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

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.