Huang C H, Kao J H, Kuo Y M, Tsai T J, Hung K Y, Chen D S
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
Nephrol Dial Transplant. 1998 Nov;13(11):2914-9. doi: 10.1093/ndt/13.11.2914.
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.
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.
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).
Patients on CAPD are at increased risk of GBV-C/HGV infection, and the risk parallels the number of previously transfused units of blood.
GB病毒C型或庚型肝炎病毒(GBV-C/HGV)可通过肠道外途径传播,很可能与丙型肝炎病毒(HCV)有共同的传播途径。已证实维持性血液透析患者感染新型GBV-C/HGV的风险增加。持续性非卧床腹膜透析(CAPD)是否能像对HCV那样降低GBV-C/HGV感染风险尚不清楚。
采用逆转录-聚合酶链反应(RT-PCR),使用源自病毒基因组5'-非翻译区(5'UTR)的巢式引物检测血清GBV-C/HGV RNA。我们调查了60例CAPD患者中GBV-C/HGV病毒血症的患病率及可能的传播途径。选取100名健康成年人作为对照。
CAPD患者中GBV-C/HGV病毒血症的患病率为23.3%,而健康成年人中为1%(P<0.05)。与未感染乙型肝炎病毒(HBV)、HCV或GBV-C/HGV的患者(n = 39)相比,单纯感染GBV-C/HGV的患者(n = 11)接受的输血次数更多(平均18.9单位对6.8单位,P<0.05)。病毒血症组和非病毒血症组在年龄、性别、CAPD持续时间、既往血液透析持续时间、既往手术史以及合并HBV或HCV感染方面无显著差异。11例单纯GBV-C/HGV感染患者中有3例(27.3%)血清丙氨酸氨基转移酶(ALT)水平升高,该频率显著高于病毒血症阴性患者(0%,P<0.05)。此外,与未感染HBV、HCV和GBV-C/HGV的患者相比,GBV-C/HGV感染组的平均血清ALT水平也更高(22.3±16.9 U/L对14.0±6.8 U/L,P<0.01)。
CAPD患者感染GBV-C/HGV的风险增加,且该风险与既往输血单位数成正比。