Nephrology Dialysis Transplantation, Vol 12, Issue 7 1326-1329, Copyright © 1997 by Oxford University Press
C Cornu, M Jadoul, G Loute and P Goubau
BACKGROUND: The prevalence, incidence, risk factors, and clinical impact of
infection by the recently discovered hepatitis G virus (HGV) in
haemodialysed (HD) patients, are poorly defined. METHODS: All 119 HD
patients from two Belgian units selected for their different hepatitis C
virus (HCV) prevalences (A: 19.2%, B: 3.4%) were tested for the presence of
HGV-RNA, using the reverse transcriptase polymerase chain reaction (RT-PCR)
and primers from the 5'-NC and NS 5a genome regions. The results of
anti-HCV antibodies and alamine aminotransferase levels (ALT) at the time
of RT-PCR, number of transfusions from the onset of HD, and time on HD were
retrieved from the medical charts. Forty patients were retested by RT-PCR
3-64 months later. RESULTS: HGV-RNA was detected with both sets of primers
in 11/78 patients (14.1%) from centre A and 8/41 patients (19.5%) from
centre B, for an average prevalence of 16%. One patient was indeterminate
(positive with one set of primers). The presence of HGV-RNA correlated
neither with time on HD (P = 0.18), nor with the number of transfusions on
HD (P = 0.14). It was associated with the presence of anti-HCV antibodies
in centre A (P < 0.01) but not B (P > 0.5). Twenty-seven initially
negative (-) patients (A: n = 18; B: n = 9) were retested: two became
positive (+) both in the absence of transfusions for years, giving a yearly
incidence of 1.7%. The 13 initially HGV-RNA (+) patients remained so over
time (33 patient-years). The presence of HGV-RNA alone does not increase
significantly the ALT level, in contrast to the strong influence of HCV.
CONCLUSION: The prevalence and yearly incidence of HGV infection are 16%
and 1.7%, respectively, in our HD patients. Neither the number of
transfusions on HD nor the time on HD are significant risk factors.
Although mixed HCV/HGV infections indicate common risks, the prevalence of
HCV in a particular setting does not predict prevalence of HGV. As new
infections are detected in the absence of blood transfusions, HGV may be
another marker of nosocomial viral transmission. Once acquired, the
infection persists for many years in HD patients.
ORIGINAL ARTICLES
Hepatitis G virus infection in haemodialysed patients: epidemiology and clinical relevance
Department of Virology, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels, Belgium.
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