Clinical features of coinfection with TTV in hepatitis C virus–infected patients undergoing hemodialysis

BACKGROUND: Transfusion-transmitted virus (TTV) was identified recently as a DNA virus associated with post-transfusion hepatitis. The significance of TTV in biochemical or histologic evidence of liver disease still remains uncertain. In this study, we investigated the frequency of TTV viremia in hepatitis C virus (HCV)–infected patients undergoing hemodialysis to determine weather TTV coinfection has any independent effect on liver enzymes abnormality. METHODS: We studied 37 HCV infected patients who were on dialysis in a dialysis center in Tehran, Iran. There were no other cofactors in patients to elevate the aminotransferase enzymes such as other kinds of hepatitis, hemochromatosis, sarcoidosis, history of recent MI, medications, etc. Sera were tested for TTV DNA by polymerase chain reaction (PCR). Alanine aminotransferase (ALT) level was measured for each patient on four continual occasions within 9 months, and the mean value was recorded in analysis. RESULTS: TTV DNA was detected in 7 patients (18.9%) who all had a prior history of transfusion. There were no significant differences in gender (p = 0.08), age (p = 0.36), and duration of dialysis (p = 0.38) between TTV positive and negative groups. Five patients (71.4%) of TTV positive patients had elevated ALT versus 19 patients (62.5%) in the other group. Therefore, ALT elevation didn't differ significantly between TTV positive and negative patients (p = 1). CONCLUSIONS: This study suggests that TTV viremia doesn't correlate with serum ALT elevation. If these patients are followed up continuously in future, it will be possible to determine weather TTV coinfection deteriorates hepatitis C course.