ABSTRACT
Hepatitis G virus [HGV] is, like hepatitis C virus, a blood-borne virus and a member of the family of flaviviridae. HGV is distributed globally and is present in the volunteer blood donor population. Thus, for epidemiological reasons, HGV is of interest in hemodialysis [HD] patients, who are at risk of parenterally transmitted infections. To study HGV infection among hemodialysis patients in our locality, 50 HD patients and 25 apparently healthy volunteer blood donors were studied. All subjects' sera were tested for transaminases [ALT and AST], HBsAg, anti-HCV IgG, HCV-RNA, anti-HGV-E2 and HGV RNA. Anti-HGV-E2 was determined using an enzyme immunoassay; HGV RNA and HCV RNA were detected using reverse transcription polymerase chain reaction [RT-PCR]. HBsAg was detected in 10 [20%] of HD patients in comparison to none of the control. Anti-HGV-E2 and HGV- RNA were found in 18% and 42% of HD patients respectively, in comparison to 8% and 12% in the control group. The total prevalence of HGV infection in our HD patients was 60%. All the HGV-RNA positive sera were negative for anti-HGVE2 and vice versa. 15 of the HGV-RNA positive patients were followed up for 18 months, one of them showed anti-HGV-E2 seroconvertion with loss of viremia. HGV exposure did not correlate with age, gender, duration of HD therapy, or history of blood transfusions. HCV-RNA and HGV co-infection was found in 71.4% of HD patients. In addition, HGV infection was not found to cause significant elevation of ALT or AST enzymes levels in the group exposed to HGV. Although 18/21[85.7%] of HGV-RNA positive HD patients had history of blood transfusion, 3 [14.3%] HD patients who were HGV-RNA positive had neither history of transfusion nor other risk of parenteral exposure, supporting the hypothesis of nosocomial transmission. To conclude, patients on maintenance dialysis are at increased risk for HGV infection in our locality. In addition to transmission through blood transfusion, HGV may have been transmitted nosocomially, patient-to-patient, within the HD unit and the universal precautions should be strictly followed to prevent transmission of viruses among HD patients. The HGV RNA is considered a marker for current HGV viremia, while the anti-HGV-E2 is considered a marker for recovery from HGV infection. Detection of both antibody and viraemia is important to establish the real rate of HGV infection