Noh H, Kang S W, Choi S H, Shin S K, Seo B J, Lee I H, Choi K H, Han D S, Kim H S, Lee H Y
Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 1998 Apr;39(2):116-21. doi: 10.3349/ymj.1998.39.2.116.
To determine the prevalence and clinical relevance of HGV infection in dialysis patients, we performed a cross-sectional study of 61 HD patients and 79 Continuous Ambulatory Peritoneal Dialysis (CAPD) patients. HGV-RNA was identified by reverse-transcription (RT) polymerase chain reaction (PCR) assay with primers from the 5'-untranslated region of the viral genome. The prevalence of HGV infection was similar in HD and CAPD patients (9.8% vs. 12.7%), while that of HCV infection was significantly higher in HD patients compared to CAPD patients (16.4% vs. 1.3%, p < 0.05). The mean age (49.2 +/- 13.4 vs. 46.7 +/- 13.0 years), male to female ratio (2.4:1 vs. 1.3:1), history of transfusion (62.3% vs. 49.4%), history of hepatitis (27.9% vs. 26.6%), mean ALT level during the previous 6 months (22.4 +/- 37.9 vs. 14.0 +/- 7.4 IU/L), and the prevalence of HBsAg (8.2% vs. 6.3%) showed no difference between HD and CAPD patients. In both HD and CAPD patients, the presence of HGV RNA was not related to age, sex, duration of dialysis, history of transfusion, history of hepatitis, or to the presence of HBV or HCV markers. There was no significant difference in the clinical and biochemical data between patients with isolated HGV infection (n = 12) and patients without viremia (n = 106). The clinical feature of patients coinfected with HGV and HBV (n = 2), or HGV and HCV (n = 2) seemed to be similar to those of patients with isolated HBV (n = 8) or HCV (n = 9) infection. In conclusion, the prevalence of HGV infection was not different between HD and CAPD patients, and HGV infections did not seem to be associated with clinically significant hepatitis. The routes of HGV transmission, other than transfusion or contamination during HD procedure, were suspected.
为确定透析患者中庚型肝炎病毒(HGV)感染的患病率及其临床相关性,我们对61例血液透析(HD)患者和79例持续性非卧床腹膜透析(CAPD)患者进行了一项横断面研究。采用来自病毒基因组5'-非翻译区的引物,通过逆转录(RT)聚合酶链反应(PCR)检测法鉴定HGV-RNA。HD患者和CAPD患者中HGV感染的患病率相似(分别为9.8%和12.7%),而HD患者中丙型肝炎病毒(HCV)感染的患病率显著高于CAPD患者(分别为16.4%和1.3%,p<0.05)。HD患者和CAPD患者的平均年龄(分别为49.2±13.4岁和46.7±13.0岁)、男女比例(分别为2.4:1和1.3:1)、输血史(分别为62.3%和49.4%)、肝炎病史(分别为27.9%和26.6%)、前6个月的平均丙氨酸氨基转移酶(ALT)水平(分别为22.4±37.9和14.0±7.4 IU/L)以及乙肝表面抗原(HBsAg)的患病率(分别为8.2%和6.3%)均无差异。在HD患者和CAPD患者中,HGV RNA的存在与年龄、性别、透析时间、输血史、肝炎病史或HBV或HCV标志物的存在均无关。孤立性HGV感染患者(n = 12)和无病毒血症患者(n = 106)之间的临床和生化数据无显著差异。同时感染HGV和HBV(n = 2)或HGV和HCV(n = 2)的患者的临床特征似乎与孤立性HBV感染(n = 8)或HCV感染(n = 9)的患者相似。总之,HD患者和CAPD患者中HGV感染的患病率无差异,且HGV感染似乎与具有临床意义的肝炎无关。怀疑存在HD过程中输血或污染以外的HGV传播途径。