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Exploring the Cause of Diarrhoea and Poor Growth in 8-11-Week-Old Pigs from an Australian Pig Herd Using Metagenomic Sequencing. Viruses 2021; 13:v13081608. [PMID: 34452472 PMCID: PMC8402840 DOI: 10.3390/v13081608] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/24/2022] Open
Abstract
Diarrhoea and poor growth among growing pigs is responsible for significant economic losses in pig herds globally and can have a wide range of possible aetiologies. Next generation sequencing (NGS) technologies are useful for the detection and characterisation of diverse groups of viruses and bacteria and can thereby provide a better understanding of complex interactions among microorganisms potentially causing clinical disease. Here, we used a metagenomics approach to identify and characterise the possible pathogens in colon and lung samples from pigs with diarrhoea and poor growth in an Australian pig herd. We identified and characterized a wide diversity of porcine viruses including RNA viruses, in particular several picornaviruses—porcine sapelovirus (PSV), enterovirus G (EV-G), and porcine teschovirus (PTV), and a porcine astrovirus (PAstV). Single stranded DNA viruses were also detected and included parvoviruses like porcine bocavirus (PBoV) and porcine parvovirus 2 (PPV2), porcine parvovirus 7 (PPV7), porcine bufa virus (PBuV), and porcine adeno-associated virus (AAV). We also detected single stranded circular DNA viruses such as porcine circovirus type 2 (PCV2) at very low abundance and torque teno sus viruses (TTSuVk2a and TTSuVk2b). Some of the viruses detected here may have had an evolutionary past including recombination events, which may be of importance and potential involvement in clinical disease in the pigs. In addition, our metagenomics data found evidence of the presence of the bacteria Lawsonia intracellularis, Brachyspira spp., and Campylobacter spp. that may, together with these viruses, have contributed to the development of clinical disease and poor growth.
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Maev IV, Karlovich TI, Burmistrov AI, Chekmazov IA, Andreev DN, Reshetnyak VI. Current Views of Torque Teno Virus (TTV) in Liver Diseases. RUSSIAN JOURNAL OF GASTROENTEROLOGY, HEPATOLOGY, COLOPROCTOLOGY 2020; 30:7-22. [DOI: 10.22416/1382-4376-2020-30-4-7-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Affiliation(s)
- I. V. Maev
- Moscow State University of Medicine and Dentistry
| | - T. I. Karlovich
- Central Clinical Hospital with Outpatient Care of the Russian President Administration
| | | | - I. A. Chekmazov
- Central Clinical Hospital with Outpatient Care of the Russian President Administration
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Reshetnyak VI, Maev IV, Burmistrov AI, Chekmazov IA, Karlovich TI. Torque teno virus in liver diseases: On the way towards unity of view. World J Gastroenterol 2020; 26:1691-1707. [PMID: 32351287 PMCID: PMC7183866 DOI: 10.3748/wjg.v26.i15.1691] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 02/06/2023] Open
Abstract
The review presents the data accumulated for more than 20 years of research of torque teno virus (TTV). Its molecular genetic structure, immunobiology, epidemiology, diagnostic methods, possible replication sites, and pathogenicity factors are described. TTV is a virus that is frequently detectable in patients with different viral hepatitides, in cases of hepatitis without an obvious viral agent, as well as in a healthy population. There is evidence suggesting that biochemical and histological changes occur in liver tissue and bile duct epithelium in TTV monoinfection. There are sufficient histological signs of liver damage, which confirm that the virus can undergo a replicative cycle in hepatocytes. Along with this, cytological hybridization in TTV-infected cells has shown no substantial cytopathic (cell-damaging) effects that are characteristic of pathogenic hepatotropic viruses. Studying TTV has led to the evolution of views on its role in the development of human pathology. The first ideas about the hepatotropism of the virus were gradually reformed as new data became available on the prevalence of the virus and its co-infection with other viruses, including the viruses of the known types of hepatitides. The high prevalence of TTV in the human population indicates its persistence in the body as a virome and a non-pathogenic virus. It has recently been proposed that the level of TTV DNA in the blood of patients undergoing organ transplantation should be used as an endogenous marker of the body’s immune status. The available data show the polytropism of the virus and deny the fact that TTV can be assigned exclusively to hepatitis viruses. Fortunately, the rare detection of the damaging effect of TTV on hepatic and bile duct epithelial cells may be indirect evidence of its conditionally pathogenic properties. The ubiquity of the virus and the variability of its existence in humans cannot put an end to its study.
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Affiliation(s)
- Vasiliy I Reshetnyak
- Department of Propaedeutic of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow 127473, Russia
| | - Igor V Maev
- Department of Propaedeutic of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow 127473, Russia
| | - Alexandr I Burmistrov
- Department of Propaedeutic of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow 127473, Russia
| | - Igor A Chekmazov
- Central Clinical Hospital with Polyclinic, Presidential Administration of the Russian Federation, Moscow 121359, Russia
| | - Tatiana I Karlovich
- Central Clinical Hospital with Polyclinic, Presidential Administration of the Russian Federation, Moscow 121359, Russia
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Hultin E, Mühr LSA, Bzhalava Z, Hortlund M, Lagheden C, Sundström P, Dillner J. Viremia preceding multiple sclerosis: Two nested case-control studies. Virology 2018; 520:21-29. [PMID: 29772404 DOI: 10.1016/j.virol.2018.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/26/2018] [Accepted: 04/10/2018] [Indexed: 11/28/2022]
Abstract
Infections have been suggested to be involved in Multiple Sclerosis (MS). We used metagenomic sequencing to detect both known and yet unknown microorganisms in 2 nested case control studies of MS. Two different cohorts were followed for MS using registry linkages. Serum samples taken before diagnosis as well as samples from matched control subjects were selected. In cohort1 with 75 cases and 75 controls, most viral reads were Anelloviridae-related and >95% detected among the cases. Among samples taken up to 2 years before MS diagnosis, Anellovirus species TTMV1, TTMV6 and TTV27 were significantly more common among cases. In cohort2, 93 cases and 93 controls were tested under the pre-specified hypothesis that the same association would be found. Although most viral reads were again related to Anelloviridae, no significant case-control differences were seen. We conclude that the Anelloviridae-MS association may be due to multiple hypothesis testing, but other explanations are possible.
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Affiliation(s)
- Emilie Hultin
- Department of Laboratory Medicine, Karolinska Institutet, Huddinge SE-141 86, Sweden
| | | | - Zurab Bzhalava
- Department of Laboratory Medicine, Karolinska Institutet, Huddinge SE-141 86, Sweden
| | - Maria Hortlund
- Department of Laboratory Medicine, Karolinska Institutet, Huddinge SE-141 86, Sweden
| | - Camilla Lagheden
- Department of Laboratory Medicine, Karolinska Institutet, Huddinge SE-141 86, Sweden
| | - Peter Sundström
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå SE-901 87, Sweden
| | - Joakim Dillner
- Department of Laboratory Medicine, Karolinska Institutet, Huddinge SE-141 86, Sweden.
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Najafimemar Z, Tabarraei A, Talei G, Moradi A. Prevalence and Genotyping of Torque Teno Virus in HBV/HIV and Chronic HBV Patients in Iran. IRANIAN BIOMEDICAL JOURNAL 2017; 22:338-44. [PMID: 29253922 PMCID: PMC6058187 DOI: 10.29252/ibj.22.5.338] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Torque teno virus (TTV) was the first human Anelloviridae detected in a Japanese patient with an unknown type of hepatitis in 1997. TTV is by far the first known single-stranded circular DNA virus infecting human. In spite of its widespread nature in human population, its pathogenesis is still unclear. In addition, information regarding TTV infection in Iranian population is limited. Therefore, we attempted to determine the prevalence and genotype of TTV in three groups: HIV/HBV patients, chronic hepatitis B patients, and healthy individuals. Methods: The presence of TTV DNA in sera was investigated using PCR. The primer sets encompassing two 5’-UTR and N22 regions were used, and the positive products were collected for sequencing. Phylogenetic tree was generated based on N22 region and using the MEGA 7 software. Results: TTV DNA was detected in 452 patients with HIV/HBV and chronic hepatitis B, as well as in healthy control groups. The results from PCR indicated positive rates for these three groups 48%, 54%, and 49.3% using 5’-UTR primer and 15.1%, 12%, and 8% using N22 primer, respectively. Conclusion: Five genogroups were observed, which the second group was found to be the most frequent. The results of 5’-UTR primer showed more prevalence of TTV DNA comparing to N22 primer in patients and healthy control.
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Affiliation(s)
- Zahra Najafimemar
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alijan Tabarraei
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gholamreza Talei
- Department of Microbiology, Faculty of Medicine, Lorestan University of Medical Sciences, Lorestan, Iran
| | - Abdolvahab Moradi
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Golestan, Iran
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Bzhalava D, Hultin E, Arroyo Mühr LS, Ekström J, Lehtinen M, de Villiers EM, Dillner J. Viremia during pregnancy and risk of childhood leukemia and lymphomas in the offspring: Nested case-control study. Int J Cancer 2015; 138:2212-20. [PMID: 26132655 DOI: 10.1002/ijc.29666] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/24/2015] [Accepted: 06/01/2015] [Indexed: 01/29/2023]
Abstract
A possible role for infections of the pregnant mother in the development of childhood acute leukemias and lymphomas has been suggested. However, no specific infectious agent has been identified. Offspring of 74,000 mothers who had serum samples taken during pregnancy and stored in a large-scale biobank were followed up to the age of 15 years (750,000 person years) through over-generation linkages between the biobank files, the Swedish national population and cancer registers to identify incident leukemia/lymphoma cases in the offspring. First-trimester sera from mothers of 47 cases and 47 matched controls were retrieved and analyzed using next generation sequencing. Anelloviruses were the most common viruses detected, found in 37/47 cases and in 40/47 controls, respectively (OR: 0.6, 95% CI: 0.2-1.9). None of the detected viruses was associated with leukemia/lymphoma in the offspring. Viremia during pregnancy was common, but no association with leukemia/lymphoma risk in the offspring was found.
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Affiliation(s)
- Davit Bzhalava
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, SE-141 86, Sweden
| | - Emilie Hultin
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, SE-141 86, Sweden
| | | | - Johanna Ekström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Matti Lehtinen
- National Institute for Health and Welfare, Oulu, Finland
| | - Ethel-Michele de Villiers
- Abteilung Tumorvirus-Charakterisierung, Deutsches Krebsforschungszentrum, Heidelberg, 69120, Germany
| | - Joakim Dillner
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, SE-141 86, Sweden.,Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, SE-171 77, Sweden
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Human anelloviruses: an update of molecular, epidemiological and clinical aspects. Arch Virol 2015; 160:893-908. [PMID: 25680568 DOI: 10.1007/s00705-015-2363-9] [Citation(s) in RCA: 177] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 02/03/2015] [Indexed: 12/14/2022]
Abstract
Human torque teno viruses (TTVs) are new, emerging infectious agents, recently assigned to the family Anelloviridae. The first representative of the genus, torque teno virus (TTV), was discovered in 1997, followed by torque teno mini virus (TTMV) in 2000, and torque teno midi virus (TTMDV) in 2007. These viruses are characterized by an extremely high prevalence, with relatively uniform distribution worldwide and a high level of genomic heterogeneity, as well as an apparent pan-tropism at the host level. Although these viruses have a very high prevalence in the general population across the globe, neither their interaction with their hosts nor their direct involvement in the etiology of specific diseases are fully understood. Since their discovery, human anelloviruses, and especially TTV, have been suggested to be associated with various diseases, such as hepatitis, respiratory diseases, cancer, hematological and autoimmune disorders, with few arguments for their direct involvement. Recent studies have started to reveal interactions between TTVs and the host's immune system, leading to new hypotheses for potential pathological mechanisms of these viruses. In this review article, we discuss the most important aspects and current status of human TTVs in order to guide future studies.
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Lin J, Ganesh A. Water quality indicators: bacteria, coliphages, enteric viruses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2013; 23:484-506. [PMID: 23438312 DOI: 10.1080/09603123.2013.769201] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Water quality through the presence of pathogenic enteric microorganisms may affect human health. Coliform bacteria, Escherichia coli and coliphages are normally used as indicators of water quality. However, the presence of above-mentioned indicators do not always suggest the presence of human enteric viruses. It is important to study human enteric viruses in water. Human enteric viruses can tolerate fluctuating environmental conditions and survive in the environment for long periods of time becoming causal agents of diarrhoeal diseases. Therefore, the potential of human pathogenic viruses as significant indicators of water quality is emerging. Human Adenoviruses and other viruses have been proposed as suitable indices for the effective identification of such organisms of human origin contaminating water systems. This article reports on the recent developments in the management of water quality specifically focusing on human enteric viruses as indicators.
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Affiliation(s)
- Johnson Lin
- a School of Life Sciences , University of KwaZulu-Natal , Durban , South Africa
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Spengler U, Fischer HP, Caselmann WH. Liver Disease Associated with Viral Infections. ZAKIM AND BOYER'S HEPATOLOGY 2012. [PMCID: PMC7152320 DOI: 10.1016/b978-1-4377-0881-3.00034-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Huang YW, Ni YY, Dryman BA, Meng XJ. Multiple infection of porcine Torque teno virus in a single pig and characterization of the full-length genomic sequences of four U.S. prototype PTTV strains: implication for genotyping of PTTV. Virology 2009; 396:289-97. [PMID: 19913866 DOI: 10.1016/j.virol.2009.10.031] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 09/23/2009] [Accepted: 10/19/2009] [Indexed: 11/17/2022]
Abstract
Porcine Torque teno virus (PTTV) was recently shown to partially contribute to the experimental induction of porcine dermatitis and nephropathy syndrome and postweaning multisystemic wasting syndrome in pigs in the United States. We report here the identification of four distinct full-length genomic sequences of PTTV strains from a single pig in Virginia. Detailed analyses of the genomic organization, the degree of variability and the characteristics of conserved nucleotide and amino acid motifs of PTTV were conducted. The results showed that these four prototype U.S. strains of PTTV identified from the same pig represent distinct genotypes or subtypes and a revised classification system for PPTV is subsequently proposed. This is the first study documenting multiple PTTV infections with distinct genotypes or subtypes in a single pig. The identification of novel PTTV strains from pigs in the United States also pave the way for future disease characterization and genotyping of PTTV.
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Affiliation(s)
- Y W Huang
- Center for Molecular Medicine and Infectious Diseases, Department of Biomedical Sciences and Pathobiology, College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, 1981 Kraft Drive, Blacksburg, VA 24061-0913, USA
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Taira O, Ogawa H, Nagao A, Tuchiya K, Nunoya T, Ueda S. Prevalence of swine Torque teno virus genogroups 1 and 2 in Japanese swine with suspected post-weaning multisystemic wasting syndrome and porcine respiratory disease complex. Vet Microbiol 2009; 139:347-50. [PMID: 19570625 DOI: 10.1016/j.vetmic.2009.06.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 05/27/2009] [Accepted: 06/03/2009] [Indexed: 10/20/2022]
Abstract
Torque teno virus (TTV) was first isolated from a human hepatitis patient in 1997. TTV was also identified in several animals, including pigs, cattle, sheep, cats and dogs. In this study, we analysed the prevalence of swine TTV genogroups 1 (TTV1) and 2 (TTV2) in Japanese swine populations with suspected post-weaning multisystemic wasting syndrome and porcine respiratory disease by using a nested polymerase chain reaction method. Of 153 serum samples from 16 different herds in Japan, TTV1 was detected in 46 samples (30%), TTV2 in 47 samples (31%) and both in 15 samples (10%). There was no significant difference in the detection rate among geographical regions. The overall prevalence rate of TTV genogroups was significantly lower in < or = 30-day-old pigs (11%) compared to that in older age groups (54-82%). These results suggest that swine TTV may be widespread in post-weaning pigs and could play aetiological roles in pig diseases in Japan. This is the first report on the prevalence of swine TTV in Japan.
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Affiliation(s)
- Osamu Taira
- Nippon Institute for Biological Science, 9-2221-1 Shinmachi, Ome, Tokyo 198-0024, Japan.
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12
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Abstract
Since 1997, groups of novel nonenveloped DNA viruses with a circular, single-stranded (negative sense) DNA genome of 3.6-3.9 kb, 3.2 kb, or 2.8-2.9 kb in size have been discovered and designated Torque teno virus (TTV), Torque teno midi virus (TTMDV), and Torque teno mini virus (TTMV), respectively, in the floating genus Anellovirus. These three anelloviruses frequently and ubiquitously infect humans, and the infections are characterized by lifelong viremia and great genetic variability. Although TTV infection has been epidemiologically suggested to be associated with many diseases including liver diseases, respiratory disorders, hematological disorders, and cancer, there is no direct causal evidence for links between TTV infection and specific clinical diseases. The pathogenetic role of TTMV and TTMDV infections remains unknown. The changing ratio of the three anelloviruses to each other over time, relative viral load, or combination of different genotype(s) of each anellovirus may be associated with the pathogenicity or the disease-inducing potential of these three human anelloviruses. To clarify their disease association, polymerase chain reaction (PCR) systems for accurately detecting, differentiating, and quantitating all of the genotypes and/or genogroups of TTV, TTMDV, and TTMV should be established and standardized, as should methods to detect past infections and immunological responses to anellovirus infections.
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Affiliation(s)
- H Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi-Ken 329-0498, Japan.
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Griffin JS, Plummer JD, Long SC. Torque teno virus: an improved indicator for viral pathogens in drinking waters. Virol J 2008; 5:112. [PMID: 18834517 PMCID: PMC2569923 DOI: 10.1186/1743-422x-5-112] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Accepted: 10/03/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Currently applied indicator organism systems, such as coliforms, are not fully protective of public health from enteric viruses in water sources. Waterborne disease outbreaks have occurred in systems that tested negative for coliforms, and positive coliform results do not necessarily correlate with viral risk. It is widely recognized that bacterial indicators do not co-occur exclusively with infectious viruses, nor do they respond in the same manner to environmental or engineered stressors. Thus, a more appropriate indicator of health risks from infectious enteric viruses is needed. PRESENTATION OF THE HYPOTHESIS Torque teno virus is a small, non-enveloped DNA virus that likely exhibits similar transport characteristics to pathogenic enteric viruses. Torque teno virus is unique among enteric viral pathogens in that it appears to be ubiquitous in humans, elicits seemingly innocuous infections, and does not exhibit seasonal fluctuations or epidemic spikes. Torque teno virus is transmitted primarily via the fecal-oral route and can be assayed using rapid molecular techniques. We hypothesize that Torque teno virus is a more appropriate indicator of viral pathogens in drinking waters than currently used indicator systems based solely on bacteria. TESTING THE HYPOTHESIS To test the hypothesis, a multi-phased research approach is needed. First, a reliable Torque teno virus assay must be developed. A rapid, sensitive, and specific PCR method using established nested primer sets would be most appropriate for routine monitoring of waters. Because PCR detects both infectious and inactivated virus, an in vitro method to assess infectivity also is needed. The density and occurrence of Torque teno virus in feces, wastewater, and source waters must be established to define spatial and temporal stability of this potential indicator. Finally, Torque teno virus behavior through drinking water treatment plants must be determined with co-assessment of traditional indicators and enteric viral pathogens to assess whether correlations exist. IMPLICATIONS OF THE HYPOTHESIS If substantiated, Torque teno virus could provide a completely new, reliable, and efficient indicator system for viral pathogen risk. This indicator would have broad application to drinking water utilities, watershed managers, and protection agencies and would provide a better means to assess viral risk and protect public health.
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Affiliation(s)
- Jennifer S Griffin
- Department of Civil and Environmental Engineering, 100 Institute Road, Worcester Polytechnic Institute, Worcester, MA 01609, USA
| | - Jeanine D Plummer
- Department of Civil and Environmental Engineering, 100 Institute Road, Worcester Polytechnic Institute, Worcester, MA 01609, USA
| | - Sharon C Long
- Department of Soil Science and Wisconsin State Laboratory of Hygiene, 2601 Agriculture Drive, Madison, WI 53718, USA
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Irshad M, Joshi YK, Sharma Y, Dhar I. Transfusion transmitted virus: A review on its molecular characteristics and role in medicine. World J Gastroenterol 2006; 12:5122-34. [PMID: 16937521 PMCID: PMC4088008 DOI: 10.3748/wjg.v12.i32.5122] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The present review gives an updated overview of transfusion transmitted virus (TTV), a novel agent, in relation to its molecular characteristics, epidemiological features, modes of transmission, tissue tropism, pathogenesis, role in various diseases and its eradication from the body. TTV, a DNA virus, is a single stranded, non-enveloped, 3.8 kb long DNA virus with a small and covalently closed circular genome comprising 3852 bases. It was tentatively designated Circinoviridae virus. TTV genome sequence is heterogeneous and reveals the existence of six different genotypes and several subtypes. TTV has been reported to transmit not only via parenteral routes, but also via alternate routes. This virus has been detected in different non-human primates as well. At present, TTV is detected by polymerase chain reaction (PCR) with no other available diagnostic assays. It shows its presence globally and was detected in high percent populations of healthy persons as well as in various disease groups. Initially it was supposed to have strong association with liver disease; however, there is little evidence to show its liver tropism and contribution in causing liver diseases. It shows high prevalence in hemodialysis patients, pointing towards its significance in renal diseases. In addition, TTV is associated with several infectious and non-infectious diseases. Although its exact pathogenesis is not yet clear, TTV virus possibly resides and multiplies in bone marrow cells and peripheral blood mononuclear cells (PBMCs). Recently, attempts have been made to eradicate this virus with interferon treatment. More information is still needed to extricate various mysteries related to TTV.
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Affiliation(s)
- M Irshad
- Clinical Biochemistry Division, Department of Laboratory Medicine, PO Box -4938, A I I M S, New Delhi-110029, India.
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Ozyürek E, Ergünay K, Kuskonmaz B, Unal S, Cetin M, Ustaçelebi S, Gürgey A, Gümrük F. Transfusion-transmitted virus prevalence in Turkish patients with thalassemia. Pediatr Hematol Oncol 2006; 23:347-53. [PMID: 16621777 DOI: 10.1080/08880010600631995] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In hematology patients on chronic transfusion regimes, liver diseases are frequent, and mostly related to the agents transmitted by blood products and concominant iron deposition in liver. Besides hepatitis B (HBV) and C (HCV) viruses, new viral agents like hepatitis G virus (HGV) and TorqueTeno virus (TTV) are identified in these patients, although their association with any pathology or disease is not yet proved. In the present work, the authors studied the clinical importance of TTV in Turkish multitransfused patients with thalassemia. Forty-six healthy and 57 thalassemic patients were enrolled in the study. TTV was detected in serum samples by 3'-UTR nested PCR. Transaminase and ferritin levels, hepatitis B and C virus markers and number of transfusions were interpreted for possible association with TTV infection. As a result, TTV was detected in 63% of the thalassemia and 54% of the control patients. Prevalence of TTV infection, clinical features, laboratory data, and annual transfusion numbers of TTV-positive and -negative patients were not observed to be statistically significant. In conclusion, in Turkish patients with thalassemia, TTV infection cannot be considered as a risk factor for liver disease.
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Affiliation(s)
- Emel Ozyürek
- Department of Paediatrics, Section of Hematology, Hacettepe University, Medical School, Ankara, Turkey.
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Hanabusa H. Efficacy of induction therapy with high-dose interferon for patients with hemophilia and human immunodeficiency virus-hepatitis C virus coinfection. Clin Infect Dis 2002; 35:1527-33. [PMID: 12471573 DOI: 10.1086/344755] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2002] [Accepted: 08/13/2002] [Indexed: 11/03/2022] Open
Abstract
To evaluate the efficacy of high-dose interferon (IFN) on human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection, 15 HIV-positive patients and 15 age-matched HIV-negative patients with hemophilia were treated with 9 million units (MU) of IFN-alpha2a daily for 2 weeks, followed by 9 MU of IFN-alpha2a 3 times/week for a further 22 weeks. At week 2, HIV RNA levels decreased from 7410+/-2190 to 320+/-130 copies/mL, and HCV RNA levels decreased from 390x10(3)+/-80x10(3) to 70x10(3)+/-30x10(3) copies/mL in the HIV-positive group and from 300x10(3)+/-80x10(3) to 10x10(3)+/-10x10(3) copies/mL in the HIV-negative group. HCV RNA was undetectable after treatment in 4 of 12 HIV-positive and 6 of 15 HIV-negative patients. IFN therapy was discontinued because of adverse effects in 3 HIV-positive patients. Induction therapy and the dose of IFN should be evaluated in combination therapy with IFN and ribavirin.
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Affiliation(s)
- Hideji Hanabusa
- Department of Hematology, Ogikubo Hospital, Tokyo 167-0035, Japan.
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17
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Dai CY, Yu ML, Hou C, Lu SN, Wang JH, Huang JF, Chen SC, Lin ZY, Hsieh MY, Tsai JF, Wang LY, Chuang WL, Chang WY. Clinical characteristics and distribution of genotypes of TT virus infection in a hepatitis C virus-hyperendemic township of a hepatitis B virus-endemic country (Taiwan). J Gastroenterol Hepatol 2002; 17:1192-7. [PMID: 12453279 DOI: 10.1046/j.1440-1746.2002.02878.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND The prevalence of TT virus (TTV) viremia, without definite clinical significance, has been reported to be higher among chronic hepatitis C patients. The status and clinical characteristics of TT virus (TTV) infection and distribution of TTV genotypes in a hepatitis C virus (HCV) hyperendemic township (Masago community) in a hepatitis B virus (HBV) endemic country (Taiwan) were investigated. METHODS Sera from 100 Masago residents were tested for alanine aminotransferase (ALT) and markers of HBV, HCV and GB virus C/hepatitis G virus (GBV-C/HGV) and TTV-DNA. Sera of 250 blood donors as a control group were tested for TTV-DNA. Sera of Masago residents and blood donors with positive TTV-DNA were directly sequenced, and phylogenetic analyses were performed subsequently. RESULTS The prevalences of TTV viremia in different age groups among individuals from Masago were significantly higher than that among blood donors. In regard to the subtypes of TTV, 23, seven, two, eight, one, six and one isolate were related to the genotypes 1a, 1b, 2a, 2b, 3, 4 and 5, respectively, from Masago and 21, 14, one, nine and three isolates were related to the genotypes 1a, 1b, 2a, 2b, and 4, respectively, from donors. No clinical or virological factor was associated with TTV viremia or TTV genotypes. CONCLUSIONS TT Virus prevalence was higher among HCV hyperendemic township residents than blood donors with similar genotype distributions (genotype 1 was the most prevalent) in Taiwan. Neither TTV viremia nor a particular genotype was associated with HBV, HCV or GBV-C/HGV infection and abnormal ALT levels.
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Affiliation(s)
- Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, College of Medicine, Koasiung Medical University, Taiwan
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18
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Yan J, Chen LL, Lou YL, Zhong XZ. Investigation of HGV and TTV infection in sera and saliva from non-hepatitis patients with oral diseases. World J Gastroenterol 2002; 8:857-62. [PMID: 12378630 PMCID: PMC4656575 DOI: 10.3748/wjg.v8.i5.857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine the frequencies of HGV and TTV infections in serum and saliva samples of non-hepatitis patients with oral diseases in Hangzhou area, and to understand the correlation between detected results of HGV RNA and/or TTV DNA in sera and in saliva from the same patients.
METHODS: RT-nested PCR for HGV RNA detection and semi-nested PCR for TTV DNA detection were performed in the serum and saliva samples from 226 non-hepatitis patients with oral diseases, and nucleotide sequence analysis.
RESULTS: Twenty-seven (11.9%) and 21 (9.3%) of the 226 serum samples were only positive for HGV RNA and TTV DNA, respectively. 10 (4.4%) and 9 (3.9%) of the 226 saliva samples were only positive for HGV RNA and TTV DNA, respectively. And 7 (3.1%) of the serum samples and 2 (0.9%) of the saliva samples showed the positive amplification results for both HGV RNA and TTV DNA. 12 saliva samples from the 34 patients (35.3%) with HGV or HGV/TTV viremia and 11 saliva samples from the 28 patients (39.3%) with TTV or HGV/TTV viremia were HGV RNA detectable, respectively, including two patients positive for both HGV RNA and TTV DNA in serum and saliva samples. No saliva samples from the 226 patients were found to be HGV RNA or TTV DNA detectable while their serum samples were negative for HGV or TTV. Homologies of the nucleotide sequences of HGV and TTV amplification products from the serum and saliva samples of the two patients compared with the reported sequences were 88.65%-91.49% and 65.32%-66.67%, respectively. In comparison with the nucleotide sequences of amplification products between serum and from saliva sample from any one of the two patients, the homologies were 98.58% and 99.29% for HGV, and were 98.65% and 98.20% for TTV, respectively.
CONCLUSION: Relatively high carrying rates of HGV and/or TTV in the sera of non-hepatitis patients with oral diseases in Hangzhou area are demonstrated. Parts of the carriers are HGV and/or TTV positive in their saliva. The results of this study indicate that dentists may be one of the populations with high risk for HGV and/or TTV infection, and by way of saliva HGV and TTV may be transmitted among individuals.
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Affiliation(s)
- Jie Yan
- Department of Pathogenic Biology, College of Medical Science, Zhejiang University, Hangzhou 310031, Zhejiang Province, China.
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19
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Kocazeybek B, Arabaci U, Sezgiç M. Investigation of transfusion transmitted viruses in cases clinically suspected of posttransfusion hepatitis with undetermined ethiology. Transfus Apher Sci 2002; 26:157-65. [PMID: 12126200 DOI: 10.1016/s1473-0502(02)00008-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Transfusion transmitted viruses (TTV) were investigated in cardiac surgery cases who were previously transfused with blood and/or blood products and were suspected of having posttransfusion hepatitis (PTH) based on the results of physical examination, clinical findings, biochemical blood test results and in a smaller number, on radiological results. They were identified as having non-A-C hepatitis based on serological or molecular test methods. In this study, out of 90 cases suspected for PTH and non-A-C, 78 (86.7%) were male, 12 (13.3%) were female and their ages were between 17 and 67. Ninety healthy blood donors, who donated blood for the first time and had never had a transfusion, were selected as the control group. They had alanine aminotransferase (ALT) levels < 40 U, were seronegative for hepatitis B virus (HBV) and hepatitis C virus (HCV). Seventy-seven were immune, and 13 were seronegative for hepatitis A virus (HAV). In this study, TTV-deoxyribonucleic acid (DNA) investigation was performed by the polymerase chain reaction (PCR) method suggested by Takahashi et al. with 5' GCT ACG TCA CTA ACC ACG TG 3' (T801) and 5' CTG CGG TGT GTA AAC TCA CC 3' (T935) primers. TTV-DNA was found to be positive in 21 (23.3%) of the patient group and 4 (4.4%) of the control group (p < 0.05). In the patients determined to be TTV-DNA positive, the admission time following transfusion was a minimum of 3, and a maximum of 15 (average 7) weeks. The average ALT levels detected at the time of admission did not show a difference between TTV-DNA positive and negative cases (p > 0.05). However the ALT levels had a tendency to rise and reached their highest level nine weeks after transfusion in the TTV-DNA positive cases, although in two cases the ALT levels decreased to normal value after the 13th week. During the 24 month follow up of the TTV-DNA positives all cases except one were positive at the end of this period. The results of this study are the same as those reported in the literature suggesting that TTV-DNA, excluding the main viral agents which are known to cause PTH, can be determined in transfused PTH or non-transfused asymptomatic patients in varying ratios. In order to define the epidemiological properties and hepatic-extrahepatic pathologies more clearly we have looked for evidence of the viral agent, which probably contaminates both by transfusion and non-transfusion routes. It is suggested that, in addition to the case groups in this study, new clinical studies are necessary including transfused but non-PTH patients.
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Affiliation(s)
- Bekir Kocazeybek
- Department of Microbiology and Clinical Microbiology, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey.
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20
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Ali S, Fevery J, Peerlinck K, Verslype C, Schelstraete R, Gyselinck F, Emonds MP, Vermylen J, Hiem Yap S. TTV infection and its relation to serum transaminases in apparently healthy blood donors and in patients with clotting disorders who have been investigated previously for hepatitis C virus and GBV-C/HGV infection in Belgium. J Med Virol 2002. [DOI: 10.1002/jmv.2181] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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21
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Takamatsu J, Toyoda H, Fukuda Y, Nakano I, Yokozaki S, Hayashi K, Saito H. Effects of HAART on hepatitis C, hepatitis G, and TT virus in multiply coinfected HIV-positive patients with haemophilia. Haemophilia 2001; 7:575-81. [PMID: 11851756 DOI: 10.1046/j.1365-2516.2001.00567.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In multiply coinfected human immunodeficiency virus (HIV)-positive patients, we investigated the effects of high-activity antiretroviral therapy (HAART) using HIV protease inhibitors on three other viruses: hepatitis C virus (HCV), hepatitis G virus (HGV), and TT virus (TTV). Viral concentrations were measured serially by polymerase chain reaction methods in five patients with quadruple infection (HIV, HCV, HGV, and TTV) and in two patients with triple infection (HIV, HCV, and HGV) before and during HAART. In addition, CD4+ cell counts and serum alanine aminotransferase (ALT) levels were measured serially. Generally we observed no difference in serum HCV RNA, HGV RNA, or TTV DNA concentrations between samples obtained before and after initiation of HAART, whereas HIV RNA concentration decreased and CD4 counts increased in most patients. However, two patients had markedly decreased concentrations of HCV RNA and HGV RNA, respectively, more than 12 months after beginning HAART. Normalization of serum ALT levels was observed in a patient with decline of HCV RNA concentrations. No interactions were observed among these four viruses. HAART had no apparent direct effects on HCV, HGV, or TTV. Further studies will be required to elucidate whether the restoration of immune status through suppression of HIV replication by HAART may affect HCV or HGV RNA concentrations.
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Affiliation(s)
- J Takamatsu
- Department of Transfusion Medicine, Nagoya University School of Medicine, Nagoya, Japan
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22
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Abstract
AIM: To determine the frequencies of HGV and TTV infections in blood donors in Hangzhou.
METHODS: RT-nested PCR for HGV RNA detection and semi-nested PCR for TTV DNA detection in the sera from 203 blood donors, and nucleotide sequence analysis were performed.
RESULTS: Thirty-two (15.8%) and 30 (14.8%) of the 203 serum samples were positive for HGV RNA and TTV DNA, respectively. And 5 (2.5%) of the 203 serum samples were detectable for both HGV RNA and TTV DNA. Homology of the nucleotide sequences of HGV RT-nested PCR products and TTV semi-nested PCR products from 3 serum samples compared with the reported HGV and TTV sequences was 89.36%, 87.94%, 88.65% and 63.51%, 65.77% and 67.12%, respectively.
CONCLUSION: The infection rates of HGV and/or TTV in blood donors are relatively high, and to establish HGV and TTV examinations to screen blood donors is needed for transfusion security. The genomic heterogeneity of TTV or HGV is present in the isolates from different areas.
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Affiliation(s)
- J Yan
- Department of Pathogenic Biology, Medical School of Zhejiang University, 353 Yan An Road, Hangzhou 310006, Zhejiang Province,China.
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23
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Maggi F, Fornai C, Zaccaro L, Morrica A, Vatteroni ML, Isola P, Marchi S, Ricchiuti A, Pistello M, Bendinelli M. TT virus (TTV) loads associated with different peripheral blood cell types and evidence for TTV replication in activated mononuclear cells. J Med Virol 2001; 64:190-4. [PMID: 11360252 DOI: 10.1002/jmv.1035] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
TT virus (TTV) loads associated with the peripheral blood cells of seven patients known to carry the virus in plasma were investigated by real-time PCR. Whereas red cells/platelets were uniformly negative, six and four patients yielded positive peripheral blood mononuclear cells (PBMCs) and polymorphonuclear leukocytes, respectively, but viral titres were generally low. Fractionation of PBMCs into monocyte- and B, T4, and T8 lymphocyte-enriched subpopulations showed no pattern in the viral loads that might suggest the preferential association of TTV to one or more specific cell types. TTV-negative PBMCs absorbed measurable amounts of virus when incubated with infected plasma at 4 degrees C. Furthermore, cultures of TTV-negative phytohaemagglutinin-stimulated PBMCs exposed in vitro to virus-positive plasma and faecal extracts released considerable levels of infectious TTV into the supernatant fluid and the same was true for TTV-positive stimulated PBMCs. These results indicate that, whereas freshly harvested resting PBMCs seem to produce little, if any TTV, stimulated PBMCs actively replicate the virus.
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Affiliation(s)
- F Maggi
- Virology Section and Retrovirus Centre, Department of Biomedicine, University of Pisa, Via San Zeno 37, I-56127 Pisa, Italy
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24
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Shibuya A, Satomichi A, Takeuchi A, Saigenji K, Sakurai K, Kobayashi N, Yoshida A. Transfusion transmitted virus infection in patients on maintenance haemodialysis and in hospital workers. J Hosp Infect 2001; 47:277-81. [PMID: 11289770 DOI: 10.1053/jhin.2000.0919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A newly discovered DNA virus, transfusion transmitted virus (TTV), was isolated from a post-transfusional hepatitis patient in Japan. A high prevalence (32-46%) of TTV infections in patients receiving maintenance haemodialysis (HD) has been reported but the occupational risk of TTV on HD units has not yet been determined. We determined the prevalence of TTV in workers in the same HD unit and the risk factors for TTV infection in HD patients, using logistic regression analysis. The prevalence of TTV DNA was 59.6% in 198 HD patients, significantly higher than that in the HD unit (13 of 39, 33.3%;P= 0.002) and non-HD healthcare workers (20 of 75, 26.7%; P= 0.001). A logistic regression analysis showed that male gender and negative test results for hepatitis G virus RNA were risk factors for TTV infection, but prior blood transfusion and duration of HD were not. Stepwise selection of multiple regression analysis showed that the presence of hepatitis C virus RNA was the only significant predictor for high serum ALT activity, and that the presence of TTV DNA was not. These results indicate that TTV is one of the prevalent human viruses transmissible either parenterally or nonparenterally in HD patients, but the occupational risk of TTV infection in HD unit workers is as low as in other healthcare workers. The pathogenic effects of TTV on the liver appear to be limited.
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Affiliation(s)
- A Shibuya
- Department of Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
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25
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Ohbayashi H, Tanaka Y, Ohoka S, Chinzei R, Kakinuma S, Goto M, Watanabe M, Marumo F, Sato C. TT virus is shown in the liver by in situ hybridization with a PCR-generated probe from the serum TTV-DNA. J Gastroenterol Hepatol 2001; 16:424-8. [PMID: 11354281 DOI: 10.1046/j.1440-1746.2001.02460.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM It has been a conflicting issue whether TT virus (TTV), a newly isolated DNA virus from a patient with liver injury of unknown cause, is a causative agent of acute and/or chronic hepatitis. TT Virus DNA titers were shown to be 10-100-fold greater in liver tissue than in serum, whereas the majority of TTV-positive cases had no biochemical or histological evidence of significant liver damage. We therefore attempted in situ hybridization to investigate whether TTV is hepatotropic. METHODS Because of the marked divergence in TTV genome types, a template for TTV-DNA (coding region for N22 clone) was amplified and labeled with digoxigenin-dUTP by using hemi-nested PCR from the serum, then DNA probes were applied to the liver sections of the same case. After hybridization, the probes were visualized immunohistochemically. Besides TTV-DNA-negative cases, competitive inhibition experiments with unlabeled probes were performed to confirm the specificity. RESULTS There were no positive signals in the negative controls, and the intensity of positive signals was markedly diminished in the competitive inhibition experiments. No cross-hybridization with different genotype probes also confirms the specificity. Under the optimal conditions, the positive signals were located in the cytoplasm of the hepatocytes in eight of nine TTV-DNA-positive cases. The signals were not seen in non-parenchymal cells of the liver. CONCLUSION TT Virus is proved to be hepatotropic by in situ hybridization.
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Affiliation(s)
- H Ohbayashi
- Second Department of Internal Medicine, Faculty of Medicine, Tokyo Medical and Dental University, Japan
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26
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Shibayama T, Masuda G, Ajisawa A, Takahashi M, Nishizawa T, Tsuda F, Okamoto H. Inverse relationship between the titre of TT virus DNA and the CD4 cell count in patients infected with HIV. AIDS 2001; 15:563-70. [PMID: 11316992 DOI: 10.1097/00002030-200103300-00004] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To investigate the prevalence and relative titre of TT virus (TTV) DNA, and to examine the relationship between the extent of TTV viraemia and the immune status among 144 patients with HIV infection; 178 age- and sex-matched healthy individuals were also studied. METHODS TTV DNA was detected quantitatively by two distinct polymerase chain reaction (PCR) methods [untranslated region (UTR) and N22]. UTR PCR detects all TTV genotypes, and N22 PCR can primarily detect four major TTV genotypes (1-4). RESULTS Using UTR PCR and N22 PCR, respectively, TTV DNA was detected significantly more frequently in HIV-infected patients than in controls (99 versus 91%, P < 0.001; 56 versus 27%, P < 0.0001), and the relative titre (10N/ml) was significantly higher in HIV-infected patients [4.5 +/- 1.2 (mean +/- SD) versus 3.1 +/- 0.9, P < 0.0001; 2.6 +/- 1.5 versus 1.5 +/- 0.9, P < 0.0001]. Age, sex, co-infection with hepatitis B or C virus, and risk factors for HIV transmission did not appear to be significant factors associated with the titre of TTV viraemia. However, the titre of TTV DNA was significantly higher in HIV-infected patients with AIDS (P < 0.0001), those with low CD4 T cell count (P < 0.0001), or those with high HIV viral loads (P = 0.0047). CONCLUSION TTV is highly prevalent and high-titred in HIV-infected patients. The TTV viral load may reflect the degree of immune status of these immunocompromised hosts.
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Affiliation(s)
- T Shibayama
- Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo 113-0021, Japan
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27
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Dai CY, Yu ML, Chuang WL, Wang CS, Lin ZY, Chen SC, Hsieh MY, Wang LY, Tsai JF, Chang WY. The molecular epidemiology and clinical significance of TT virus (TTV) infection in healthy blood donors from southern Taiwan. Transfus Apher Sci 2001; 24:9-15. [PMID: 11515617 DOI: 10.1016/s0955-3886(00)00121-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To evaluate the molecular epidemiology and clinical significance of th
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Affiliation(s)
- C Y Dai
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan, ROC
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28
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Abstract
TT virus (TTV) was cloned as a possible causative agent for non A to C posttransfusion hepatitis. Determination of the entire sequence of the virus revealed that the virus is the first human circovirus. The nucleotide sequence of TTV has a wide range of diversity and at least sixteen genotypes have been discovered to date. The prevalence of TTV infection in the normal population differs among countries, but exceeds 10% in several countries. Most of TTV infections are not associated with hepatitis, although there is evidence of TTV-induced hepatitis, especially caused by TTV of genotype I. To determine whether TTV is replicated in the liver is important in order to show that TTV is really a hepatitis virus, because results of a study in bone marrow transplant (BMT) recipients suggested that TTV might be replicated mainly in the hematopoietic cells. The prevalence of TTV infection in patients with hematological disorders who regularly require blood products was extremely high, but most of the infections did not cause liver injury, even in BMT recipients.
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Affiliation(s)
- Y Kanda
- Department of Cell Therapy and Transplantation Medicine, Faculty of Medicine, University of Tokyo, Japan
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29
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Bendinelli M, Pistello M, Maggi F, Fornai C, Freer G, Vatteroni ML. Molecular properties, biology, and clinical implications of TT virus, a recently identified widespread infectious agent of humans. Clin Microbiol Rev 2001; 14:98-113. [PMID: 11148004 PMCID: PMC88963 DOI: 10.1128/cmr.14.1.98-113.2001] [Citation(s) in RCA: 167] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
TT virus (TTV) was first described in 1997 by representational difference analysis of sera from non-A to non-G posttransfusion hepatitis patients and hence intensively investigated as a possible addition to the list of hepatitis-inducing viruses. The TTV genome is a covalently closed single-stranded DNA of approximately 3.8 kb with a number of characteristics typical of animal circoviruses, especially the chicken anemia virus. TTV is genetically highly heterogeneous, which has led investigators to group isolates into numerous genotypes and subtypes and has limited the sensitivity of many PCR assays used for virus detection. The most remarkable feature of TTV is the extraordinarily high prevalence of chronic viremia in apparently healthy people, up to nearly 100% in some countries. The original hypothesis that it might be an important cause of cryptogenic hepatitis has not been borne out, although the possibility that it may produce liver damage under specific circumstances has not been excluded. The virus has not yet been etiologically linked to any other human disease. Thus, TTV should be considered an orphan virus.
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Affiliation(s)
- M Bendinelli
- Virology Section, Department of Biomedicine and Retrovirus Center, University of Pisa, Pisa, Italy.
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30
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Shibata M, Morizane T, Baba T, Inoue K, Sekiyama K, Yoshiba M, Mitamura K. TT virus infection in patients with fulminant hepatic failure. Am J Gastroenterol 2000; 95:3602-6. [PMID: 11151899 DOI: 10.1111/j.1572-0241.2000.03301.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE A new DNA virus, which has been designated the TT virus, was discovered in 1997. It is not clear whether TT virus is a cause of any of the types of hepatitis. We conducted a case-control study to test the hypothesis that the presence of TT virus is a necessary condition for the development of fulminant hepatic failure in people who have non-A, -B, or -C hepatitis. METHODS We studied 55 patients with fulminant hepatic failure [28 men, 27 women, mean (+/- SD) age, 47 +/- 15 yr], 32 patients with acute hepatitis (18 men, 14 women, mean age, 38 +/- 15 yr), and 200 healthy subjects (106 men, 94 women, mean age, 42 +/- 14 yr). TT virus DNA was detected in sera by a nested polymerase chain reaction using a primer set for genotype 1. RESULTS TT virus was more frequently detected in patients with fulminant hepatic failure [in 33 of 55 (60%); 95% confidence interval (CI), 47-73%] than in those with acute hepatitis [in 8 of 32 (25%); 95% CI, 10-40%; p = 0.0016] or in healthy subjects [in 50 of 200 (25%); 95% CI, 19-31%; p < 0.0001]. TT virus was detected at a significantly higher rate in non-A, -B, or -C fulminant hepatic failure [in 18 of 22 (82%); 95% CI, 66-98%] than in fulminant hepatic failure of A, B, or C type [45%, 28-62%, 15/33; p = 0.007] or in non-A, -B, or -C acute hepatitis [24%, 3-44%, 4/17; p = 0.0003]. The logistic regression analysis selected TT virus (p = 0.0009), age (p = 0.0116), and etiology (p = 0.0309) as independent variables associated with fulminant hepatic failure (coefficient of determination, 0.2335). CONCLUSIONS TT virus comparatively plays a role in the pathogenesis of non-A, -B, or -C fulminant hepatic failure.
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Affiliation(s)
- M Shibata
- Second Department of Internal Medicine, Showa University, School of Medicine, Tokyo, Japan
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31
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Bruno R, Sacchi P, Debiaggi M, Patruno SF, Zara F, Ciappina V, Brunetti E, Filice C, Zocchetti C, Maffezzini E, Pistorio A, Filice G. Prevalence and histologic features of transfusion transmitted virus and hepatitis C virus coinfection in a group of HIV patients. Dig Liver Dis 2000; 32:617-20. [PMID: 11142562 DOI: 10.1016/s1590-8658(00)80846-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND A recently identified DNA transfusion-transmitted virus has been associated with post-transfusion non-A to G hepatitis. AIM To determine the prevalence of transfusion-transmitted virus in patients with human immunodeficiency virus infection. Its clinical role in the pathogenesis of liver disease was also evaluated in patients with transfusion-transmitted-virus hepatitis C virus coinfection compared with those with hepatitis C Virus infection alone. PATIENTS AND METHODS We evaluated 312 HIV-hepatitis C virus coinfected patients (225 males, 87 females). All underwent screening for transfusion-transmitted virus DNA using a nested polymerase chain reaction technique. In some transfusion transmitted virus-DNA positive patients, we performed a phylogenetic analysis. In 56 patients (20 transfusion-transmitted-virus-hepatitis C virus and 36 hepatitis C virus alone), liver biopsy was collected. RESULTS The prevalence of transfusion-transmitted virus was 113/312 (36%). The genotype distribution was similar to that reported in other studies. No difference in liver histology was found between the two groups. CONCLUSION Transfusion-transmitted virus infection is common in human immunodeficiency virus patients. We found no histologic differences between liver biopsy specimens from patients coinfected with transfusion-transmitted virus plus hepatitis C virus compared with those infected with hepatitis C virus alone. Transfusion-transmitted virus is not clearly associated with a distinct liver injury.
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Affiliation(s)
- R Bruno
- Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo, Pavia, Italy.
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32
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Tuveri R, Jaffredo F, Lunel F, Nalpa B, Pol S, Feray C, Marcellin P, Thibault V, Delagneau JF, Opolon P, Scarpa B, Bréchot C, Thiers V. Impact of TT virus infection in acute and chronic, viral- and non viral-related liver diseases. J Hepatol 2000; 33:121-7. [PMID: 10905595 DOI: 10.1016/s0168-8278(00)80168-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS The prevalence and pathogenicity of TT virus, recently identified in patients with non A-non G post-transfusional hepatitis, are questioned. METHODS We investigated the impact of this new viral infection in a large series of patients with non A-non G, cryptogenic, non-viral and viral-related, acute and chronic liver diseases (n=577) and blood donors (n=300). TTV DNA was detected in serum by hemi-nested polymerase chain reaction. Phylogenetic analysis was performed in 13 isolates. RESULTS TTV DNA was detected in 6/25 and 15/127 patients with cryptogenic non A-non G acute and chronic liver disease, respectively. TTV DNA positive subjects with post-transfusional acute hepatitis scored negative before transfusion. TTV prevalence was increased in patients with cryptogenic non A-non G acute and chronic liver disease compared to blood donors (6/300; p<0.001) and non-viral-related chronic liver diseases (6/137; p<0.05). TTV/HBV coinfection was frequently identified (35/147), but this was not the case for HCV-infected subjects (4/77). Transaminase activity or liver histological score was not significantly increased among TTV positive, HBV infected or non A-non G patients. The HBV infection and Mediterranean origin were the risk factors associated with TTV infection. The majority of analysed sequences clustered in genotype 1 (8=1b; 3=1a). Two isolates showed homology to genotype 2. CONCLUSIONS These results support the view that TTV is a widely spread infectious agent with a weak pathogenicity. It raises the possibility, however, that TTV might be implicated in a few cases of acute and chronic non A-non G hepatitis. TTV-DNA-analysed sequences are related to genotypes 1 and 2 described in Europe.
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Affiliation(s)
- R Tuveri
- CNR on Viral Hepatitis, Necker Institute, Necker University, Paris, France
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Kangxian L, Weifang L, Lian Z, Zhiying C. Epidemiological survey and follow-up of transfusion-transmitted virus after an outbreak of enterically transmitted infection. J Viral Hepat 2000; 7:309-12. [PMID: 10886542 DOI: 10.1046/j.1365-2893.2000.00231.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
An outbreak of enterically transmitted hepatitis occurred during 1996 among students at a vocational school. Viral fragments homologous to transfusion-transmitted virus (TTV) were detected in faeces. To elucidate the endemic status, an epidemiological survey and case follow-up after the outbreak were carried out. During and after the outbreak, virus carriers among staff were, respectively, 32.1% and 31.3% in serum, and 24.6% and 18.2% in faeces. After the last outbreak, attacks were still occurring among new students with an incidence of 2.4% in 1997 and 2.3% in 1998. There was also a small-scale outbreak in 1998 with a prevalence of 17.9%. On follow-up at 6 and 18 months after onset, alanine aminotransferase (ALT) elevation was found in 29.7% and 13.9% of patients. At 6 months, viral fragments were detected in serum in 78.1% and 46.7% of patients, with and without ALT elevation, respectively. At 18 months the corresponding figures were 55.6% and 19.2%, respectively. At the 18-month follow-up, viral fragments were detected in faeces in 29.6% and 19.3% of patients with and without ALT elevation. In conclusion, this disease might be transmitted from asymptomatic virus carriers. According to the laboratory data, both parenteral and non-parenteral transmissions are involved, and the faecal-oral route might be more important.
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Affiliation(s)
- L Kangxian
- Department of Infectious Disease, Nanfang Hospital, Guangzhou, China
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Springfeld C, Bugert JJ, Schnitzler P, Tobiasch E, Kehm R, Darai G. TT virus as a human pathogen: significance and problems. Virus Genes 2000; 20:35-45. [PMID: 10766305 DOI: 10.1023/a:1008156022845] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In 1997 TTV was detected using representational difference analysis (RDA) in serum of a patient with posttransfusion hepatitis unrelated to known hepatitis viruses. The genome of TTV is a circular single-stranded DNA molecule of 3852 nt with negative polarity. TTV possibly can be grouped either into the existing family Circoviridae or into a recently established virus family "Circinoviridae". Analysis of the complete DNA nucleotide sequence of TTV identified three partially overlapping open reading frames (ORFs). Neither DNA nucleotide nor corresponding amino acid sequences of TTV do show significant homologies to known sequences. TTV DNA nucleotide sequences amplified by PCR from sera of different patients show considerable sequence variations. Although the natural route of transmission of TTV is still unknown, there is clear evidence for a transmission of TTV through blood and blood products. TTV DNA can be detected in the feces of infected individuals suggesting that it may be possible to attract TTV infection from environmental sources. Since the discovery of TTV, numerous studies have investigated the prevalence of TTV infections in different human population groups all over the world. All these studies are based on PCR detection systems, but the technical aspects of the PCR systems vary significantly between the different investigators. The results of the epidemiological studies do not show a clear picture. The discovery of TTV as a viral agent and particularly the identification of a high percentage of infected carriers in the healthy human population raises the following questions: Firstly, what is the origin and molecular relatedness of TT virus. Secondly, what is the significance of TTV as a human pathogen. And thirdly, what are the exact molecular mechanisms of viral replication. To answer these questions it will be necessary to determine the primary structure and the coding capacity of several TTV patient isolates.
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Affiliation(s)
- C Springfeld
- Institut für Medizinische Virologie der Ruprecht-Karls-Universität Heidelberg, Federal Republic of Germany
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Abstract
The list of potential hepatotrophic viruses continues to grow, with the recent discovery of the GB virus-C, the TT virus, and the SEN virus. Prevalence rates of the GB virus-C have ranged from 1.2% to 13% among healthy blood donors from all over the world. Higher prevalence rates have been reported among intravenous drug users. Similarly, the TT virus has a global distribution. However, in spite of numerous reports of the presence of both of these viruses in various kinds of liver diseases, definite evidence linking it to a specific disease or illness is lacking. The SEN virus is thought to be a novel viral agent that may be linked to cryptogenic chronic hepatitis, but data are awaited.
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Affiliation(s)
- K V Menon
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
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Prevalence and Route of Transmission of Infection With a Novel DNA Virus (TTV), Hepatitis C Virus, and Hepatitis G Virus in Patients Infected With HIV. J Acquir Immune Defic Syndr 2000. [DOI: 10.1097/00042560-200001010-00012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Puig-Basagoiti F, Cabana M, Guilera M, Giménez-Barcons M, Sirera G, Tural C, Clotet B, Sánchez-Tapias JM, Rodés J, Saiz JC, Martínez MA. Prevalence and route of transmission of infection with a novel DNA virus (TTV), hepatitis C virus, and hepatitis G virus in patients infected with HIV. J Acquir Immune Defic Syndr 2000; 23:89-94. [PMID: 10708061 DOI: 10.1097/00126334-200001010-00012] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the prevalence, route of transmission and clinical significance that current co-infection with TT virus (TTV), hepatitis C virus (HCV), and hepatitis G virus (HGV) have in HIV-1-infected patients. DESIGN Presence of TTV, HCV, and HGV was analyzed in plasma samples from 160 HIV-1-infected patients with parenteral (38 intravenous drug users [IVDUs] and 41 patients with hemophilia) or sexual (39 homosexuals and 42 heterosexuals) risk of exposure, and in 168 volunteer blood donors. Alanine aminotransferase (ALT) levels and CD4+ counts were also analyzed. METHODS HCV and HGV RNA were detected by specific reverse transcriptase (RT) nested polymerase chain reaction (PCR) and TTV DNA by specific heminested PCR. RESULTS TTV DNA was detected in 39% of the patients and in 14% of the volunteer blood donors. HCV and HGV infections were detected in 42% and in 14% of the patients, and in 0% and 3% of the blood donors, respectively. Prevalences of TTV and HCV infection were higher among patients with parenteral (62% and 68%) than in those with sexual (17% and 16%) risk of exposure. A higher prevalence of TTV infection (but not of HCV or HGV infection) was observed among patients with hemophilia (76%) than IVDUs (47%), and among homosexuals (26%) than among heterosexuals (10%). Abnormal ALT levels were related with the presence of HCV infection, independently of the detection of TTV DNA. TTV infection did not seem to alter the levels of CD4+ T cells. CONCLUSIONS Prevalence of current TTV infection is high among HIV-infected patients with parenteral risk of exposure, but TTV is also transmitted through sexual routes; detection of TTV does not seem to influence the clinical or immune status of HIV-infected patients.
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Affiliation(s)
- F Puig-Basagoiti
- Department of Medicine, Institut d'Investigacions Biomèdiques August Pí i Sunyer, Facultad de Medicina, Universidad de Barcelona, Spain
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Affiliation(s)
- P A Bonis
- UpToDate, Inc., Wellesley, Massachusetts 02481, USA.
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Takayama S, Yamazaki S, Matsuo S, Sugii S. Multiple infection of TT virus (TTV) with different genotypes in Japanese hemophiliacs. Biochem Biophys Res Commun 1999; 256:208-11. [PMID: 10066448 DOI: 10.1006/bbrc.1999.0270] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To clarify the persistent TT virus (TTV) infection, we studied a possibility of multiple TTV infection by genotype analysis of isolated TTV obtained from seven Japanese hemophiliacs. The nucleotide sequences including 222 bp in the open reading frame 1 (ORF1) region of 10 TTV isolates from each patient were analyzed and classified into various TTV genotypes such as G1 to G6 by phylogenetic analysis using a N-J method. Multiple TTV genotypes were observed in all the hemophiliacs: three different TTV genotypes were found in three patients, whereas four different TTV genotypes were observed in the other three patients. The remaining patient was also infected with TTV of five different genotypes. Moreover, new TTV genotypes were found in these seven patients and tentatively designated as G7. The present findings indicate that multiple TTV infection with different TTV genotypes has occurred in Japanese hemophiliacs. They also provide valuable information to understand persistent TTV infection.
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Affiliation(s)
- S Takayama
- Division of Laboratory Research, St. Marianna University-Yokohamashi Seibu Hospital.
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