Presence and significance of transfusion-transmitted virus infection in Iranian patients on maintenance hemodialysis

Background and Purpose: Transfusion-transmitted virus (TTV), a recently discovered DNA virus, was first identified in patients with non-A to -G hepatitis following blood transfusion. Transmission is generally via the parenteral route but recent data suggest that TTV can also be transmitted by the fecal-oral route. Methods: This cross-sectional study was conducted in March 2005 and included 324 patients on maintenance hemodialysis (HD) at 3 different centers in Tabriz, Iran. Demographic and clinical data were recorded. Blood samples for virological and biochemical tests were drawn simultaneously. TTV DNA was detected using semi-nested polymerase chain reaction. Serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase were also measured. Results: Overall seroprevalence of TTV was 9.3% (95% confidence interval, 6.1-12.5%). Prevalence rates of hepatitis B surface antigen, hepatitis C virus antibody, and hepatitis E virus antibody were 4.6% (15/324), 20.4% (66/324), and 7.4% (24/324), respectively. Patients were negative for human immunodeficiency virus antibody. There was no association between TTV infection and elevated ALT levels. TTV-positive patients were significantly younger than TTV-negative patients (p=0.018). There was no significant association between TTV positivity and age, gender, duration of HD, positivity for hepatitis B, C, or E virus infection markers, and history of transfusion and transplantation. Conclusion: We observed low TTV prevalence and no association between TTV and blood-borne infections in our HD patients. TTV infection was not related to elevated levels of liver enzymes; however, the clinical impact of this virus need further investigations.