Hepatitis G virus in clotting factor concentrates

Abstract

Blood-borne hepatitis is a well-known complication in patients with bleeding disorders. A recently discovered parentally transmitted virus, hepatitis G [GB virus C (GBV-C)] has an increased prevalence in patients with haemophilia. Clotting factor concentrates derived from pools of human plasma currently undergo viral inactivation techniques known to be effective against hepatitis B, C and HIV; however, the effectiveness of current purification and viral inactivation techniques against newly discovered viruses such as GBV-C is unknown. A total of 37 vials of clotting factor concentrates manufactured in the USA from 1981 to 1995 were tested for the presence of GBV-C virus. All samples that did not undergo a specific viral inactivation step were positive for GBV-C. Viral inactivation techniques that did not uniformly remove GBV-C included vapour heat treatment and dry heat treatments for less than 144 h. All samples treated by pasteurization, solvent detergent or dry heat for 144 h, were negative for the presence of GBV-C.

Comparison of GB virus C, HIV, and HCV infection markers in hemophiliacs exposed to non-inactivated or inactivated factor concentrates

“…Finally, our data confirm the findings of Jarvis et al (1996), Garcia-Trevijano et al (1996), Yamada-Osaki et al (1998), andAlonso-Rubiano et al (2003) that the introduction of effective virus-inactivation procedures for plasma pools dramatically reduced the rate of GBV-C, HCV, and HIV transmission. The solitary HCV infection in the group of hemophiliacs who received exclusively virus-inactivated clotting factor was possibly caused by the donation of several blood transfusions due to acute bleedings in 1985/1986.…”

“…Previous studies have shown an extremely high rate of GBV-C contamination (up to 100%) of non-virus-inactivated blood products (Jarvis et al, 1996;Garcia-Trevijano et al, 1996;Alonso-Rubiano et al, 2003). Interestingly, we did not find any correlation between the amount of consumed non-inactivated clotting factor and the rate of GBV-C transmission.…”

“…The overall prevalence of GBV-C infection markers was significantly lower than the prevalence of HCV infection (40.3% versus 98.6%). Since almost all non-virus-inactivated clotting factor concentrates appear to be contaminated with GBV-C (Jarvis et al, 1996;Garcia-Trevijano et al, 1996;Alonso-Rubiano et al, 2003) the relatively low rate of detected GBV-C markers in the recipients could be a consequence of lower infectivity compared to HCV. Underestimation due to potential suboptimal assay procedures and loss of anti-E2 antibodies after GBV-C clearance (Devereux et al, 1998;Stark et al, 1999) could also have minor effects on the identification rate of infection.…”

“…The solitary HCV infection in the group of hemophiliacs who received exclusively virus-inactivated clotting factor was possibly caused by the donation of several blood transfusions due to acute bleedings in 1985/1986. The GBV-C infections of three hemophiliacs who received exclusively virus-inactivated clotting factor concentrates are likely to be caused by alternative routes of transmission since virus-inactivation steps has led not only to the elimination of GBV-C transmissions (Yamada-Osaki et al, 1998) but even to the disappearance of GBV-C RNA in virus-inactivated clotting factor (Jarvis et al, 1996;Alonso-Rubiano et al, 2003).…”