Infection with hepatitis GB virus C in patients on maintenance hemodialysis.
BACKGROUND
A recently discovered non-A-E hepatitis virus has been designated hepatitis GB virus C (HGBV-C), but little is known about its mode of transmission and its clinical manifestations. We studied 519 patients on maintenance hemodialysis to determine whether they were infected with HGBV-C.


METHODS
HGBV-C RNA was identified in serum by a reverse-transcription-polymerase-chain-reaction assay with nested primers deduced from a non-structural region. A nucleotide sequence of 100 bp in the nonstructural region was determined on HGBV-C clones.


RESULTS
HGBV-C RNA was detected on 3.1 percent of the patients on hemodialysis (16 of 519), as compared with 0.9 percent of healthy blood donors (4 of 448, P<0.03). None of the 16 patients had evidence of active liver disease, although 7 were also infected with hepatitis C virus. Eight patients with HGBV-C infection were followed for 7 to 16 years. In two patients the virus was present at the start of hemodialysis. One had a history of transfusion, and HGBV-C persisted over a period of 16 years; 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 transfusion was infected with an HGBV-C variant with the same sequence as in two of the patients with post-transfusion HGBV-C infections.


CONCLUSIONS
Patients on maintenance hemodialysis are at increased risk for HGBV-C infection. This virus produces persistent infections, which may be transmitted by transfusions but may also be transmitted by other means.
Masuko
K
K
Masuko Hospital, Aichi-Ken, Japan.
Mitsui
T
T
Iwano
K
K
Yamazaki
C
C
Okuda
K
K
Meguro
T
T
Murayama
N
N
Inoue
T
T
Tsuda
F
F
Okamoto
H
H
Miyakawa
Y
Y
Mayumi
M
M
D000328:Adult; D000368:Aged; D001483:Base Sequence; D018076:DNA, Complementary / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D018067:Flaviviridae / Q000235:genetics* / Q000302:isolation & purification; D006518:Hepatitis Viruses / Q000235:genetics* / Q000302:isolation & purification; D006525:Hepatitis, Viral, Human / Q000209:etiology / Q000635:transmission / Q000821:virology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects*; D065227:Transfusion Reaction
D018076:DNA, Complementary; D004279:DNA, Viral; D012367:RNA, Viral