Human pegivirus infection after transplant: Is there an impact?

Table 1 Seroprevalence and RNA prevalence studies in different transplant populations

Type of transplant and period	Country/region	Patients (n)	RNA prevalence	Seroprevalence	Comment	Ref.
Liver transplant; 1997-2017	Japan	313	14.1%	/	No significant association between HPgV infection and liver transplant outcomes; HPgV infection induced the up-regulation of ISG expression in peripheral blood mononuclear cells	Izumi et al[27], 2019
Renal transplant; 1989-1996	Italy	155	24%	17%	Not associated with disease pathogenicity; Lower serum levels of HCV-RNA in HGV/HCV co-infected carriers compared to those infected with HCV only	De Filippi et al[34], 2001
Renal transplant; 2015-2016	Brazil	61	36.1%	/	Most common genotype 2 (80.9%), followed by G3 (9.5%), G1 (4.85), and G5 (4.8%); no significant impact on patient outcomes	Savassi-Ribas et al[31], 2020
Renal transplant	France	103 HCV positive RT recipients	28%	/	HGV infection has no detrimental effect on liver enzymes or liver histology in HCV-positive patients	Rostaing et al[37], 1999
Heart transplant; 1993-1998	Germany	51 transplant candidates	2.0%; 0	0; 6.0%	RNA persisted after transplant; anti-E2 antibodies persisted after transplant	Kallinowski et al[38], 2002
		Post-transplant	36.0% de novo	/	RNA persisted in 94% infected patients; No significant correlation between the number of blood transfusions and the infection; No impact on liver disease or patient outcome
Liver transplant; 1993-1998	Germany	72 transplant candidates	11.%	/	RNA persisted in 88% of infected patients	Kallinowski et al[38], 2002
		Post-transplant	36% de novo	/	RNA persisted in 87% of infected patients; no significant correlation between the number of blood transfusions and the infection; no impact on liver disease or patient outcome
Kidney transplant; 1997	Thailand	94	43%	/	Co-circulation of HGV and HCV RNA was detected in 12 patients (13%)	Raengsakulrach et al[30], 1997
Heart transplant; 1993-1996	Germany	243	24%	/	HGV infections are transfusion related; not related to the use of mechanical circulatory assist devices or immunosuppression	Wolff et al[36], 1996
Liver transplant; 1989-1996	Germany	98	Pre-tx 8.2%; post-tx 44%	/	None of the hepatitis B, hepatitis C, or fulminant hepatitis, were HGV-RNA positive preoperatively; HGV was frequently acquired after LT but had no impact on the short- and medium-term clinical course post-LT	Fischer et al[23], 1999
Liver transplant; 2007-2010	Iran	106	9.4%	/	Moderate prevalence of HGV infection in liver transplant recipients	Ebadi et al[39], 2011
Kidney transplant; 1986-1990	United States	93	12%	/	HGV infection does not adversely affect clinical outcome during early follow-up	Isaacson et al[32], 1999
Liver transplant; 1989-1996	Italy	136	Pre-tx 18.4%; post-tx 47.8%	Pre-tx 26.5%	Liver transplant patients are heavily exposed to HGV before and after transplantation; HGV does not induce liver disease; most infections are self-limited and induce a protective immunity (anti-E2 antibodies presence)	Silini et al[40], 1998
HSCT; 1985-1996	France	95	29.5%	/	Acute GVHD, chronic GVHD, or veno-occlusive disease are similar in HGV+ and HGV- recipients in early period after allogenic BMT	Corbi et al[21],1997
Kidney transplant; 1997	Germany	221	14%	40%	The majority of infected individuals eliminate the virus over time	Stark et al[33], 1997
Kidney transplant; NA	Turkey	69	42%	/	Genotype 2 is the dominant type; subgroup 2a most common of the isolates	Erensoy et al[41], 2002
Liver transplant; 1993-1995	United Kingdom	47	47%	/	HGV does not cause significant liver disease after LT	Karayiannis et al[42], 1998
Liver transplant; 1979-1990	Netherlands	39	Pre-tx 15.4%; post-tx 43.6%	/	HGV infection is highly prevalent in liver transplant patients; in the absence of HBV or HCV co-infection with, no long-term negative influence on the graft	Haagsma et al[24], 1997
Kidney transplant; 1997-2000	India	70	52.9%	58.6%	GBV-C/HGV RNA significantly associated with ≥ 20 hemodialysis sessions	Abraham et al[29], 2003
Liver transplant; 1990-1994	United States	179	Pre-tx 15%; post-tx 50%	/	HGV infection not associated with poor outcome	Hoofnagle et al[26], 1997
HSCT; 2011-2017	China	188	18.6%	/	HPgV is highly prevalent in HSCT patients; blood transfusions significantly increase the risk of HPgV infection	Li et al[22], 2019
HSCT; 2014-2015	Switzerland	40	35%	/	HPgV is highly prevalent and persists for several months	Vu et al[20], 2019

HBV: Hepatitis B virus; HCV: Hepatitis C virus; HGV: Hepatitis G virus; HSCT: Hematopoietic stem cell transplantation; HpgV: Human pegivirus; GBV-C: GB virus C; GVHD: Graft versus host disease; BMT: Bone marrow transplantation; ISG: Interferon-stimulated gene.