Determining the HGV infection in hemodialysis patients with cDNA polymerase chain reaction and evaluating the HGV genotype

HGV is an RNA virus within the Flavtviridae family whose presence was determined by molecular cloning techniques in 1995. The virus is common throughout the world and its mainly transmitted by parenteral routes. HGV infections are more frequent in unknown hepatitis cases, blood transfusion recipients, IV drug abusers and in hemodialysis patients. In this study, the presence of HGV-RNA was sought out in 42 hemodialysis patients, 17 dialysis unit personnel and in 158 dermatological patients as a control group by reverse transcriptase-cDNA PCR. The 5-NCR sequences of the HGV isolates were determined by Sanger's dideoxynucleotide chain termination method. Phylogenetic analysis of these sequences along with the known HGV 5'-NCR sequences has been utilized to determine the genotypes and phylogenetic relationships. Five of the 42 dialysis patients (%12), one of the 17 personnel (% 5,8) and two of the 158 dermatological patients (%1,2) have been shown to harbor HGV sequences. Eventhought the rate of HGV infection in hemodialysis patients is significantly higher than the control group (p<0,05), no known risk factors could be ascribed to HGV-RNA positivity in these patients. All isolates from the hemodialysis unit were related to HGV sequences, whereas a HGV group 4 sequence was determined in one the positive patients in the latter group. Three of the five HGV sequences isolated from hemodialysis patients clustered closely together, with bootstrap support for all three sequences, indicating a common source of infection. Besides, these sequences contained a similar insertion of 4 nucleotides between position -180 and -177. These data suggest that the viral sequences in these patients may have a common origin and nosocomial transmission of HGV infection in a hemodialysis setting is possible.Key words: GBV-C/HGV, HGV-RNA, Phylogenetic analysis, Genotype, Hemodialysis.