Kumar Deepak, Arora Ashu, Singh Narendera Pal, Kohli Rajiv, Kar Premashish, Das Bhudev C
Department of Medicine, Maulana Azad Medical College, New Delhi, India.
Ren Fail. 2005;27(1):87-93.
This study was designed to evaluate the seroprevalence of hepatitis G virus (HGV) infection, its impact, and its relationship with other hepatotropic viruses among chronic renal failure patients undergoing hemodialysis at the Lok Nayak Hospital, New Delhi. The study group consisted of 100 consecutive cases of patients with chronic renal failure undergoing hemodialysis and equal healthy controls matched for age and sex. The patients were included on the basis of detailed history, clinical examination, and liver function profile. HGV RNA was detected in serum samples of all patients as well as of healthy controls using nested reverse transcription polymerase chain reaction (RT-PCR). The primers used were derived from the NS3 helicase region of the viral genome. Serological assay was used for screening the viral markers for hepatitis B and C (HbsAg and Anti HCV). A history of blood transfusion was recorded in 65% of the cases. HGV RNA was detected in only six out of 100 (6%) cases of chronic renal failure. The seroprevalence of HCV infection was detected in 27 (27%), while HBV infection was seen in 10 (10%) out of 100 cases. The mixed infection of HGV and HCV was seen in 33.3% (two out of six) of the chronic renal failure cases, while the coinfection between HGV and HBV was not observed. In the 100 cases of healthy controls, HGV RNA was detected in only three (3%) subjects. Serological markers for Anti HCV antibody and HbsAg were positive in only one (1%) and two (2%) of the subjects, respectively. The seroprevalence of HGV infection in chronic renal failure was found to be statistically nonsignificant when compared to that of healthy controls. Also, there was no difference in clinical course and liver function profile of HGV-positive and HGV-negative cases. However, alanine aminotransferase (ALT) was significantly out of range in HCV-positive patients compared with HCV-negative patients. The presence of HGV infection reflected a postparental exposure to blood and blood-contaminated products in hemodialysis patients. It is suggested that HGV infection in cases of chronic renal failure is unlikely to influence the course of the disease and may be considered an innocent bystander.
本研究旨在评估新德里洛克·纳亚克医院接受血液透析的慢性肾衰竭患者中庚型肝炎病毒(HGV)感染的血清流行率、其影响以及它与其他嗜肝病毒的关系。研究组由100例连续接受血液透析的慢性肾衰竭患者以及年龄和性别相匹配的100例健康对照组成。患者入选基于详细病史、临床检查和肝功能检查结果。使用巢式逆转录聚合酶链反应(RT-PCR)检测所有患者以及健康对照血清样本中的HGV RNA。所用引物来源于病毒基因组的NS3解旋酶区域。采用血清学检测筛查乙型和丙型肝炎病毒标志物(乙肝表面抗原和抗丙肝病毒抗体)。65%的病例记录有输血史。100例慢性肾衰竭患者中仅6例(6%)检测到HGV RNA。100例患者中,27例(27%)检测到丙肝病毒感染,10例(10%)检测到乙肝病毒感染。6例慢性肾衰竭患者中有2例(33.3%)出现HGV和丙肝病毒混合感染,未观察到HGV和乙肝病毒合并感染。100例健康对照中,仅3例(3%)检测到HGV RNA。抗丙肝病毒抗体和乙肝表面抗原血清学标志物分别仅在1例(1%)和2例(2%)对照中呈阳性。与健康对照相比,慢性肾衰竭患者中HGV感染的血清流行率在统计学上无显著差异。此外,HGV阳性和HGV阴性病例的临床病程和肝功能检查结果无差异。然而,与丙肝病毒阴性患者相比,丙肝病毒阳性患者的丙氨酸氨基转移酶(ALT)显著超出正常范围。HGV感染的存在反映了血液透析患者经输血接触血液及血液污染制品。提示慢性肾衰竭患者中的HGV感染不太可能影响疾病进程,可被视为无辜旁观者。