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Transfusion‐associated TT virus infection and its relationship to liver disease
Author(s) -
Matsumoto Akihiro,
Yeo Anthony E.,
Shih J. Wai,
Tanaka Eiji,
Kiyosawa Kendo,
Alter Harvey J.
Publication year - 1999
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510300118
Subject(s) - medicine , viremia , hepatitis , liver disease , virology , alanine transaminase , hepatology , blood transfusion , gastroenterology , virus , immunology
TT virus (TTV) has been proposed as the causative agent of non‐A to E hepatitis. We studied the association between TTV viremia and biochemical evidence of hepatitis in blood donors and prospectively‐followed patients. TTV was found in 7.5% of 402 donors and in 11.0% of 347 patients before transfusion. The rate of new TTV infections was 4.7% in 127 nontransfused, and 26.4% in 182 transfused patients ( P < .0001). The risk of infection increased with the number of units transfused ( P < .0001). The rate of new TTV infections in 13 patients with non‐A to E hepatitis (23.2%) was almost identical to the rate in 124 patients who were transfused, but did not develop hepatitis (21.8%). Of 45 patients with acute hepatitis C, 40.0% were simultaneously infected with TTV. TTV did not worsen the biochemical severity (mean ALT: 537 in TTV+; 550 in TTV−) or persistence of hepatitis C. In non‐A to E cases, the mean ALT was 182 in those TTV–positive and 302 in TTV–negatives. No consistent relationship between alanine transaminase level and TTV DNA level was observed in 4 patients with long‐term, sequential samples. Of 21 viremic subjects, 67% cleared TTV within 5 years (38% in 1 year); 33% were viremic throughout follow‐up extending to 22 years. We conclude that TTV is a very common, often persistent infection that is transmitted by transfusion and by undefined nosocomial routes. We found no association between TTV and non‐A to E hepatitis and no effect of TTV on the severity or duration of coexistent hepatitis C. TTV may not be a primary hepatitis virus