Korean J Hematol.  2011 Jun;46(2):123-127. 10.5045/kjh.2011.46.2.123.

Clinical outcomes of Torque teno virus-infected thalassemic patients with and without hepatitis C virus infection

Affiliations
  • 1Pediatric Hematology-Oncology Department and Pediatric Infectious Research Center, Shahid Beheshti Medical University, Mofid Childrens' Hospital, Tehran, Iran.
  • 2Iranian Blood and Transfusion Organization, Tehran, Iran.
  • 3Student's Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran. Ali_kord2006@yahoo.com
  • 4Pediatric Infectious Research Center, Shahid Beheshti Medical University, Tehran, Iran.

Abstract

BACKGROUND
Although a marked proportion of thalassemic patients acquire Torque teno virus (TTV) through blood transfusion, its clinical importance is unclear. This study was designed to investigate the clinical importance of TTV infection in thalassemic patients with and without hepatitis C virus (HCV) co-infection in Iran.
METHODS
In this case-control study, 107 thalassemic patients on chronic transfusion and 107 healthy individuals were selected. According to HCV and TTV infection status (detected by semi-nested PCR), patients were categorized into 4 groups: TTV and HCV negative, TTV positive, HCV positive, and TTV and HCV positive. Blood ferritin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels in these 4 groups were assessed.
RESULTS
Approximately half of the thalassemic patients (50.5%) and 27.1% of controls had TTV infection. Thalassemic patients had a greater chance of TTV infection compared to the control group with a sex-adjusted OR of 4.13 (95% CI=2.28-8.13). The increased levels of ALT, AST, and ferritin in the TTV and HCV-infected group were not significantly different from those in the TTV and HCV negative group. Co-infection with TTV and HCV did not significantly increase ALT, AST, and ferritin levels compared to infection with TTV alone.
CONCLUSION
Although common in thalassemic patients, TTV infection appears to have a negligible role in increasing the severity of liver disease, even when co-infection with HCV occurs.

Keyword

Torque teno virus (TTV); Hepatitis C virus (HCV); Thalassemia

MeSH Terms

Alanine Transaminase
Aspartate Aminotransferases
Blood Transfusion
Case-Control Studies
Coinfection
Ferritins
Hepacivirus
Hepatitis
Hepatitis C
Humans
Liver Diseases
Thalassemia
Torque
Torque teno virus
Alanine Transaminase
Aspartate Aminotransferases
Ferritins

Reference

1. Okamoto H, Mayumi M. TT virus: virological and genomic characteristics and disease associations. J Gastroenterol. 2001; 36:519–529. PMID: 11519830.
Article
2. Chen BP, Rumi MG, Colombo M, et al. TT virus is present in a high frequency of Italian hemophilic patients transfused with plasma-derived clotting factor concentrates. Blood. 1999; 94:4333–4336. PMID: 10590078.
Article
3. Nishizawa T, Okamoto H, Konishi K, Yoshizawa H, Miyakawa Y, Mayumi M. A novel DNA virus (TTV) associated with elevated transaminase levels in posttransfusion hepatitis of unknown etiology. Biochem Biophys Res Commun. 1997; 241:92–97. PMID: 9405239.
Article
4. Hino S. TTV, a new human virus with single stranded circular DNA genome. Rev Med Virol. 2002; 12:151–158. PMID: 11987140.
Article
5. Poovorawan Y, Tangkijvanich P, Theamboonlers A, Hirsch P. Transfusion transmissible virus TTV and its putative role in the etiology of liver disease. Hepatogastroenterology. 2001; 48:256–260. PMID: 11268979.
6. Cossart Y. TTV - a virus searching for a disease. J Clin Virol. 2000; 17:1–3. PMID: 10814932.
Article
7. Simmonds P. Transfusion virology: progress and challenges. Blood Rev. 1998; 12:171–177. PMID: 9745887.
Article
8. Blejer JL, Salamone HJ. Is TT virus (TTV) a true hepatitis virus cause? Medicina (B Aires). 2000; 60:631–638. PMID: 11188907.
9. Okamoto H, Takahashi M, Nishizawa T, et al. Marked genomic heterogeneity and frequent mixed infection of TT virus demonstrated by PCR with primers from coding and noncoding regions. Virology. 1999; 259:428–436. PMID: 10388666.
Article
10. Kondili LA, Pisani G, Beneduce F, et al. Prevalence of TT virus in healthy children and thalassemic pediatric and young adult patients. J Pediatr Gastroenterol Nutr. 2001; 33:629–632. PMID: 11740244.
Article
11. Liweń I, Januszkiewicz-Lewandowska D, Nowak J. TT virus-characteristics, occurrence and routes of transmission. Przegl Epidemiol. 2002; 56:91–99.
12. Hsu HY, Ni YH, Chen HL, Kao JH, Chang MH. TT virus infection in healthy children, children after blood transfusion, and children with non-A to E hepatitis or other liver diseases in Taiwan. J Med Virol. 2003; 69:66–71. PMID: 12436479.
Article
13. Davidson F, MacDonald D, Mokili JL, Prescott LE, Graham S, Simmonds P. Early acquisition of TT virus (TTV) in an area endemic for TTV infection. J Infect Dis. 1999; 179:1070–1076. PMID: 10191206.
Article
14. Yzèbe D, Xueref S, Baratin D, Boulétreau A, Fabry J, Vanhems P. TT virus. A review of the literature. Panminerva Med. 2002; 44:167–177. PMID: 12094130.
15. Tokita H, Murai S, Kamitsukasa H, et al. High TT virus load as an independent factor associated with the occurrence of hepatocellular carcinoma among patients with hepatitis C virus-related chronic liver disease. J Med Virol. 2002; 67:501–509. PMID: 12115995.
Article
16. Meng XW, Komatsu M, Goto T, et al. Clinical significance of TT virus in chronic hepatitis C. J Gastroenterol Hepatol. 2001; 16:202–208. PMID: 11207902.
Article
17. Cleavinger PJ, Persing DH, Li H, et al. Prevalence of TT virus infection in blood donors with elevated ALT in the absence of known hepatitis markers. Am J Gastroenterol. 2000; 95:772–776. PMID: 10710073.
Article
18. Yuki N, Kato M, Masuzawa M, et al. Clinical implications of coinfection with a novel DNA virus (TTV) in hepatitis C virus carriers on maintenance hemodialysis. J Med Virol. 1999; 59:431–436. PMID: 10534723.
Article
19. Charlton M, Adjei P, Poterucha J, et al. TT-virus infection in North American blood donors, patients with fulminant hepatic failure, and cryptogenic cirrhosis. Hepatology. 1998; 28:839–842. PMID: 9731581.
Article
20. Zein NN, Arslan M, Li H, et al. Clinical significance of TT virus infection in patients with chronic hepatitis C. Am J Gastroenterol. 1999; 94:3020–3027. PMID: 10520863.
Article
21. Ni YH, Chang MH, Lue HC, et al. Posttransfusion hepatitis C virus infection in children. J Pediatr. 1994; 124:709–713. PMID: 8176556.
Article
22. Lai MW, Chang MH, Hsu HY. Non-A, non-B, non-C hepatitis: its significance in pediatric patients and the role of GB virus-C. J Pediatr. 1997; 131:536–540. PMID: 9386654.
Article
23. Chen HL, Chang MH, Ni YH, Hsu HY, Kao JH, Chen PJ. Hepatitis G virus infection in normal and prospectively followed posttransfusion children. Pediatr Res. 1997; 42:784–787. PMID: 9396558.
Article
24. Hu YW, Al-Moslih MI, Al Ali MT, et al. Clinical outcome of frequent exposure to Torque Teno virus (TTV) through blood transfusion in thalassemia patients with or without hepatitis C virus (HCV) infection. J Med Virol. 2008; 80:365–371. PMID: 18098140.
Article
25. Sampietro M, Tavazzi D, Martinez di Montemuros F, et al. TT virus infection in adult beta-thalassemia major patients. Haematologica. 2001; 86:39–43. PMID: 11146569.
26. Ozyürek E, Ergünay K, Kuskonmaz B, et al. Transfusion-transmitted virus prevalence in Turkish patients with thalassemia. Pediatr Hematol Oncol. 2006; 23:347–353. PMID: 16621777.
27. Erensoy S, Sayiner AA, Türkoğlu S, et al. TT virus infection and genotype distribution in blood donors and a group of patients from Turkey. Infection. 2002; 30:299–302. PMID: 12382090.
Article
28. Chan PK, Chik KW, Li CK, et al. Prevalence and genotype distribution of TT virus in various specimen types from thalassaemic patients. J Viral Hepat. 2001; 8:304–309. PMID: 11454183.
Article
29. Dhenain M, Boulétreau A, Bourguignon F, et al. The TT virus: review of the literature. Clin Invest Med. 2000; 23:355–365. PMID: 11271001.
Full Text Links
  • KJH
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr