Epidemiology and Clinical Significance of Chronic Hepatitis-Related Viruses Infection in Hemodialysis Patients from Taiwan

Abstract

Background/Aims: A novel DNA virus which was designated TT virus (TTV) in 1997 was considered a possible hepatitis-related virus, like hepatitis C (HCV), hepatitis B (HBV) and GB virus C/hepatitis G viruses (GBV-C/HGV). In the present study, the molecular epidemiology and clinical significance of TTV, GBV-C/HGV and HCV infection in hemodialysis patients from Taiwan are investigated. Methods: Sera of 85 patients on maintenance hemodialysis were tested for alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), second-generation HCV antibody (anti-HCV), anti-envelope protein 2 antibody (anti-E2) and RNA of GBV-C/HGV, HCV RNA and TTV DNA. Sera of patients with positive TTV DNA, GBV-C/HGV RNA or HCV RNA were tested for viruses 2 years later. Results: Seven (8.2%) 29 (34.1%), 21 (24.7%), 12 (14.1%) and 9 (10.6%) hemodialysis patients were positive for HBsAg, Anti-HCV, HCV RNA, GBV-C/HGV RNA and anti-E2, respectively. TTV DNA was positive in 46 (54.1%) patients. Neither clinical nor virological factors were associated with TTV viremia. The ALT level was significantly elevated in HCV RNA-positive individuals than –negative ones (34.5 vs. 12.5%, p < 0.05). TTV DNA, GBV-C/HGV RNA and HCV RNA remained detectable in sera of 31 (86.1%), 6 (50%) and 21 (100%) patients collected 2 years after first diagnosis of viremia. Conclusion: Among Taiwanese hemodialysis patients, TTV infection is highly prevalent. No clinical or virological factor was observed to be significantly associated with TTV infection. The ALT abnormality was mainly attributable to HCV but not TTV infection in Taiwanese hemodialysis patients.

SEN virus infection among patients on maintenance hemodialysis in southern Taiwan

“…However, the GBV-C/HGV or TTV infection was not associated with elevated serum ALT levels. 6,7 The most critical affect on elevated serum ALT levels in uremic patients was from HCV infection. The clinical implication and etiological importance of an association between liver diseases and SENV infection still remain uncertain.…”

“…Other parenterally transmitted viruses which have been suggested as candidates for hepatitis of unknown origin include GB virus C/hepatitis G virus (GBV-C/HGV) 4 and TT virus (TTV), 5 which are also epidemic among uremic patients. 6,7 However, our previous studies have failed to show an association between liver disease and either GBV-C/HGV or TTV infection in uremic patients. 6,7 A new family of DNA viruses was recently isolated and designated as SEN virus (SENV).…”

“…6,7 However, our previous studies have failed to show an association between liver disease and either GBV-C/HGV or TTV infection in uremic patients. 6,7 A new family of DNA viruses was recently isolated and designated as SEN virus (SENV). 8,9 SENV is a small, single-stranded circular DNA virus that is distantly related to the large TTV family.…”

TT Virus Infection in Patients on Peritoneal Dialysis in Taiwan

“…[3,4] Many studies have reported the prevalence of TTV infection in hemodialysis patients. [5][6][7][8][9] Patients on hemodialysis are at risk of parenteral infections, including viral hepatitis. Patients on peritoneal dialysis are also prone to infections via contamination during exchange of peritoneal dialysate.…”

Prevalence and Genotypes of Hepatitis G Virus among Hemodialysis Patients in Eastern Anatolia, Turkey

“…Some of the most common viral infections are caused by hepatotropic or other hepatitis-associated viruses such as hepatitis B virus (HBV) [8] , hepatitis C virus (HCV) [9] , HGV [10] and transfusion-transmitted virus [11] . In recent years, a high prevalence of HGV infection among end-stage renal disease and chronic HD patients has been well documented, varying between 6 and 44%, in different countries [12][13][14][15] . Analysis of the 5 untranslated region (UTR) has led to the suggestion that variants of HGV can be divided into fi ve genotypes [16] .…”