Enteric transmission of transfusion-transmitted virus.

OBJECTIVE

To detect the virus in the feces and sera of patients in an outbreak of enterically transmitted non-A, non-E hepatitis, and this review covers the epidemiologic features and experimental infection of this novel virus.

DATA SOURCES

Data sources come from our own work on this subject, published and unpublished.

STUDY SELECTION

Mainly our own work is included, and related literature is collected.

RESULTS

In an outbreak of enterically transmitted non-A-E hepatitis among students, a total of 381 cases (60.7%) were documented. Viral fragments identical to transfusion transmitted virus (TTV) were detected in both serum and stool samples. Asymptomatic virus carriers among the staff had positive serum (32.1%) and feces (24.6%), clearly a potential source of infection. This viral infection prevalence in 2 remote villages in northern and southern China was 9.2% and 10.6%, respectively, suggesting that China is an endemic area. In this study, groups of 3 Rhesus monkeys were infected via oral or intravenous inoculation with patient feces. Two additional monkeys were infected by passage. The virus was detected in serum, peripheral blood mononuclear cell (PBMC), liver, spleen and small intestine, while the virus positive single strand, which might be a replicative intermediate, was only in liver, intestine and PBMC of all animals.

CONCLUSIONS

This nonenveloped DNA virus might be transmitted both by blood and enteric routes. Considering its wide distribution and high prevalence, we suppose that nonparenteral transmission is more important.