, respectively. The WNV-specific IgM antibody and WNV RNA are negative in blood donors. Prevalence rates of SEN-V in Iranian blood donors range from 23 to 90.8%. Consequences of these infectious agents for blood safety are different. Thus, the need to perform laboratory screening as well as effectiveness and efficiency of laboratory tests depend on pathogenicity level and epidemiological conditions of emerging infections. However, being prepared based on the current level of risk and interventions to reduce the risk can be effective in reducing the potential threat for blood supply.

Viral hepatitis in India

Hepatitis in India is caused mainly by hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis E virus (HEV). HAV infection occurs frequently in children, though in parts of India there is an evolving epidemiology. HEV is the most common cause of acute sporadic hepatitis in India and has been associated with several large-scale epidemics in the past. India belongs to the intermediate endemicity zone for HBV carriers. HBV is the major cause of chronic liver disease and liver cancer. Horizontal transmission of HBV plays an important role. Genotypes D, A, and C have been reported in India. HCV is transmitted mainly through suboptimal blood banking and injection practices in India. Genotype 3 is the most predominant, followed by genotype 1.

Hepatitis-G virus infection in multi-transfused patients and intravenous drug abusers: New Delhi experience

Hepatitis G virus (HGV) is a newly described virus that has been implicated in transfusion-associated hepatitis. HGV-RNA indicating current infection has frequently been isolated from the sera of multi-transfused patients (MTPs) and that of intravenous drug abusers (IVDAs). There is insufficient data on its prevalence among these high-risk groups in India. Hence this study was designed to evaluate the prevalence of HGV infection in MTPs and IVDAs. A total of 90 (57 males and 33 females) MTPs and 65 (44 males and 21 females) IVDAs were recruited in the study. Patients' sera were tested for liver function profile, HGV-RNA, anti-HCV, HCV-RNA, HBsAg, and HBV-DNA. HGV-RNA was detected in 17.7% (16/90) MTPs and 23% (15/65) IVDAs, and 93.5% of our HGV-positive patients were found to be co-infected with either HBV (38.7%) or HCV (74.1%). The sero-prevalence of HBV was found out to be 40% and 21.5%, respectively, in the two groups, that of HCV was 32.2% and 32.3%, respectively, and dual infection was observed in 15.5% and 10.7% of the subjects, respectively. There were no statistically significant differences between the clinical, biochemical, and serological profiles of HGV-positive and negative patients. The prevalence of HGV infection in these high-risk groups is significantly higher than in controls. HGV is found to be co-infected more frequently with HCV than with HBV.

Prokaryotical expression of structural and non-structural proteins of hepatitis G virus

AIM: To study the epitope distribution of hepatitis G virus (HGV) and to seek for the potential recombinant antigens for the development of HGV diagnositic reagents.

METHODS: Fourteen clones encompassing HGV gene fragments from core to NS3 and NS5 were constructed using prokaryotic expression vector pRSE T and (or) pGEX, and expressed in E. coli. Western blotting and ELISA were used to detect the immunoreactivity of these recombinant proteins.

RESULTS: One clone with HGV fragment from core to E1 (G1), one from E2 (G31), three from NS3 (G6, G61, G7), one from NS5B (G821) and one chimeric fragment from NS3 and NS5B (G61-821) could be expressed well and showed obvious immunoreactivity by Western blotting. One clone with HGV framment from NS5B (G82) was also well expressed, but could not show immunoreactivity by Western blotting. No obvious expression was found in the other six clones. All the expressed recombinant proteins were in inclusion body form, except the protein G61 which could be expressed in soluble form. Further purified recombinant proteins G1, G31, G61, G821 and G61-821 were detected in indirected ELISA as coating antigen respectively. Only recombinant G1 could still show immunoreactivity, and the other four recombinant proteins failed to react to the HGV antibody positive sera. Western blotting results indicated that the immunoactivity of these four recombinant proteins were lost during purification.

CONCLUSION: Core to E1, E2, NS3 and NS5 fragment of HGV contain antigenic epitopes, which could be produced in prokaryotically expressed recombinant proteins. A high-yield recombinant protein (G1) located in HGV core to E1 could remain its epitope after purification, which showed the potential that G1 could be used as a coating antigen to develop an ELISA kit for HGV specific antibody diagnosis.