Weinstein T, Tur-Kaspa R, Chagnac A, Korzets A, Ori Y, Zevin D, Herman M, Gafter U
Department of Nephrology, Golda Campus, Rabin Medical Center, Petah Tiqva, Israel.
Isr Med Assoc J. 2001 Mar;3(3):174-7.
Hepatitis C virus is the major cause of acute and chronic hepatitis in patients with end-stage renal disease receiving replacement therapy.
To define the prevalence of HCV RNA in a population of patients on dialysis in Israel, to determine the relative risk of acquiring HCV infection while treated by hemodialysis or chronic ambulatory peritoneal dialysis, and to define the HCV genotypes in this population.
During 1995 we studied 162 dialysis patients. Information was obtained regarding the mode of dialysis, years of treatment, number of blood transfusions, and results of serological testing for HCV, hepatitis B virus, and human immunodeficiency virus. Anti-HCV antibodies were tested by a third-generation microparticle enzyme immunoassay. HCV RNA was determined by polymerase chain reaction. HCV genotyping was performed by a hybridization assay.
HCV RNA was detected in 18% of the HD group and 7% of the CAPD group. The number of HCV RNA-positive patients was significantly higher in the HD than the CAPD group (P < 0.05). HCV RNA-positive HD patients were treated longer than the HCV RNA-negative patients (P < 0.02).
Third-generation immunoassay proved to be highly sensitive (94%) and specific (91%) in identifying HCV RNA positivity. Several HCV subtypes were detected, 1b being the most frequent. Identification and isolation of infected HCV patients may minimize its spread in dialysis units and prevent cross-infection.
丙型肝炎病毒是接受替代治疗的终末期肾病患者急性和慢性肝炎的主要病因。
确定以色列透析患者群体中丙型肝炎病毒RNA（HCV RNA）的流行率，确定血液透析或持续性非卧床腹膜透析治疗期间感染HCV的相对风险，并确定该群体中的HCV基因型。
1995年期间，我们研究了162例透析患者。获取了有关透析方式、治疗年限、输血次数以及HCV、乙型肝炎病毒和人类免疫缺陷病毒血清学检测结果的信息。采用第三代微粒酶免疫测定法检测抗HCV抗体。通过聚合酶链反应测定HCV RNA。采用杂交试验进行HCV基因分型。
血液透析（HD）组中18%检测到HCV RNA，持续性非卧床腹膜透析（CAPD）组中7%检测到HCV RNA。HD组中HCV RNA阳性患者的数量显著高于CAPD组（P<0.05）。HCV RNA阳性的HD患者治疗时间比HCV RNA阴性患者更长（P<0.02）。
第三代免疫测定法在识别HCV RNA阳性方面具有高度敏感性（94%）和特异性（91%）。检测到几种HCV亚型，其中1b型最为常见。识别和隔离受感染的HCV患者可将其在透析单位的传播降至最低，并防止交叉感染。
