International Urology and Nephrology

, Volume 39, Issue 4, pp 1257–1263 | Cite as

Hepatitis G virus exposure in dialysis patients

  • Ali Eslamifar
  • Rasool Hamkar
  • Amitis Ramezani
  • Farrokhlagha Ahmadi
  • Latif Gachkar
  • Somayeh Jalilvand
  • Ladan Adibi
  • Shahnaz Atabak
  • Ali Khameneh
  • Ramin Ghadimi
  • Arezoo AghakhaniEmail author
Original Article



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.


Anti-HGV envelope protein E2 Continuous ambulatory peritoneal dialysis Haemodialysis Hepatitis G virus 



The authors are grateful to the Pasteur Institute of Iran for financial support of this study. Special thanks are extended to Ms. Jaleh Taeb for her contribution in writing this publication.


  1. 1.
    Simons JN, Leary TP, Dawson GJ et al (1995) Isolation of novel virus-like sequences associated with human hepatitis. Nat Med 1:564–569PubMedCrossRefGoogle Scholar
  2. 2.
    Linnen J, Wages J, Zhang-Keck ZY et al (1996) Molecular cloning and disease association of hepatitis G virus: a transfusion-transmissible agent. Science 271:505–508PubMedCrossRefGoogle Scholar
  3. 3.
    Roth WK, Waschk D, Marx S et al (1997) Prevalence of hepatitis G virus and its strain variant, the GB agent, in blood donations and their transmission to recipients. Transfusion 37:651–656PubMedCrossRefGoogle Scholar
  4. 4.
    Katayama K, Kageyama T, Fukushi S et al (1998) Full-length GBV-C/HGV genomes from nine Japanese isolate: characterization by comparative analyses. Arch Virol 143:1063–1075PubMedCrossRefGoogle Scholar
  5. 5.
    Li G, Ma HH, Lau GK, Leung YK, Yao CL, Chong YT, Tang WH Yao JL (2002) Prevalence of hepatitis G virus infection and homology of different viral strains in Southern China. World J Gastroenterol 8:1081–1087Google Scholar
  6. 6.
    Lefrère JJ, Roudot TF, Morand JL, Brossard Y et al (1999) Prevalence of GB virus type C/hepatitis G virus RNA and of anti-E2 in individuals at high or low risk for blood-borne or sexually-transmitted viruses: evidence of sexual and parenteral transmission. Transfusion 39:83–94PubMedCrossRefGoogle Scholar
  7. 7.
    Lefrere JJ, Sender A, Mercier B et al (2000) High rate of GB virus type C/HGV transmission from mother to infant: possible implications for the prevalence of infection in blood donors. Transfusion 40:602–607PubMedCrossRefGoogle Scholar
  8. 8.
    Chen M, Sonnerborg A, Johansson B, Sallberg M (1997) Detection of hepatitis G virus (GB virus C) RNA in human saliva. J Clin Microbiol 35:973–975PubMedGoogle Scholar
  9. 9.
    Seemayer CA, Viazov S, Philipp T, Roggendorf M (1998) Detection of GBV-C/HGV RNA in saliva and serum, but not in urine of infected patients. Infection 26:39–41PubMedGoogle Scholar
  10. 10.
    Yashina TL, Favorov MO, Khudyakov YE et al (1997) Detection of hepatitis G virus (HGV) RNA: clinical characteristics of acute HGV infection. J Infect Dis 175:1302–1306PubMedCrossRefGoogle Scholar
  11. 11.
    Ling BH, Zhuang H, Cui YH et al (1998) A cross-sectional study on HGV infection in a rural population. World J Gastroenterol 4:489–492PubMedGoogle Scholar
  12. 12.
    Moaven LD, Locarnini SA, Bowden DS et al (1997) Hepatitis G virus and fulminant hepatic failure: infection. J Hepatol 27:613–619PubMedCrossRefGoogle Scholar
  13. 13.
    Sheng L, Soumillion A, Beckers N et al (1998) Hepatitis G virus infection in acute fulminant hepatitis: prevalence of HGV infection and sequence analysis of a specific viral strain. J Viral Hepatitis 5:301–306CrossRefGoogle Scholar
  14. 14.
    Corun C, Jadoul M, Loute G, Goubau P (1997) Hepatitis G virus infection in haemodialysis patients: epidemiology and clinical relevance. Nephrol Dial Transplant 12:1326–1329CrossRefGoogle Scholar
  15. 15.
    Alter HJ, Nakatsuji Y, Melpolder J et al (1997) The incidence of transfusion-associated hepatitis G virus infection and its relation to liver disease. N Engl J Med 336:747–757PubMedCrossRefGoogle Scholar
  16. 16.
    Masuko K, Mitsui T, Iwano K et al (1996) Infection with hepatitis GB virus C in patients on maintenance hemodialysis. N Engl J Med 334:1485–1490PubMedCrossRefGoogle Scholar
  17. 17.
    De Lamballerie X, Charrel RN (1996) Hepatitis GB virus C in patients on hemodialysis. N Engl J Med 334:1549 PubMedCrossRefGoogle Scholar
  18. 18.
    Shibuya A, Takeuchi A, Kamata K et al (1998) Prevalence of hepatitis G virus RNA and anti-E2 in a Japanese haemodialysis population. Nephrol Dial Transplant 13:2033–2036PubMedCrossRefGoogle Scholar
  19. 19.
    Schulte-Frohlinde E, Schmolke S, Reindl W et al (1998) Significance of antibodies to recombinant E2 protein of hepatitis G virus in haemodialysis patients. J Viral Hepat 5:341–344PubMedCrossRefGoogle Scholar
  20. 20.
    Campo N, Sinelli N, Brizzolara R et al (1999) Hepatitis G virus infection in haemodialysis and in peritoneal dialysis patients. Nephron 82:17–21PubMedCrossRefGoogle Scholar
  21. 21.
    Hyunjin N, Kang SW, Choi SH et al (1998) Hepatitis G virus infection in hemodialysis and continuous ambulatory peritoneal dialysis patients. Yonesi Med J 39:116–121Google Scholar
  22. 22.
    Fabrizi F, De Vecchi AF, Lunghi G et al (2002) Epidemiology of GB virus C/Hepatitis G virus infection in patients on peritoneal dialysis. Perit Dial Int 22:405–410PubMedGoogle Scholar
  23. 23.
    Dille BJ, Surowy TK, Gutierrez RA et al (1997) An ELISA for detection of antibodies to the E2 protein of GB virus C. J Infect Dis 175:458–461 PubMedGoogle Scholar
  24. 24.
    Tacke M, Kiyosawa K, Stark K et al (1997) Detection of antibodies to a putative hepatitis G virus envelope protein. Lancet 349:318–320PubMedCrossRefGoogle Scholar
  25. 25.
    Thomas DL, Vlahov D, Alter HJ et al (1998) Association of antibody to GB virus C (hepatitis G virus) with viral clearance and protection from reinfection. J Infect Dis177:539–542Google Scholar
  26. 26.
    Sugai Y, Nakayama H, Fukuda M et al (1997) Infection with GB virus C in patients with chronic liver disease. J Med Virol 51:175–181PubMedCrossRefGoogle Scholar
  27. 27.
    Andonov A, Sauder C, Jacobsen H, Chaudhary R (1998) Comparison of six sets of PCR primers from two different genomic regions for amplification of GB virus C/hepatitis G virus RNA J Clin Microbiol 36:286–289 PubMedGoogle Scholar
  28. 28.
    Goldblum SE, Reed WP (1980) Host defenses and immunologic alternations associated with chronic hemodialysis. Ann Intern Med 93:597–613PubMedGoogle Scholar
  29. 29.
    Jacobs C, Brunner FP, Chantler C et al (1977) Combined report on regular dialysis and transplantation in Europe, VII, 1976. Proc Eur Dial Transplant Assoc 14:3–69 PubMedGoogle Scholar
  30. 30.
    Sheng L, Widyastuti A, Kosala H et al (1998) High prevalence of hepatitis G virus infection compared with hepatitis C virus infection in patients undergoing chronic hemodialysis. Am J Kidney Dis 31:366–368Google Scholar
  31. 31.
    Fabrizi F, Martin P (1999) GBV-C/HGV infection in end-stage renal. J Nephrol 12:131–139 PubMedGoogle Scholar
  32. 32.
    Cabrerizo M, Bartolome J, de Sequera P et al (1999) GBV-C/HGV-RNA in serum and peripheral blood mononuclear cells in hemodialysis patients. Kidney Int 56:1120–1128PubMedCrossRefGoogle Scholar
  33. 33.
    Desassis JF, Laperche S, Girault A et al (1999) Prevalence of present and past hepatitis G virus infection in a French hemodialysis centre. Nephrol Dial Transplant 14:2692–2697PubMedCrossRefGoogle Scholar
  34. 34.
    Konomi N, Miyoshi C, Zerain CF et al (1999) Epidemiology of hepatitis B, C, E and G virus infection and molecular analysis of hepatitis G isolates in Bolivia. J Clin Microbiol 37:3291–3295 PubMedGoogle Scholar
  35. 35.
    Forns X, Fernandez-Llama P, Costa J et al (1997) Hepatitis G virus infection in a haemodialysis unit: prevalence and clinical implications. Nephrol Dial Transplant 12:956–960 PubMedCrossRefGoogle Scholar
  36. 36.
    Bastani B, Frenche D, Gellens M, Di Bisceglie A (1998) Infection with hepatitis G (HGV) and hepatitis C (HCV) viruses in patients on chronic hemodialysis. Am J Nephrol 9:199ACrossRefGoogle Scholar
  37. 37.
    Medina M, Ashby M, Schlüter V et al (1998) Prevalence of hepatitis C and G virus infection in chronic hemodialysis patients. Am J Kid Dis 31:224–226PubMedGoogle Scholar
  38. 38.
    Desai XX, Pal RB, Banker DD (2004) GB virus C/hepatitis G virus infection in Indian blood donors and high-risk groups. Transfus Apher Sci 30:111–117PubMedCrossRefGoogle Scholar
  39. 39.
    Tsuda F, Hadiwandowo S, Sawada N et al (1996) Infection with GB virus C (GBV-C) in patients with chronic liver disease or on maintenance hemodialysis in Indonesia. J Med Virol 49:248–252PubMedCrossRefGoogle Scholar
  40. 40.
    Zali MR, Mayumi M, Raoufi M, Nowroozi A (1999) GBV-C infection among patients with hepatitis C virus in the Islamic Republic of Iran: a preliminary report. East Mediterr Health J 5:1023–1029Google Scholar
  41. 41.
    Huang JJ, Lee WC, Ruaan MK et al (2001) Incidence, transmission, and clinical significance of hepatitis G virus infection in hemodialysis patients. Eur J Clin Microbiol Infect Dis 20:374–379PubMedCrossRefGoogle Scholar
  42. 42.
    Pilot-Matias TJ, Carrick RJ, Coleman PF et al (1996) Expression of the GB virus E2 glycoprotein using the Semliki Forest virus vector system and its utility as a serologic marker. Virology 255:282–292CrossRefGoogle Scholar
  43. 43.
    Ross RS, Viazov S., Schmitt U et al (1998) Distinct prevalence of antibodies to the E2 protein of GB virus C/hepatitis G virus in different parts of the world (abstr). J Med Virol 54:103–106 PubMedCrossRefGoogle Scholar
  44. 44.
    Szabo A, Viazov S, Heemann U et al (1997) GBVC/HGV infection in renal dialysis and transplant patients. Nephrol Dial Transplant 12:2380–2384PubMedCrossRefGoogle Scholar
  45. 45.
    Tribl B, Oesterreicher C, Pohanka E et al (1998) GBV-C/HGV in hemodialysis patients: Anti-E2 antibodies and GBV-C/RNA in serum and peripheral blood mononuclear cells. Kidney Int 53:212–216 PubMedCrossRefGoogle Scholar
  46. 46.
    Kallinowski B, Ahmadi R, Seipp S et al (1998) Clinical impact of GB-C virus in haemodialysis patients. Nephrol Dial Transplant 13:93–98PubMedCrossRefGoogle Scholar
  47. 47.
    Lefrère JJ, Loiseau P, Maury J et al (1997) Natural history of GBV-C/hepatitis G virus infection through the follow-up of GBV-C/hepatitis G virus-infected blood donors and recipients studied by RNA polymerase chain reaction and Anti-E2 serology Blood 90:3776–3780PubMedGoogle Scholar
  48. 48.
    Stránský J (1996) Discovery of hepatitis G virus. J Czech Physicians 4:99–101Google Scholar
  49. 49.
    Mushahwar IK, Zuckerman JN (1998) Clinical implications of GB virus-C. J Med Virol 56:1–3PubMedCrossRefGoogle Scholar
  50. 50.
    Hinrichsen H, Leimenstoll G, Stegen G et al (2002) Prevalence of and risk factors for hepatitis G (HGV) infection in haemodialysis patients: a multicentre study. Nephrol Dial Transplant 17:271–275PubMedCrossRefGoogle Scholar
  51. 51.
    Wang Y, Chen HS, Fan MH et al (1997) Infection with GB virus C and hepatitis C virus in hemodialysis patients and blood donors in Bejing. J Med Virol 52:26–30PubMedCrossRefGoogle Scholar
  52. 52.
    Tanaka E, Alter HJ, Nakatsuji Y et al (1996) Effect of hepatitis G virus infection on chronic hepatitis C. Ann Int Med 125:740–743 PubMedGoogle Scholar
  53. 53.
    Martinot M, Marcellin P, Boyer N et al (1997) Influence of hepatitis G virus infection on the severity of liver disease and response to interferon alpha in patients with chronic hepatitis C. Ann Int Med 126:874–881 PubMedGoogle Scholar
  54. 54.
    Fabrizi F, Lunghi G, Bacchini G et al (1997) Hepatitis G virus infection in chronic dialysis patients and kidney transplant recipients. Nephrol Dial Transplant 12:1645–1651PubMedCrossRefGoogle Scholar
  55. 55.
    Tringali G (1998) Prevalence of HGV infection in hemodialysis patients from eastern Sicily, Giorn. Ital Nefrol 15:141–147Google Scholar
  56. 56.
    Filho RR, Carneiro M.AS, Teles SA et al (2004) GB virus C/hepatitis G virus infection in dialysis patients and kidney transplant recipients in central Brazil, Mem Inst Oswaldo Cruz 99:639–643Google Scholar
  57. 57.
    Klusonova H, Pliskova L, Palicka V, Fixa P (2001) Prevalence of viral hepatitis G infection in hemodialysis patients and coinfection with viral hepatitis B and C. Vnitr Lek 47:678–681PubMedGoogle Scholar
  58. 58.
    Lopez-Alcorocho JM, Barril G, Ortiz-Movilla N et al (2001) Prevalence of hepatitis B, hepatitis C, GB virus C/hepatitis G and TT viruses in predialysis and hemodialysis patients. J Med Virol 63:103–107PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Ali Eslamifar
    • 1
  • Rasool Hamkar
    • 2
  • Amitis Ramezani
    • 1
  • Farrokhlagha Ahmadi
    • 3
  • Latif Gachkar
    • 4
  • Somayeh Jalilvand
    • 2
  • Ladan Adibi
    • 2
  • Shahnaz Atabak
    • 5
  • Ali Khameneh
    • 6
  • Ramin Ghadimi
    • 7
  • Arezoo Aghakhani
    • 1
    Email author
  1. 1.Clinical Research DepartmentPasteur Institute of IranTehranIran
  2. 2.Virology DepartmentTehran University of Medical SciencesTehranIran
  3. 3.Nephrology DepartmentTehran University of Medical SciencesTehranIran
  4. 4.Infectious Diseases Research CenterShahid Beheshti University of Medical SciencesTehranIran
  5. 5.Nephrology DepartmentShahid Beheshti University of Medical SciencesTehranIran
  6. 6.Microbiology DepartmentLahijan Azad UniversityLahijanIran
  7. 7.Gastroenterology DepartmentTehran University of Medical SciencesTehranIran

Personalised recommendations