Prevalence of a novel DNA virus (TTV) among patients on maintenance hemodialysis

TT virus infection in patients on peritoneal dialysis in Taiwan

Many studies have reported the prevalence of transfusion-transmitted virus (TTV) infection in hemodialysis patients, but few reports studied the prevalence of TTV infection in peritoneal dialysis patients. In this study, we determined the prevalence of TTV in a peritoneal dialysis population in Taiwan and related its prevalence with history of blood transfusion, serum hepatitis B surface antigen (HBsAg), antibody to hepatitis C virus (anti-HCV), and serum aminotransferases (AST and ALT) levels. Serum samples from 47 peritoneal dialysis patients and a control group of 43 patients at health examination were studied for TTV viremia by using polymerase chain reaction. The rate of blood transfusion exposure (p < 0.0001), female gender (p = 0.001), younger age (p = 0.0014), and serum AST level (p = 0.012) were significantly higher in peritoneal dialysis patients. The prevalence of TTV viremia was not significantly different between peritoneal dialysis patients and the control group (23.4% vs. 37.2%). TTV infection was not associated with evident liver diseases in peritoneal dialysis patients, and the infection rate was not different between automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) patients. There was no statistically significant association between TTV infection and age, gender, transfusion history, duration of peritoneal dialysis, AST level, ALT level, HBsAg, or anti-HCV seropositivity in peritoneal dialysis patients. Our results suggest that TTV infection is not associated with evident liver diseases, and there is no difference between TTV infection in healthy individuals and peritoneal dialysis patients. TTV transmission probably occurs via routes unrelated to peritoneal dialysis.

A novel DNA virus (SEN) among patients on maintenance hemodialysis: prevalence and clinical importance

BACKGROUND

A recently discovered DNA virus (SEN) has been assumed to be responsible for posttransfusion hepatitis in humans. Phylogenetic analysis of SEN virus has revealed the existence of 8 different strains. Two of them (SEN virus strain H (SENV-H) and SENV-D) have been described as possible candidate viruses for inducing posttransfusion hepatitis. Until now, it is unclear whether patients on maintenance hemodialysis are on increased risk for acquiring SEN virus.

OBJECTIVES

To investigate the prevalence of SENV-H among patients on maintenance hemodialysis and to examine whether special measures have to be taken to prevent nosocomial spreading of the virus.

STUDY DESIGN

Serum samples derived from 78 chronically hemodialysed patients were examined for SENV-H viremia by seminested polymerase chain reaction. A panel of 226 samples from healthy blood donors served as a control group.

RESULTS

The prevalence of SENV-H was determined to be 12.8% (n=10) among patients on maintenance hemodialysis. This is nearly the same prevalence as in healthy blood donors (16.8%; n=38). None of the solely SENV-H-viremic individuals had clinical or biochemical signs of liver disease. Enhanced severity of liver disease could not be observed in patients coinfected with hepatitis C virus and SENV-H.

CONCLUSION

We conclude that SENV-H viremia is widespread among hemodialysis patients. Since no viremic patient had clinical or biochemical signs of liver disease, in our setting the hepatitis-inducing capacity of SENV-H remains unclear. On the basis of our results, at present, we do not regard it as necessary to dialyse SENV-H-viremic patients on separate machines.