Lu A, Wang A, Sheng R
Peking Union Medical College Hospital, Beijing.
Zhonghua Nei Ke Za Zhi. 1997 Jun;36(6):402-5.
We determined the prevalence and incidence of hepatitis C virus (HCV) infection among hemodialysis patients and evaluate their risk factors. 80 patients on maintenance hemodialysis in Peking Union Medical College Hospital Dialysis Center from December 1994 to June 1995 were studied. 30 medical students were used as health controls. Serum samples were tested for HCV antibodies by a second-generation enzyme-linked immunosorbent assay (ELISA) and for HCV RNA using nested polymerase chain reaction (PCR) and retested for anti-HCV and HCV RNA three months later. 24 (30%) of 80 hemodialysis patients were anti-HCV positive, and 2 (3.6%) of 56 anti-HCV negative cases were found HCV RNA positive. By combined assessment, the HCV infection rate of hemodialysis patient was 32.5% (26/80). Mantel-Haenszel analysis showed that HCV infection was associated with multi-transfusions, dialysis over a long period, renal transplantation, history of operation. Samples of dialysate in 9 serum HCV RNA positive cases were directly detected for HCV RNA, and 3 were found HCV RNA detectable. HCV infection rate in hemodialysis patients is higher than that of general population. The main risk factors for HCV transmission is transfusion of unscreened blood but is not an independent factor, hemodialysis itself plays an important role, the length of time on dialysis, renal transplantation, blood-contaminated material and contaminated dialysis equipment are also the risk factors. Infected hemodialysis patients should be isolated.
我们确定了血液透析患者丙型肝炎病毒(HCV)感染的患病率和发病率,并评估了其危险因素。对1994年12月至1995年6月在北京协和医院透析中心进行维持性血液透析的80例患者进行了研究。选取30名医学生作为健康对照。采用第二代酶联免疫吸附试验(ELISA)检测血清样本中的HCV抗体,采用巢式聚合酶链反应(PCR)检测HCV RNA,并在3个月后重新检测抗-HCV和HCV RNA。80例血液透析患者中有24例(30%)抗-HCV阳性,56例抗-HCV阴性患者中有2例(3.6%)HCV RNA阳性。综合评估显示,血液透析患者的HCV感染率为32.5%(26/80)。Mantel-Haenszel分析表明,HCV感染与多次输血、长期透析、肾移植、手术史有关。对9例血清HCV RNA阳性病例的透析液样本直接检测HCV RNA,发现3例可检测到HCV RNA。血液透析患者的HCV感染率高于普通人群。HCV传播的主要危险因素是输注未筛查血液,但这不是一个独立因素,血液透析本身起重要作用,透析时间长短、肾移植、血液污染材料和污染的透析设备也是危险因素。感染的血液透析患者应予以隔离。