Prevalence and Genotypes of Hepatitis C Virus and GB Virus C/Hepatitis G Virus among HIV-1-Infected High-Risk Behavior Groups in Hawaii

Hepatitis C virus (HCV) and GB virus C/hepatitis G virus (GBV-C/HGV) are two recently discovered flaviviruses.  HCV, which is principally  transmitted by the parenteral route, has emerged as an urgent public health problem.  During the past 30 years, approximately 4 million people in the United States and millions more worldwide have been infected with HCV.  HCV-associated chronic liver disease and hepatocellular carcinoma are predicted to present formidable long-term health-care problems for individuals infected with HIV-1.  By contrast, GBV-C/HGV, which is distantly related to HCV, has not been definitively linked with any human disease. The objective of this study was to determine the prevalence and genotypes of HCV and GBV-C/HGV in 296 HIV-1-infected individuals (208 men, 88 women; mean and median age, 38 years) in Hawaii.  IgG antibodies against HCV and GBV-C/HGV were detected in serum by enzyme immunoassay and specific segments encompassing the 5â-noncoding region of HCV and GBV-C/HGV were amplified by RT-PCR.  The overall prevalence of HCV infection was 66.2% (51/77) among HIV-1-infected individuals who admitted to using injection drugs, compared to 15.2% (31/203) in individuals who likely acquired HIV-1 infection by engaging in high-risk homosexual or heterosexual intercourse.  Overall prevalences of GBV-C/HGV infection, as well as past (Antibody+) and recent (RNA+) infection, were higher among HIV-1-infected individuals engaging in injection drug use (IDU) or homosexual sex than in those acquiring HIV-1 infection by high-risk heterosexual sex (Table 1).  GBV-C/HGV viremia was inversely correlated with anti-GBV-C/HGV antibodies.  Analysis of serum alanine amino transferase (ALT) measurements, available from 181 study participants, indicated higher median levels among HCV-infected individuals (46 IU/L, n = 55 vs 30 IU/L, n = 126; OR 2.7, P = 0.002).  No such elevations in serum ALT were found in GBV-C/HGV-infected individuals.  Phylogenetic analysis of HCV sequences revealed the presence of genotypes 1, 2 and 3.  No association was found between HCV and GBV-C/HGV genotypes and ethnicity, HIV-1 risk factor or ALT levels.  The demonstration of HCV genotypes 2 and 3 among HIV-1-infected individuals in Hawaii provides a potential resource of nongenotype 1-infected people for national clinical trials of anti-HCV therapies.  

Table 1. Prevalence of GBV-C/HGV Infection in HIV-1-Infected Individuals in Hawaii

Nerurkar, V.R., Nishiura, Y., Dashwood, W-M., and Yanagihara, R.:  Prevalence and genotypes of hepatitis C virus and GB virus C/hepatitis G virus among HIV-1-infected high-risk behavior groups in Hawaii.  Hepatology  (in preparation).

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