GB virus C Viremia and Anti-E2 Antibody Response Among Hemodialysis Patients in Gorgan, Iran

Abstract

Background:GB Virus C is a blood-borne virus and a member of Flaviviridae, like hepatitis C that is distributed globally and puts hemodialysis patients at high risk of developing liver disease. The clinical significance of GBV-C in this population remains unclear.Objectives:The current study aimed to evaluate GBV-C infection among hemodialysis patients.Patients and Methods:Totally, 149 patients receiving hemodialysis were included in the study. The detection of GBV-C sequences in plasma was done by the nested Reverse transcription polymerase chain reaction (RT-PCR) using specific primers selected from highly conserved regions of 5' UTR of GBV-C and antibodies to the envelope protein of GBV-C (anti-E2 GBV-C antibody) were analyzed by also serological methods. In addition, Hepatitis B surface antigen (HBsAg), Hepatitis B core antibody (HBcAb) IgM, anti- Hepatitis C virus (HCV) and anti- hepatitis E virus (HEV) Ab was determined in patients who were GBV-C RNA and anti-E2 GBV-C antibody positive.Results:The total prevalence of GBV-C infection was 14.7% (95%CI: 0.09-0.21) among patients receiving hemodialysis. The rate of GBV-C viremia and anti-E2 antibody positivity were 6.04% and 10.73%, respectively. Among the subjects who were positive for GBV-C, 27.27% (95% CI: 0.02-0.09), 45.45% (95% CI: 0.03-0.11), 59.9% (95% CI: 0.06-0.16) and 0% (95% CI: 0.01-0.07) were positive for anti-HCV, anti-HBsAg, anti-HBc IgM and anti-(HEV) Ab, respectively. In addition, the rate of both anti-HBc IgM /anti-HCV/ HBsAg and anti-HBc IgM /anti-HCV positivity in GBV-C infected cases were 9.09%. The liver enzymes were normal in all of them. There was significant difference between GBV-C exposures with viral hepatitis co-infection, but there was no correlation between GBV-C exposure with gender, age, ethnicity, time on dialysis and history of blood transfusions. A relatively high frequency of positivity GBV-C-exposure among hemodialysis patients suggested that the transmission route for GBV-C may be nosocomial transmission, and via transfusions.Conclusions:The current study found a relatively high frequency of positivity GBV-C-exposure among the patients receiving hemodialysis in the area understudy. Nosocomial transmission seems to be the main route of GBV-C infection in the area.

Prevalence of Hepatitis G Virus and Co-Infection with Hepatitis B Virus and Hepatitis C Virus Among Hemodialysis Patients in Ahvaz, Iran

“…Generally, the prevalence of HGV varies from 11% to 24%, among HCV-infected individuals (16)(17)(18). The prevalence of HGV infection varies in different regions of Iran and ranges from 3.14% to 10.73% (19,20).…”

Presence of GB Virus C in Whole-Blood Derivatives: A Pilot Study

“…In the present study, we screened samples from whole blood CPDA1, CPDA1 RBC, washed RBC (washed to reduce plasma proteins for reducing the risk of allergic reactions) and leukocyte-reduced RBC (filtered to remove most leukocytes for reducing the risk of febrile transfusion reactions and viral infection, such as cytomegalovirus) products. A high frequency (31.5%) of GBV-C viremia was observed in whole blood or RBC products, which is surprisingly higher than the rate of GBV-C-RNA positivity in healthy blood donors (0.9 to 20%) and high risk individuals (1 to 43.6%), suggesting the likely transmission of the virus via contaminated environmental surfaces (6). The virus was detected in almost all types of RBC components but absent in whole blood CPDA1, which might be related to the small whole blood CPDA1 sample size.…”

“…Although the virus has not been clearly linked to any human disease, it has been shown that GBV-C does not replicate in hepatocytes but rather in lymphocytes (1, 8), thus suggesting the possible extrahepatic pathogenicity of the virus (9, 10). There are several reports of an association between GBV-C and hepatitis-associated aplastic anemia besides other hepatitis-causing viruses (3,6,8). In addition, an association between GBV-C and hepatitis B virus (HBV) co-infection and pathogenesis of non-Hodgkin"s lymphoma has been demonstrated.…”

“…In addition, an association between GBV-C and hepatitis B virus (HBV) co-infection and pathogenesis of non-Hodgkin"s lymphoma has been demonstrated. Moreover, the potential association of the virus with hematological disorders and hematological malignancies has been suggested (6,11,12).…”

“…A study in America confirmed the presence of GBV-C in brain specimens from deceased patients with progressive multiple sclerosis by deep sequencing method (8). Screening GBV-C infection in different populations showed that the virus may be associated with persistent infection or graft rejection in immunosuppressed patients, such as transplant recipients, patients with chronic renal failure, HIV-infected patients, patients on hemodialysis, intravenous drug users and patients with thalassemia or leukemia (6)(7)(8). Since no GBV-C nucleic acid testing has yet been proposed for whole blood or red blood cell (RBC) components in Iran, this study was designed to determine the frequency of GBV-C infection in RBC products in Gorgan, north east of Iran.…”