Shibuya A, Takeuchi A, Kamata K, Saigenji K, Kobayashi N, Yoshida A
Department of Internal Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Nephrol Dial Transplant. 1998 Aug;13(8):2033-6. doi: 10.1093/ndt/13.8.2033.
Patients on maintenance haemodialysis (HD) are at greater risk of parenterally transmitted infection with not only A-E hepatitis virus but also with hepatitis G virus (HGV) that has been recovered from patients with non A-E hepatitis. The prevalence of HGV infection in HD patients, which is based on the detection of HGV RNA using reverse transcription-polymerase chain reaction techniques, differs widely between countries. Recently, a new assay has been developed that detects an antibody to the envelope protein (E2) of HGV (anti-E2) that appears to be associated with the loss of HGV RNA from the serum and which may be a useful marker for previous HGV infection.
To determine the actual prevalence of HGV infection in maintenance HD patients, we examined both HGV RNA and anti-E2 antibody in sera from 200 patients undergoing maintenance HD.
Thirty patients (15%) tested positive for HGV RNA, and 14 (7%) tested positive for E2 antibody. Of these, two individuals tested positive for both markers. Overall, 21% of these HD patients had been exposed to HGV. A logistic regression analysis failed to show any clinical feature associated with the detection of HGV RNA. The duration of HD and the presence of HCV RNA were associated with anti-E2. Male gender and HCV RNA were risk factors for the elevation of serum ALT activities. HGV RNA sequences of the patients were not identical to each other.
Our data indicate that HGV infection is prevalent in patients undergoing HD but that liver abnormalities are rare. The nosocomial transmission of HGV in the HD unit was not confirmed.
维持性血液透析（HD）患者不仅感染甲-戊型肝炎病毒，还感染庚型肝炎病毒（HGV）的经肠道外传播感染风险更高，HGV已在非甲-戊型肝炎患者中发现。基于逆转录-聚合酶链反应技术检测HGV RNA，HD患者中HGV感染的患病率在不同国家差异很大。最近，已开发出一种新的检测方法，可检测HGV包膜蛋白（E2）抗体（抗-E2），该抗体似乎与血清中HGV RNA的消失有关，可能是既往HGV感染的有用标志物。
为确定维持性HD患者中HGV感染的实际患病率，我们检测了200例接受维持性HD患者血清中的HGV RNA和抗-E2抗体。
30例患者（15%）HGV RNA检测呈阳性，14例（7%）E2抗体检测呈阳性。其中，2例患者两种标志物检测均呈阳性。总体而言，这些HD患者中有21%曾接触过HGV。逻辑回归分析未显示与检测HGV RNA相关的任何临床特征。HD持续时间和HCV RNA的存在与抗-E2相关。男性和HCV RNA是血清ALT活性升高的危险因素。患者的HGV RNA序列彼此不相同。
我们的数据表明，HGV感染在HD患者中很普遍，但肝脏异常很少见。未证实HD单元中HGV的医院内传播。
