Teles S A, Martins R M, Silva S A, Gomes D M, Cardoso D D, Vanderborght B O, Yoshidà C F
Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Brasil.
Rev Inst Med Trop Sao Paulo. 1998 Sep-Oct;40(5):281-6. doi: 10.1590/s0036-46651998000500003.
Hepatitis B has proved to be a major health hazard in hemodialysis patients. In order to investigate the hepatitis B virus (HBV) infection profile in the hemodialysis population of Goiânia city--Central Brazil, all dialysis patients (N = 282) were studied. The prevalence of any HBV marker (HBsAg, anti-HBs, and anti-HBc) was 56.7% (95% CI: 51.1-62.7), ranging from 33.3% to 77.7% depending on dialysis unit. HBV-DNA was detected in 67.6% and 88.2% of the HBsAg-positive serum samples, in 91.3% and 100% of the HBsAg/HBeAg-positive samples, and in 18.2% and 63.6% of the HBsAg/anti-HBe-reactive sera by hybridization and PCR, respectively. The length of time on hemodialysis was significantly associated with HBV seropositivity. Only 10% of the patients reported received hepatitis B vaccination. The findings of a high HBV infection prevalence in this population and the increased risk for HBV infection on long-term hemodialysis suggest the environmental transmission, emphasizing the urgent need to evaluate strategies of control and prevention followed in these units.
事实证明,乙型肝炎是血液透析患者的主要健康危害。为了调查巴西中部戈亚尼亚市血液透析人群中的乙型肝炎病毒(HBV)感染情况,对所有透析患者(N = 282)进行了研究。任何HBV标志物(HBsAg、抗-HBs和抗-HBc)的流行率为56.7%(95%CI:51.1 - 62.7),因透析单位不同而在33.3%至77.7%之间。通过杂交和PCR检测,在HBsAg阳性血清样本中,HBV-DNA的检出率分别为67.6%和88.2%;在HBsAg/HBeAg阳性样本中分别为91.3%和100%;在HBsAg/抗-HBe反应性血清中分别为18.2%和63.6%。血液透析时间长短与HBV血清学阳性显著相关。只有10%的患者报告接种过乙型肝炎疫苗。该人群中HBV感染流行率高以及长期血液透析时HBV感染风险增加的研究结果表明存在环境传播,强调迫切需要评估这些单位所采用的控制和预防策略。