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

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          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.

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          Most cited references35

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          Hepatitis G virus.

          A Reshetnyak, Tatiana Igorevna Karlovich, Ljudmila Urievna Ilchenko (2008)
          A number of new hepatitis viruses (G, TT, SEN) were discovered late in the past century. We review the data available in the literature and our own findings suggesting that the new hepatitis G virus (HGV), disclosed in the late 1990s, has been rather well studied. Analysis of many studies dealing with HGV mainly suggests the lymphotropicity of this virus. HGV or GBV-C has been ascertained to influence course and prognosis in the HIV-infected patient. Until now, the frequent presence of GBV-C in coinfections, hematological diseases, and biliary pathology gives no grounds to determine it as an "accidental tourist" that is of no significance. The similarity in properties of GBV-C and hepatitis C virus (HCV) offers the possibility of using HGV, and its induced experimental infection, as a model to study hepatitis C and to develop a hepatitis C vaccine.
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            Hepatitis G virus exposure in dialysis patients.

            Ali Eslamifar, Rasool Hamkar, Shahnaz Atabak … (2006)
            Hepatitis G virus (HGV) is a blood-borne virus. The predominant route of its transmission is parenteral. The aim of this study was to assess the frequency of HGV exposure in haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients in Iran. This study was performed in a major dialysis centre in Tehran, Iran. The study cohort consisted of 77 patients on HD and 13 patients on CAPD. The presence of anti-HGV envelope protein E2 (anti-E2) in the blood serum, as determined by means of an ELISA assay, indicated HGV exposure. All patients were also screened for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and hepatitis C antibody (anti-HCV). In patients who tested positive for anti-E2, HGV RNA was detected by RT-PCR using primers derived from the NS5A region of the viral genome. In total, 3.89% of the HD patients and none of the CAPD patients tested positive for anti-E2. None of the patients tested positive for HGV RNA. The mean age of the anti-E2-positive patients was 53.3 +/- 26.5 years, with 66.66% having previously received blood transfusion. The mean duration of dialysis of the anti-E2-positive patients was 68 +/- 64 months. Co-infection with HCV or HBV was not observed in the anti-E2 positive patients. The rate of exposure to HGV was low among the dialysis patients in our study. The appearance of anti-E2 was accompanied by clearance of serum HGV-RNA. No relationship was noted between HGV exposure and age, sex, history of blood transfusion, time on dialysis and HCV or HBV markers.
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              Evidence for extensive genotypic diversity and recombination of GB virus C (GBV-C) in Germany.

              Ulrich Spengler, Markus Neibecker, Jürgen K Rockstroh … (2011)
              Multiple genotypes of GB virus C (GBV-C)-a non-pathogenic flavivirus-have been identified to date, although they are not uniformly distributed worldwide. It has also been suggested that GBV-C genotype may play a role in modulating HIV disease; however, the prevalence and genotype distribution of GBV-C has not been adequately studied in most countries. Among 408 HIV positive subjects in Germany, 97 (23.8%) had detectable GBV-C RNA. Based on sequencing of the 5' untranslated region (5'-UTR), the GBV-C genotypes were 1 (n=8; 8.2%), 2 (n=81; 83.5%), and 3 (n=2; 2.1%), as well as a unique genotype not previously reported (n=6; 6.2%). Among 17 samples also sequenced in the envelope 2 (E2) region, 14 had concordant genotype results when comparing the 5'-UTR and E2, while evidence of intergenotypic recombination was observed among E2 sequences from 3 individuals. These results suggest that genotypic diversity and viral recombination contribute to the overall genetic variability of GBV-C. Copyright © 2011 Wiley-Liss, Inc.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Jundishapur J Microbiol
                Journal ID (iso-abbrev): Jundishapur J Microbiol
                Journal ID (doi): 10.5812/jjm
                Journal ID (publisher-id): Kowsar
                Title: Jundishapur Journal of Microbiology
                Publisher: Kowsar
                ISSN (Print): 2008-3645
                ISSN (Electronic): 2008-4161
                Publication date (Electronic): 01 November 2014
                Publication date (Print): November 2014
                Volume: 7
                Issue: 11
                Electronic Location Identifier: e13122
                Affiliations
                [1 ]Department of Virology, Golestan University of Medical Sciences, Gorgan, IR Iran
                [2 ]Department of Hemodialysis, Azar Hospital, Gorgan, IR Iran
                Author notes
                [* ]Corresponding author: Alijan Tabarraei, Department of Virology, Golestan University of Medical Sciences, Gorgan, IR Iran. Tel: +98-1714422652, Fax: +98-1714440225, E-mail: alijant@ 123456yahoo.com
                Article
                DOI: 10.5812/jjm.13122
                PMC ID: 4332238
                PubMed ID: 25774276
                SO-VID: c35c58f5-fb52-487a-a34d-3f2e4035c8be
                Copyright © Copyright © 2014, Ahvaz Jundishapur University of Medical Sciences; Published by Kowsar.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                Date received : 26 July 2013
                Date revision received : 21 September 2013
                Date accepted : 05 October 2013
                Categories
                Subject: Research Article

                Keywords: hemodialysis,gbv-c viremia,anti-e2 gbv-c,iran
                Data availability:
                Keywords: hemodialysis, gbv-c viremia, anti-e2 gbv-c, iran

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