HEPATITIS G VIRUS INFECTION IN CHRONIC DIALYSIS PATIENTS

Recently a new human hepatitis virus was identified. Hepatitis G virus (HGV) can be transmitted parenterally. Patients on hemodialysis (HD) have been shown to be at increased risk of this new virus. Whether continuous ambulatory peritoneal dialysis (CAPD) can reduce the risk of HGV infection as demonstrated for patients hepatitis C virus (HCV) remains unknown. We studied 67 hemodialysis patients and 53 CAPD patients to evaluate prevalence, risk factors, and clinical manifestations of HGV infection in the dialysis population. 200 healthy adults were selected as controls. In all cases, HGV-RNA was determined with reverse transcriptase method using polymerase chain reaction.

The prevalence of HGV viraemia in CAPD patients was 5.6%, compared with 0.5% of healthy adults (p<0.05). But, the frequency in hemodialysis patients (31.3%) was higher than the other two groups. HGV RNA was positive in 36% of HD patients and 6.4% of CAPD patients who received blood transfusion previously (p<0.01). The frequency of anti-HCV antibody was significantly higher in HGV-positive than HGV-negative patients (16/24 (66.6%) vs 28/96 (29%), p<0.01). In addition, HGV-positive patients had higher dialysis duration than HGV-negative patients. Among the 21 HGV-positive HD and 3 CAPD patients only six of them had high serum ALT levels in different ranges, 16 of them were positive for anti-HCV and 6 for HCV RNA. There was no correlation betwen sex, patient age, ALT levels and blood transfusion amounts with the frequency of HGV-RNA in the patients with HGV viraemia, but only was positive correlated with dialysis duration (r = 0.2726, p:0.0026). 

As a result, we came to the conclusion that the risk of HGV viraemia in dialysis patients increased, more marked in HD patients. But it will be useful to planned more long-term follow-up studies investigating the transmission, routes and clinical importance of HGV, and the relationship with other viruses