INFECTION WITH HEPATITIS-GB VIRUS-C IN PATIENTS ON MAINTENANCE HEMODIALYSIS

Background. A recently discovered non-AE hepatitis virus has been desi gnated hepatitis GB virus C (HGBV-C), but little is known about its mo de of transmission and its clinical manifestations. We studied 519 pat ients on maintenance hemodialysis to determine whether they were infec ted with HGBV-C. Methods. HGBV-C RNA was identified in serum by a reve rse-transcription-polymerase-chain-reaction assay with nested primers deduced from a nonstructural region. A nucleotide sequence of 100 bp i n the nonstructural region was determined on HGBV-C clones. Results. H GBV-C RNA was detected in 3.1 percent of the patients on hemodialysis (16 of 519), as compared with 0.9 percent of healthy blood donors (4 o f 448, P<0.03). None of the 16 patients had evidence of active liver d isease, although 7 were also infected with hepatitis C virus. Eight pa tients with HGBV-C infection were followed for 7 to 16 years. In two p atients the virus was present at the start of hemodialysis. One had a history of transfusion, and HGBV-C RNA persisted over a period of 16 y ears; the other became free of HGBV-C after 10 years. In five patients , HGBV-C RNA was first detected 3 to 20 weeks after blood transfusion and persisted for up to 13 years. One patient with no history of trans fusion was infected with an HGBV-C variant with the same sequence as i n two of the patients with post-transfusion HGBV-C infections. Conclus ions. Patients on maintenance hemodialysis are at increased risk for H GBV-C infection. This virus produces persistent infections, which may be transmitted by transfusions but may also be transmitted by other me ans. (C) 1996, Massachusetts Medical Society.