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GB virus C/hepatitis G virus infection in patients on continuous ambulatory peritoneal dialysis
1Department of Internal Medicine, National Taiwan University Hospital, Taipei.
Insights
Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) face a higher risk of GB virus C or hepatitis G virus (GBV-C/HGV) infection. This risk is directly associated with the number of blood transfusions received.
Area of Science:
- Virology
- Infectious Diseases
- Nephrology
Background:
- GB virus C or hepatitis G virus (GBV-C/HGV) shares transmission routes with hepatitis C virus (HCV).
- Patients on maintenance hemodialysis exhibit an elevated risk for GBV-C/HGV infection.
- The comparative risk of GBV-C/HGV infection in continuous ambulatory peritoneal dialysis (CAPD) patients versus hemodialysis is not well-established.
Purpose of the Study:
- To determine the prevalence of GBV-C/HGV infection in CAPD patients.
- To investigate potential transmission routes of GBV-C/HGV in this population.
- To assess the association between GBV-C/HGV infection and blood transfusion history.
Main Methods:
- Serum GBV-C/HGV RNA was quantified using reverse transcription-polymerase chain reaction (RT-PCR) with nested primers targeting the 5'-untranslated region (5' UTR).
- The study included 60 CAPD patients and 100 healthy adult controls.
- Statistical analyses compared infection rates, transfusion history, and alanine aminotransferase (ALT) levels between groups.
Main Results:
- GBV-C/HGV viraemia was detected in 23.3% of CAPD patients, significantly higher than the 1% observed in healthy controls (P<0.05).
- CAPD patients with GBV-C/HGV infection had received significantly more blood transfusions (mean 18.9 units) compared to uninfected patients (mean 6.8 units) (P<0.05).
- Elevated serum ALT levels were more frequent (27.3%) and mean ALT levels were higher in GBV-C/HGV-infected CAPD patients compared to those without infection (P<0.05 and P<0.01, respectively).
Conclusions:
- CAPD patients are at an increased risk of GBV-C/HGV infection.
- The risk of GBV-C/HGV infection in CAPD patients is correlated with the number of blood units transfused.
- GBV-C/HGV infection may be associated with elevated liver enzymes in CAPD patients.
Background:
GB virus C or hepatitis G virus (GBV-C/HGV) can be transmitted parenterally, very likely sharing common routes of transmission with hepatitis C virus (HCV). Patients on maintenance haemodialysis have been shown to be at increased risk of the novel GBV-C/HGV infection. Whether continuous ambulatory peritoneal dialysis (CAPD) can reduce the risk of GBV-C/HGV infection as demonstrated for HCV remains unknown.
Methods:
Serum GBV-C/HGV RNA was detected by reverse transcription-polymerase chain reaction (RT-PCR) with nested primers derived from the 5'-untranslated region (5' UTR) of the viral genome. We investigated the prevalence of GBV-C/HGV viraemia in 60 patients on CAPD and the possible routes of transmission. One hundred healthy adults were selected as controls.
Results:
The prevalence of GBV-C/HGV viraemia in CAPD patients was 23.3%, compared with 1% of healthy adults (P<0.05). Compared with patients without hepatitis B virus (HBV), HCV or GBV-C/HGV infection (n=39), those with GBV-C/HGV infection alone (n=11) have received more blood transfusions (mean 18.9 units vs 6.8 units, P<0.05). There were no significant differences between the viraemic and nonviraemic groups with respect to age, gender, duration of CAPD, duration of previous haemodialysis, previous history of surgery and co-infection with HBV or HCV. Three of the 11 (27.3%) patients with GBV-C/HGV infection alone had elevated serum alanine aminotransferase (ALT) level, and the frequency was significantly higher than that of patients negative for the viraemia (0%, P<0.05). In addition, the mean serum ALT level was also higher in the group with GBV-C/HGV infection compared with those without HBV, HCV and GBV-C/HGV infections (22.3+/-16.9 U/l vs 14.0+/-6.8 U/l, P<0.01).
Conclusions:
Patients on CAPD are at increased risk of GBV-C/HGV infection, and the risk parallels the number of previously transfused units of blood.