Prevalence of present and past hepatitis G virus infection in a French haemodialysis centre

Abstract

Background. Previous studies, detecting GB virus-C (GBV-C) or hepatitis G virus (HGV) RNA by using reverse transcriptase polymerase chain reaction (RT-PCR), have shown that haemodialysis (HD) patients had a high risk of being infected and viraemic with this virus. A past GBV-C/HGV contact can now be detected by testing for antibodies directed against the GBV-C/HGV envelope protein E2 (anti-E2). Methods. In order to evaluate GBV-C/HGV contact, 120 patients undergoing chronic HD were tested for GBV-C/HGV RNA by RT-PCR and anti-E2 antibodies by ELISA. GBV-C/HGV viraemic patients were followed prospectively for 18 months, and retrospectively when sera were stored. The total follow-up was between 18 and 78 months. Results. GBV-C/HGV RNA was detected in 17 patients (14%), and 18 patients (15%) had a significant level of anti-E2 antibodies. No positive anti-E2 specimens were also positive for GBV-C/HGV RNA and vice versa. A total of 35 patients (29%) were contaminated with GBV-C/HGV. Sixteen of the 17 viraemic patients had a persistent viraemia (follow-up 18-78 months) and one cleared the virus during the study period. A past or present GBV-C/HGV contact was statistically correlated with the duration of HD and hepatitis C virus (HCV) infection, but was independent of age, hepatitis B virus (HBV) infection, and alanine aminotransferase (ALT) level. Conclusions. Twenty-nine per cent of patients who underwent HD in our centre have been infected by GBV-C/HGV, 49% were still viraemic and 51% have developed anti-E2 antibodies, indicating a past contact with GBV-C/HGV. Our results demonstrate that the prevalence of GBV-C/HGV contact in HD was under-estimated when only RT-PCR was used. Therefore GBV-C/HGV contact is probably much more frequent in HD than previous studies would suggest and is at this time not correlated with hepatotoxicity. Anti-HCV antibodies blood screening since 1990 and recent changes in managing HD patients have probably reduced GBV-C/HGV contact in the same way.