Excretion into bile of a novel unenveloped DNA virus (TT virus) associated with acute and chronic non-A-G hepatitis

Recently, an unenveloped, single-stranded DNA virus named TT virus (TTV) has been reported in association with hepatitis of non-A-G etiology. Five patients with TTV viremia, who received bile drainage or cholecystectomy, were tested for TTV DNA in bile by polymerase chain reaction with heminested primers. TTV DNA was detected in bile from all patients; titers were 10-100 times higher than in serum in 4 and at a comparable level in the remaining 1 patient. TTV DNA was detected in feces, also, in 1 of the 2 patients tested. The buoyant density of TTV in bile from I tested patient (1.33-1.35 g/cm(3)) was the same as that in feces (1.32-1.35 g/cm(3)). TTV may be secreted via bile into feces in a transmissible form and would spread by a fecal-oral route for deep and wide penetration into the general population.