Hepatitis G virus (HGV) infection in chronic haemodialysis patients in the County of Šibenik and Knin

Hepatitis G virus (HGV) i GB virus tipa C (GBV-C) danas se smatraju varijantama istog RNA virusa i svrstani su u porodicu Flaviviridae. Obzirom da se HGV prvenstveno prenosi parenteralnim putem, uočena je njegova učestalija pojava među dijaliziranim bolesnicima. Cilj ovog rada bio je istražiti pojavnost infekcije HGV-om u bolesnika s kroničnim zatajenjem bubrega liječenih kroničnom hemodijalizom u Jedinici za dijalizu Opće bolnice Šibenik te razmotriti značenje infekcije HGV-om u tih bolesnika. Od 79 bolesnika koji su u razdoblju od kolovoza 2004. do lipnja 2005. godine dijalizirani u ovoj bolnici, prospektivno je tijekom devet mjeseci praćeno 16 bolesnika koji su zadovoljavali uvjete za uključenje na listu čekanja za kadaveričnu transplantaciju bubrega. Infekcija HGV-om utvrđena je metodom lančane reakcija polimeraze u 6/16 ispitanika među kojima niti u jednog nije potvrđena koinfekcija HBV-om, dok je u jednog potvrđena koinfekcija HCV-om. Povišene vrijednosti aminotransferaza nađene su u 2/6 HGV-pozitivna bolesnika, od kojih je jedan bio koinficiran HCV-om. Vrijeme provedeno na hemodijalizi znatno pridonosi povećanju rizika akviriranja infekcije HGV-om. Međutim, višekratno liječenje krvnim pripravcima, koje se u literaturi spominje kao glavni čimbenik rizika za akviriranje infekcije HGV-om, nije utvrđeno kao značajan čimbenik rizika u naših ispitanika.Hepatitis G virus (HGV) and GB virus type C (GBV-C) are today considered variants of the same RNA virus that belong to the Flaviviridae family. Since HGV is primarily transmitted parenterally, its high prevalence has been recorded among dialyzed patients. The aim of this paper was to investigate the prevalence of HGV infection in patients with chronic renal failure undergoing chronic haemodialysis at the Dialysis Unit of the General Hospital Šibenik and to determine the significance of HGV infection in these patients. Out of 79 patients dialyzed in this Unit during the observed period (August, 2004 – June, 2005), we prospectively followed 16 patients that met inclusion criteria for cadaveric kidney transplant waiting list. HGV infection was detected by polymerase chain reaction (PCR) method in 6/16 examinees, non of whom had a HBV coinfection confirmed, only HCV coinfection in one patient. Elevated aminotransferases were found in two HGV-positive patients, of whom one was coinfected with HCV. The time spent on haemodialyis significantly increases the risk for activating HGV infection. However, multiple treatments with blood products, described in literature as the main risk factor for activating HGV infection, were not determined as a significant risk factor in our examinees

DISTRIBUTION OF THE MAIN ABO BLOOD GROUP ALLELES IN CROATIAN POPULATION

Raspodjela krvnih grupa ABO varira diljem svijeta u različitim populacijama, ali i unutar subpopulacija. Cilj rada je prikazati razdiobu 5 glavnih alela ABO sustava (O1, O2, A1, A2 i B) u hrvatskoj populaciji, te ih usporediti s drugim nacijama. Istraživanje je provedeno na 303 uzorka krvi, zdravih, nesrodnih dobrovoljnih davatelja krvi (123 žena, 180 muškaraca) u dobi od 18 do 65 godina. Metode: Nakon izolacije genomske DNA pomoću komercijalnih kolona (QIAamp DNA Blood Mini kit, Qiagen, Njemačka) ili na uređaju MagNA Pure Compact (Roche Diagnostics Corporation, SAD), određeni su genotipovi ABO pomoću metode PCR-SSP. Rezultati: Genotipizacijom je utvrđeno 12 genotipova. Najzastupljeniji genotip je O1O1 (37,2 %), pa slijede O1A1 (27,1 %), O1B (15,8 %), A1B (4,3 %), A1A1 (4,0 %), O1A2 (3,6 %), O1O2 (2,6 %), A1A2 (1,7 %), O2A1 (1,7 %), A2B (1,0 %), BB (0,7 %), O2O2 (0,3 %). Među ispitanicima nisu nađena tri rijetka ABO genotipa: A2A2, O2A2, O2B. Alelne frekvencije iznose: O1 – 0,62; O2 – 0,025; A1- 0,21; A2 – 0,035 i B – 0,11. Razdioba alela ABO u Hrvatskoj je usporediva s drugim europskim narodima. Zaključak: Rezultati genotipizacije ABO krvne grupe kod dobrovoljnih davatelja krvi, koji su reprezentativan uzorak hrvatske populacije, od temeljnog su značenja za istraživanja ABO sustava krvnih grupa kao genetičkog čimbenika rizika za neke bolesti, kao i za antropološka ispitivanja.The frequencies of gene polymorphisms of blood groups serve as markers for populations and races. Distribution of ABO blood groups varies among populations and subpopulations around the world. The aim of the study was to determine distribution of the 5 main alleles of ABO system among Croatian blood donors and compare them with other populations. Material and Methods: The study included 303 samples of healthy unrelated volunteer blood donors, 123 female and 180 male, aged 18-65 years, as a representative sample population of Croatia. After isolation of genomic DNA using commercial columns (QIAamp DNA Blood Mini Kit, Qiagen, Germany) or on the Magna Pure Compact (Roche Diagnostics Corp., USA) device, ABO genotypes were determined by the PCR-SSP method. Results: Twelve of 15 ABO genotypes were identifi ed. The most common was O1O1 (37.30%), followed by O1A1 (27.00%), O1B (15.80%), A1B (4.30%), A1A1 (4.00%), O1A2 (3.60%), O1O2 (2.60%), A1A2 (1.70%), O2A1 (1.70%), A2B (1.00%), BB (0.70%), and O2O2 (0.30%). Three rare ABO genotypes, A2A2, O2A2, and O2B, were not identifi ed. The calculated allele frequencies of the fi ve main alleles were as follows: O1, 0.620; O2, 0,025; A1, 0.21; A2, 0,035; and B, 0.11. In the Croatian population, O1 was found to be the most common allele, followed by A1 and B, while O2 allele was the least prevalent one. Conclusion: The distribution of alleles in Croatia is comparable to other European nations. According to the frequency of B allele, the Croatian population is comparable to Eastern Europe, probably due to migration of the population in the past. Results of ABO blood group genotyping have fundamental importance for research of the ABO system as a genetic risk factor for some diseases, as well as for anthropologic testing

ABO Blood Groups and Genetic Risk Factors for Thrombosis in Croatian Population

Aim To assess the association between ABO blood group genotypes and genetic risk factors for thrombosis (FV Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T mutations) in the Croatian population and to determine whether genetic predisposition to thrombotic risk is higher in non-OO blood group genotypes than in OO blood group genotypes. Methods The study included 154 patients with thrombosis and 200 asymptomatic blood donors as a control group. Genotyping to 5 common alleles of ABO blood groups was performed by polymerase chain reaction with sequence specific primers (PCR-SSP). FV Leiden was determined by PCR-SSP, while prothrombin and methylenetetrahydrofolate reductase were determined by PCR and restriction fragment length polymorphism (PCR-RFLP). Results There was an association between non-OO blood group genotypes and the risk of thrombosis (odds ratio [OR] 2.08, 95% confidence interval [CI], 1.32-3.27). The strongest association with thrombotic risk was recorded for A1B/A2B blood group genotypes (OR, 2.73; 95% CI, 1.10- 6.74), followed by BB/O1B/O2B (OR, 2.29; 95% CI, 1.25-4.21) and O1A1/O2A1 (OR, 1.95; 95% CI, 1.15-3.31). FV Leiden increased the risk of thrombosis 31-fold in the group of OO carriers and fourfold in the group of non-OO carriers. There was no significant difference in the risk of thrombosis between OO and non-OO blood groups associated with prothrombin mutation. Non-OO carriers positive for methylenetetrahydrofolate reductase had a 5.7 times greater risk of thrombosis than that recorded in OO carriers negative for methylenetetrahydrofolate reductase. Conclusion Study results confirmed the association of non-OO blood group genotypes with an increased risk of thrombosis in Croatia

Smjernice Hrvatskog društva za transfuzijsku medicinu za određivanje Rh(D) krvne grupe i primjenu RhD genotipizacije

SAŽETAK Radna skupina Hrvatskog društva za transfuzijsku medicinu pripremila je smjernice za određivanje Rh(D) krvne grupe i primjenu RhD genotipizacije. U smjernicama je opisan klinički značaj antigena D, povijest i ograničenja serološkog testiranja antigena D te mogućnosti RhD genotipizacije. Cilj smjernica bio je objava novih postupnika serološkog određivanja Rh(D) krvne grupe bolesnicima, trudnicama i novorođenčadi s uputama za specijaliste transfuzijske medicine u hitnom i redovnom radu te tumačenjima nalaza namijenjenim ginekolozima, pedijatrima, neonatolozima, anesteziolozima, internistima, liječnicima obiteljske medicine te svim liječnicima koji se u svom radu susreću s bolesnicima koji primaju krvne pripravke i donose odluku o primjeni RhIG imunoprofilakse. Kao rezultat provođenja smjernica predviđeno je praćenje i periodično izvještavanje u slučaju sumnje na RhD imunizaciju kod osoba nositelja D-varijante. Tijekom trudnoće postoji i mogućnost neinvazivnog određivanja prijenatalnog fetalnog RhD genotipa iz majčine plazme iza 16. tjedna gestacije, kao važnog alata u procjeni rizika razvoja hemolitičke bolesti fetusa i novorođenčeta. Radi lakšeg snalaženja navedene su vrste spremnika za uzorkovanje krvi i potrebna količina uzoraka. Navedena pretraga dostupna je u Hrvatskom zavodu za transfuzijsku medicinu na zahtjev ginekologa, a preporučuje se prvenstveno RhD imuniziranim trudnicama te u slučaju donošenja odluke o ranoj prijenatalnoj anti-D imunoprofilaksi i svim Rh(D) negativnim neimuniziranim trudnicama