Fabrizi F, Lunghi G, Bacchini G, Corti M, Guarnori I, Raffaele L, Erba G, Pagano A, Locatelli F
Nephrology and Dialysis Unit, Hospital, Lecco, Italy.
Nephrol Dial Transplant. 1997 Aug;12(8):1645-51. doi: 10.1093/ndt/12.8.1645.
The cloning of the hepatitis G virus (HGV), a novel RNA virus of the Flaviviridae family, has been very recently developed. HGV is known to be parenterally transmitted and has been detected in several patients with cryptogenic hepatitis. However, little information exists about the epidemiology of HGV infection in renal patients. We studied 178 chronic dialysis patients and 11 renal transplant individuals to evaluate prevalence, risk factors, and clinical manifestations of HGV infection in this population.
Hepatitis G virus infection has been detected by a modified PCR technology which incorporates digoxigenin-labelled nucleotides into the amplicon. Primers from the non-coding region and the NS-5 region of HGV are utilized for a single round amplification. Using a streptavidin surface and a biotin-labelled capture probe, the labelled nucleic acid is bound through the capture probe to the surface, and the amplified nucleic acid is detected using antibody to digoxigenin.
HGV RNA was detected in 6% of chronic haemodialysis (HD) patients (11/172), 36% of renal transplant recipients (4/11), and 17% (1/6) of patients on peritoneal dialysis treatment (CAPD). There were no significant differences between HGV positive and negative patients on chronic HD treatment with regard to several demographic, biochemical and virological features. However, the frequency of anti-HCV antibody was significantly higher in HGV-positive than HGV-negative patients (9/11 (82%) vs 51/161 (32%), P = 0.006). In the whole group of HGV RNA-positive patients, 78% (11/14) had a history of blood transfusion requirements, 14/16 (87%) had co-infection with HCV, and 1 (6%) had co-infection with HBsAg. There was no significant association between HCV genotypes and HGV RNA positivity. Six (37.5%) of 16 HGV RNA-positive patients showed raised aminotransferase values in serum.
Patients on maintenance dialysis and kidney transplant recipients are at increased risk of HGV infection; HGV is very frequently associated to hepatitis C co-infection, regardless of HCV genotype. HGV may be transmitted by blood transfusions but transmission routes other than transfusion are possible; 37.5% of HGV RNA-positive patients showed raised serum aminotransferase levels. Further investigations are necessary to clarify the role of HGV infection in the development of liver disease in this clinical setting.
庚型肝炎病毒（HGV）是黄病毒科的一种新型RNA病毒，其克隆技术最近才得以发展。已知HGV通过肠道外传播，并且在一些不明原因肝炎患者中已被检测到。然而，关于肾病患者中HGV感染的流行病学信息却很少。我们研究了178例慢性透析患者和11例肾移植个体，以评估该人群中HGV感染的患病率、危险因素和临床表现。
采用改良的聚合酶链反应（PCR）技术检测庚型肝炎病毒感染，该技术将地高辛标记的核苷酸掺入扩增产物中。使用来自HGV非编码区和NS-5区的引物进行单轮扩增。利用链霉亲和素表面和生物素标记的捕获探针，标记的核酸通过捕获探针与表面结合，并用抗地高辛抗体检测扩增的核酸。
在慢性血液透析（HD）患者中，6%（11/172）检测到HGV RNA；肾移植受者中，36%（4/11）检测到；腹膜透析（CAPD）患者中，17%（1/6）检测到。在慢性HD治疗的HGV阳性和阴性患者之间，在一些人口统计学、生化和病毒学特征方面没有显著差异。然而，HGV阳性患者中抗-HCV抗体的频率显著高于HGV阴性患者（9/11（82%）对51/161（32%），P = 0.006）。在整个HGV RNA阳性患者组中，78%（11/14）有输血史，14/16（87%）合并HCV感染，1例（6%）合并HBsAg感染。HCV基因型与HGV RNA阳性之间无显著关联。16例HGV RNA阳性患者中有6例（37.5%）血清转氨酶值升高。
维持性透析患者和肾移植受者感染HGV的风险增加；无论HCV基因型如何，HGV常与丙型肝炎合并感染。HGV可能通过输血传播，但也可能存在输血以外的传播途径；37.5%的HGV RNA阳性患者血清转氨酶水平升高。需要进一步研究以阐明HGV感染在这种临床情况下肝病发展中的作用。
