Publication: Sürekli ayaktan periton diyalizi uygulanan hastalarda serum HGV RNA’nın RT-PZR ve hibrid yakalama yöntemi ile saptanması
Abstract
Yüzyılın sonuna doğru tanımlanan Hepatit G virüsü (HGV) temel olarak parenteral yol ile bulaşmaktadır. Bulaş yolu ve genomik organizasyon açısından Hepatit C virüsü (HCV) ile benzerliği dikkat çekicidir. HGV hepatotropik virüs olmasına karşın, karaciğer hastalıklarındaki rolü ile ilgili tartışmalar sürmektedir. Hemodiyaliz hastaları HGV infeksiyonu açısından yüksek risk altındadır. Sürekli Ayaktan Periton Diyalizi (S.A.P.D.) uygulanan hastalarda HCV infeksiyon riskinin azaltıldığı ispat edilmesine karşın, HGV infeksiyonu riskini azaltıp azaltmadığı hala bilinmemektedir. Bu çalışmanın amacı, ülkemizde SAPD uygulanan hastalardaki HGV sıklığını ve önemini araştırmaktır. Çalışmaya 46 kronik böbrek hastası ( 24 erkek, 22 kadın) ve 34 sağlıklı kontrol (13 erkek, 21 kadın) alındı. Serum HGV RNA tayini, virüsün NS5a bölgesine ait primerler ile, Polimeraz Zincir Reaksiyonu (PZR) ve ELISA (hibrid yakalama) yöntemi kullanılarak saptandı. Serum HGV RNA hasta gurubunda % 6.5, kontrol gurubunda % 5.8 bulundu ve sonuç kontrol gurubuna göre yüksek olmakla beraber aradaki fark anlamlı bulunmadı. HGV RNA pozitif olguların tümü kan transfüzyonu almış olup, 2/ 3'ü daha önceden hemodiyalize girmişti. Sonuç olarak, HGV infeksiyonunun sıklığı SAPD hastalarında kontrollere göre farklı bulunmamıştır. HGV infeksiyonu için en önemli risk faktörünün kan transfüzyonu olduğu ve çoğunlukla asemptomatik viremi şeklinde seyir izlediği saptanmıştır.
Hepatitis G virus (HGV) which has been discovered at the end of this century, is basically transmitted parenterally. The genomic similarities between HGV and Hepatitis C virus (HCV) are intriguing. The transmission mode is also similar for HGV and HCV. Although HGV is a hepatotropic virus, its role in the liver diseases is still under debate. Patients on dialysis are under high risk for infection. Whether Continuous Ambulatory Peritoneal Dialysis (CAPD) can reduce the risk of HGV infection as demonstrated for HCV remains unknown. The aim of this study is to determine the frequency of HGV infection in CAPD patients. Forty-six patients with chronic renal disease (24 male, 22 female) and 34 healthy controls (13 male, 21 female) were included in to study. The NS5a region primers of the virus were used and the presence of serum HGV RNA was determined by using Polymerase Chain Reaction (PCR) and ELISA (hybride capture). HGV RNA was detected in sera of 6.5 % of CAPD patients and 5.8 % of controls. The frequency of HGV infection was found to be higher in the CAPD patients but this was not statistically significant when compared to the healthy controls. All the HGV RNA positive patients had history of blood transfusions and before CAPD 2/ 3 of them were already maintenance haemodialysis. In conclusion the frequency of HGV infection in CAPD patients was not higher than the healthy controls. The clinical course of HGV infection is silent viremia and blood transfusions seem to be the most important risk factor for the spread of the virus.
Hepatitis G virus (HGV) which has been discovered at the end of this century, is basically transmitted parenterally. The genomic similarities between HGV and Hepatitis C virus (HCV) are intriguing. The transmission mode is also similar for HGV and HCV. Although HGV is a hepatotropic virus, its role in the liver diseases is still under debate. Patients on dialysis are under high risk for infection. Whether Continuous Ambulatory Peritoneal Dialysis (CAPD) can reduce the risk of HGV infection as demonstrated for HCV remains unknown. The aim of this study is to determine the frequency of HGV infection in CAPD patients. Forty-six patients with chronic renal disease (24 male, 22 female) and 34 healthy controls (13 male, 21 female) were included in to study. The NS5a region primers of the virus were used and the presence of serum HGV RNA was determined by using Polymerase Chain Reaction (PCR) and ELISA (hybride capture). HGV RNA was detected in sera of 6.5 % of CAPD patients and 5.8 % of controls. The frequency of HGV infection was found to be higher in the CAPD patients but this was not statistically significant when compared to the healthy controls. All the HGV RNA positive patients had history of blood transfusions and before CAPD 2/ 3 of them were already maintenance haemodialysis. In conclusion the frequency of HGV infection in CAPD patients was not higher than the healthy controls. The clinical course of HGV infection is silent viremia and blood transfusions seem to be the most important risk factor for the spread of the virus.