SEN Virus Infection in Egyptian Patients With Chronic Hepatitis C and Patients Undergoing Hemodialysis

Maisa Omar, PhD; Samah Saad El-Din, PhD; Nevine Fam, MD; Manal Diab, MD; Mohamed Shemis, PhD; Manar Raafat, MD; Moataz Seyam, MD; Moataz Hssan, MD; Afkar Badawy, PhD; Maha Akl, PhD; Mohamed Saber, PhD


Medscape J Med. 2008;10(12):290 

In This Article


SEN virus is a putative non-A to E hepatitis virus.[1] It was first isolated from the serum of an intravenous drug user infected with HIV.[2] By phylogenetic analysis, 9 different strains (A through I) have been identified and provisionally classified as members of the Circoviridaefamily, a group of single-stranded DNA viruses that includes the TT virus (TTV), TUS01, SANBAN, and YONBAN.[3,4,5] SEN virus is transmitted by blood, as seen by comparing the sequence homology between donors and recipients. Moreover, transfused patients are at higher risk of acquiring SEN virus than are nontransfused ones.[6]

Two SEN virus strains (D and H) were shown to be significantly associated with posttransfusion non-A to E hepatitis.[1,7] SEN virus-D and SEN virus-H were also detected more frequently in patients with chronic liver disease and hepatocellular carcinoma than in healthy adults.[8,9] However, the causal relation of these viruses to hepatic disease has not yet been proven. Hepatitis C virus (HCV) is a major cause of posttransfusion hepatitis and chronic liver disease.[10] More than half of patients with acute HCV infection develop chronic hepatitis that leads to cirrhosis and hepatocellular carcinoma, and at least 20% develop both.[11] Among patients with acute or chronic HCV infection, 22% to 85% were reported to be coinfected with SEN virus.[7,12,13,14] Although coinfection of HCV and SEN virus is common, the contribution of SEN virus infection to the course of HCV infection still requires clarification.

Patients undergoing long-term hemodialysis are considered to be at risk for infection by blood-borne viruses because that procedure is often associated with bleeding and blood transfusion.[15] These patients may also show hepatic dysfunction consistent with viral hepatitis, even without documented hepatitis A to E infection.[16]

The aim of the present study was to determine the prevalence of SEN virus infection among Egyptian patients with HCV-related chronic liver disease and uremic patients undergoing maintenance hemodialysis. We also sought to demonstrate the clinical effect of SEN virus infection on coexistent hepatitis C in terms of severity and probability of developing hepatocellular carcinoma.


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