PREVALENCE OF HEPATITIS-C AND HEPATITIS-G VIRUS-INFECTION IN CHRONIC-HEMODIALYSIS PATIENTS

An RNA virus designated hepatitis G virus (HGV) has been recently iden tified in patients with acute and chronic liver disease. HGV is transf usion transmissible, it has global distribution, and it is present in the volunteer blood donor population in the United States. One hundred sixty patients undergoing maintenance hemodialysis at the University of Miami-affiliated unit were evaluated. There were 99 men and 61 wome n ranging in age from 22 to 80 years. Sixty percent had a history of b lood transfusion, 6% had a history of drug abuse, and 9% were infected with the human immunodeficiency virus. HGV-RNA was detected by revers e-transcriptase polymerase chain reaction with amplification of two in dependent regions (5'-nontranslated region and NS5a coding region). De tection of digoxigenin-labeled amplification products with specific ca pture probes to the coding and noncoding regions was performed with th e Enzymun-test DNA on an ES-300 Immunoassay System (Boehringer-Mannhei m, Mannheim, Germany). Hepatitis C antibodies were measured with anti- hepatitis C virus enzyme-linked immunosorbent third-generation assays and hepatitis C virus RNA by reverse-transcriptase polymerase chain re action. There were 32 (20%) patients with detectable HGV RNA with both primer pairs. Because of possible mutations, the HGV virus may be det ectable only with one primer pair. We considered the latter as indeter minate: 12 had detectable levels to the NS5a region only, seven to the 5'-nontranslated region, and six had borderline results. Detectable a nd indeterminate samples were confirmed by repeat measurements in a ne w blood sample, Seven of 24 (29%) patients with detectable hepatitis C virus RNA had coexisting HGV with one or both HGV primer pairs (four with both and three with one). Five patients were hepatitis B surface antigen positive and HGV negative, We conclude that HGV infection is p revalent in our dialysis patients, The clinical significance of HGV in fection remains to be established. (C) 1998 by the National Kidney Fou ndation, Inc.