Otedo A E O, Mc'Ligeyo S O, Okoth F A, Kayima J K
Department of Medicine, University of Nairobi, Kenya.
S Afr Med J. 2003 May;93(5):380-4.
Patients with end-stage renal disease (ESRD) on maintenance dialysis are predisposed to hepatitis B virus (HBV) infection for a number of reasons. In a similar way, the prevalence of anti-hepatitis C virus (HCV) antibodies among patients on chronic haemodialysis and peritoneal dialysis is consistently higher than in healthy populations. There are few published data on these diseases in patients undergoing maintenance dialysis in sub-Saharan Africa.
To determine the seroprevalence of HBV and HCV in patients on maintenance dialysis.
Renal Unit, Kenyatta National Hospital, the largest public referral and teaching hospital in Kenya.
Cross-sectional descriptive study.
All 100 patients on maintenance dialysis during the 9-month study period were evaluated.
The following information was obtained from all the patients: socio-demographic data, date of diagnosis of ESRD and commencement of dialysis, and number of blood transfusions. Additionally, a history suggestive of hepatitis in spouses was looked for and physical examination for tattoos and other scars was carried out. Laboratory investigations included urea, electrolytes and serum creatinine, liver enzymes, hepatitis B surface antigen (HBsAg), immunoglobulin M anti-hepatitis B core antibody (IgM anti-HBc), hepatitis B e antigen (HBeAg) and anti-HCV antibodies. Student's t-test was used to assess the significance of the data collected.
The results were expressed as mean (+/- SD). Fifty-seven males and 43 females were studied. Mean age was 44.3 +/- 14.6 years. Ten patients (10%) had elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (> 40 U/l for both). HBsAg was found in 8 patients (8%), IgM anti-HBc in 2%, and HBeAg in none. Anti-HCV antibody was found in 5%. Six of the HBsAg-positive patients were on haemodialysis, the other 2 on continuous ambulatory peritoneal dialysis (CAPD). There was no coexistence of HBV and HCV markers. Longer duration of dialysis and the number of blood transfusions were associated with an increased seroprevalence of HBV and HCV.
There is a low seroprevalence of HBV and HCV in our dialysis population. This should not lead to complaisance in screening for these potentially lethal complications.
维持性透析的终末期肾病（ESRD）患者因多种原因易感染乙型肝炎病毒（HBV）。同样，慢性血液透析和腹膜透析患者中抗丙型肝炎病毒（HCV）抗体的患病率始终高于健康人群。在撒哈拉以南非洲接受维持性透析的患者中，关于这些疾病的已发表数据很少。
确定维持性透析患者中HBV和HCV的血清流行率。
肯尼亚最大的公立转诊和教学医院——肯雅塔国家医院肾脏科。
横断面描述性研究。
对9个月研究期间所有100例维持性透析患者进行了评估。
从所有患者处获取以下信息：社会人口统计学数据、ESRD诊断日期和透析开始时间以及输血次数。此外，询问配偶中是否有肝炎病史，并对纹身和其他疤痕进行体格检查。实验室检查包括尿素、电解质和血清肌酐、肝酶、乙型肝炎表面抗原（HBsAg）、免疫球蛋白M抗乙型肝炎核心抗体（IgM抗-HBc）、乙型肝炎e抗原（HBeAg）和抗-HCV抗体。采用学生t检验评估所收集数据的显著性。
结果以平均值（±标准差）表示。共研究了57名男性和43名女性。平均年龄为44.3±14.6岁。10例患者（10%）的天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）升高（两者均>40 U/l）。8例患者（8%）检测到HBsAg，2%检测到IgM抗-HBc，未检测到HBeAg。5%检测到抗-HCV抗体。8例HBsAg阳性患者中有6例接受血液透析，另外2例接受持续性非卧床腹膜透析（CAPD）。HBV和HCV标志物未同时存在。透析时间延长和输血次数与HBV和HCV血清流行率增加有关。
我们的透析人群中HBV和HCV的血清流行率较低。但这不应导致在筛查这些潜在致命并发症时掉以轻心。
