A new hepatitis-associated RNA virus of the Flaviviridae products, intravenous drug use, hemodialysis, and maybe sexual contacts and from mothers to infants. [4][5][6][7][8][9][10][11] HGV RNA family has been identified and named GB virus C/ hepatitis G virus (HGV). We carried out a case-control study to evaluate has been found in patients with acute or chronic hepatic diseases and in subjects without liver diseases by use of RT-the association of HGV infection with hepatocellular carcinoma (HCC). We recruited 170 patients hospitalized for HCC PCR. 1,2 A test was developed recently to detect the presence of antibodies against HGV envelope 2 protein in human sera, (143 male and 27 female, mean age 64 years) and 306 patients hospitalized for nonliver diseases (controls) in Brescia, Italy. the HGV E2 antigen (anti-E2). 12-14 Anti-E2 has been associated with loss of detectable HGV viremia, and therefore it is HGV RNA was detected by reverse transcription-polymerase chain reaction (RT-PCR) and antibodies against HGV E2 pro-considered a marker for recovery from infection. Data on its seroprevalence suggest that the number of people infected tein (anti-E2) by an immunoassay test. HGV RNA was found in 8 cases (4.7%) and 4 controls (1.3%). The relative risk by the virus is higher than was estimated on the basis of HGV RNA seroprevalence. (RR) for HGV RNA positivity adjusted for demographic variables and hepatitis B surface antigen (HBsAg), hepatitis C
In spite of the large number of studies carried out on HGV so far, it is still unknown whether the virus can determine virus (HCV) RNA, and alcohol was 7.3 (95% confidence interval, 1.7-30.6; P Γ
.009). No HGV RNA-positive subject was liver disease in humans. 15 In fact, most information on HGV prevalence comes from case series, in which selection bias also positive for anti-E2. Anti-E2 prevalence did not differ significantly between cases (20%) and controls (15.3%), and cannot be excluded, thus making comparisons difficult. The case-control study design has been suggested to investigate no RR increase was found by this marker. Among subjects with HGV exposure (HGV RNA plus anti-E2 positive), a whether HGV is associated with liver disease. 5 To assess the association of hepatocellular carcinoma (HCC) with HGV greater proportion of cases (40%) than controls (14%) had transfusion history. The possible role of HGV in HCC etiology infection, we carried out a hospital-based case-control study in the province of Brescia, an area in northern Italy with one seems modest because the population-attributable risk is lower (4%) than those for HBsAg (22%), HCV RNA (36%), of the highest incidence rates of HCC in Europe. 16 and heavy alcohol intake (52%). This study supports the hy-
PATIENTS AND METHODS
pothesis of an association between HGV infection and HCC,
This study is part of a large case-control study carried out to Abbreviations: ELISA, enzyme-linked immunosorbent assay; HBsAG, hepatitis B surface antigen; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HCV, hepatitis local Ethics Committees, and patients gave their informed consent C virus; HGV, hepatitis G virus; RIBA, recombinant immunoblot assay; RR, relative to participate. Only subjects born in Italy, aged up to 75 years, and risk; RT-PCR, reverse transcription-polymerase chain reaction.