Hepatitis G virus infection in a haemodialysis unit: prevalence and clinical implications |
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Authors: | Forns X; Fernandez-Llama P; Costa J; Lopez-Labrador F; Ampurdanes S; Olmedo E; Saiz J; Guilera M; Lopez-Pedret J; Sanchez-Tapias J; Darnell A; Jimenez de Anta M; Ordinas A; Rodes J |
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Institution: | Liver Unit, Nephrology Department, Microbiology Department, Blood Bank, Hospital Clinic I Provincial, Barcelona, Spain; Correspondence to X Forns, Servei d'Hepatologia, Hospital Clinic I Provincial, Villarroel 170, 08036 Barcelona, Spain |
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Abstract: | Background. Hepatitis viruses have become one of the
main infectious problems in patients on long-term haemodialysis. A new RNA
virus, designated hepatitis G virus (HGV) has been recently identified. The
pathogenic relevance of this virus is currently under investigation. The
aim of this study was to analyse the prevalence and clinical implications
of hepatitis G virus infection in patients on haemodialysis.
Methods. The presence of HGV-RNA was investigated in
96 patients on maintenance haemodialysis. Hepatitis viral markers (HBsAg,
anti-HCV, HGV-RNA) and liver tests were assessed in all these patients, as
well as the risk factors for hepatitis viruses acquisition. As a control
group, 200 blood donors were tested for the presence of HGV-RNA.
Results. HGV-RNA was detected in 25 of 96 patients on
haemodialysis (26%) and in six of 200 blood donors (3%)
(P <0.001). Thirteen of 25 HGV infected
patients (52%) were coinfected with other hepatitis viruses (HBV and/or
HCV). Evidences of chronic liver disease were more frequent in patients
infected by HBV and/or HCV (61%) than in patients infected by HGV alone
(17%) (P = 0.01). Although 80% of HGV infected
patients had received blood products, the transfusion rate was not
different from non HGV-infected patients. Time on haemodialysis was
significantly shorter in patients infected with HGV alone (3.1 ±
3.5 years) compared to patients infected with HBV and/or HCV (7.6
± 5.8 years) (P = 0.04).
Conclusions. Patients on maintenance haemodialysis are
at increased risk for HGV infection. HGV infection itself does not seem to
be a frequent cause of chronic liver disease in these patients. Since the
prevalence of HGV infection in blood donors is high, blood transfusions
could be one of the main factors implicated in HGV transmission in patients
on haemodialysis. |
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