Mioli V A, Balestra E, Bibiano L, Carletti P, Della Bella S, Fanciulli E, Gaffi G, Marinelli R, Perilli R, Ricciatti A M
Nephrological Department University Hospital Torrette, Ancona, Italy.
Nephron. 1992;61(3):278-83. doi: 10.1159/000186905.
Because of the great problem of viral hepatitis in hemodialysis patients, the Italian Society of Nephrology decided to perform a national epidemiologic survey. We contacted 467 nephrological centers by a questionnaire which let us have information on 25,746 uremic patients: 18,338 on HD, 2,250 on PD and 5,176 with kidney transplant, respectively 78.5% of the total Italian dialysed patients and 91.4% of the total transplanted patients. Statistical analyses were performed. HBV infections occur in 7.8% of the patients (2,008 cases) but considering that 485 cases became spontaneously negative, the true overall incidence of chronic carriers falls to 4.9%. The main causes of the infection are reported as transfusions (64.3%) and dialysis environment (12%). The vaccination program performed by 93.2% of the centers, obtained an efficacious seroconversion in 4,626 of 7,790 cases vaccinated: the vaccine currently most utilized is the recombinant type administered by means of 3 versus 4 boosters. In the 2nd part of the survey, we report information concerning the presence of nephropaties associated with HBV infections in nonuremic patients (208 cases). We present and discuss the clinical picture of the nephropaties, the hystologic bioptic pattern and the prognosis of the kidney pathology.
由于血液透析患者中病毒性肝炎问题严重，意大利肾脏病学会决定开展一项全国性流行病学调查。我们通过问卷调查联系了467个肾脏病中心，从而获得了25746例尿毒症患者的信息：分别有18338例接受血液透析、2250例接受腹膜透析以及5176例接受肾移植，分别占意大利透析患者总数的78.5%和移植患者总数的91.4%。进行了统计分析。7.8%的患者（2008例）发生了HBV感染，但考虑到485例患者自发转阴，慢性携带者的实际总体发病率降至4.9%。感染的主要原因据报告为输血（64.3%）和透析环境（12%）。93.2%的中心实施了疫苗接种计划，在7790例接种疫苗的患者中有4626例获得了有效的血清转化：目前最常用的疫苗是重组型，接种方式为3剂与4剂加强针。在调查的第二部分，我们报告了非尿毒症患者中与HBV感染相关的肾病情况（208例）。我们展示并讨论了肾病的临床表现、组织活检模式以及肾脏病理的预后。
