血液透析中丙型肝炎病毒（HCV）感染的流行病学变化：欧洲多中心研究。

The changing epidemiology of hepatitis C virus (HCV) infection in haemodialysis: European multicentre study.

作者信息

Jadoul Michel, Poignet Jean-Louis, Geddes Colin, Locatelli Francesco, Medin Charlotte, Krajewska Magdalena, Barril Guillermina, Scheuermann Ernst, Sonkodi Sandor, Goubau Patrick

机构信息

M.D., Cliniques Universitaires St Luc, Department of Nephrology, Université catholique de Louvain, Avenue Hippocrate 10, B-1200 Brussels, Belgium.

出版信息

Nephrol Dial Transplant. 2004 Apr;19(4):904-9. doi: 10.1093/ndt/gfh012.

DOI:10.1093/ndt/gfh012

PMID:15031348

Abstract

BACKGROUND

The high prevalence of anti-hepatitis C virus (HCV) antibodies in HD patients has been known since the early 1990s but its evolution over the last decade is poorly documented.

METHODS

All chronic HD patients from 15 Belgian units were tested at (re)start of HD and every 18 months for anti-HCV antibodies (ELISA 2 in May 1991 and November 1992, then ELISA 3 until May 2000). All chronic HD patients from HD units from eight other European countries, whose prevalence of anti-HCV (+) patients had been studied in 1991-1994 (and published except in one country), were tested for anti-HCV antibodies in 1999.

RESULTS

Anti-HCV (+) prevalence decreased (P<0.001) from 13.5 (1991) to 6.8% (2000) in the Belgian cohort (n = 1710). Prevalence also decreased (P<0.05) in the participating units from France (42-30%), Sweden (16-9%) and Italy (28-16%), tended to decrease in the participating units from UK (7-3%, P = 0.058) and Hungary (26-15%, P = 0.057) but did not change (NS) in the participating units from Germany (7 to 6%), Spain (5 to 12%) and Poland (42 to 44%). In the Belgian cohort, the prevalence of anti-HCV(+) at (re)start of HD did not change significantly over 1991-2000.

CONCLUSION

The prevalence of anti-HCV(+) in HD has decreased markedly over the last decade in the participating units from most European countries. This decrease should reduce further the risk of nosocomial and occupational HCV infection in HD and ultimately contribute to improved long-term prognosis of HD patients and kidney graft recipients.

摘要

背景

自20世纪90年代初以来，人们就知道血液透析（HD）患者中抗丙型肝炎病毒（HCV）抗体的高流行率，但过去十年中其演变情况记录较少。

方法

来自比利时15个单位的所有慢性HD患者在HD开始时（重新开始时）以及每18个月检测抗HCV抗体（1991年5月和1992年11月采用酶联免疫吸附测定法2，然后直至2000年5月采用酶联免疫吸附测定法3）。来自其他八个欧洲国家HD单位的所有慢性HD患者，其抗HCV（+）患者的流行率在1991 - 1994年已进行研究（除一个国家外均已发表），于1999年检测抗HCV抗体。

结果

比利时队列（n = 1710）中抗HCV（+）流行率从1991年的13.5%降至2000年的6.8%（P<0.001）。法国（42% - 30%）、瑞典（16% - 9%）和意大利（28% - 16%）参与单位的流行率也有所下降（P<0.05），英国（7% - 3%，P = 0.058）和匈牙利（26% - 15%，P = 0.057）参与单位的流行率趋于下降，但德国（7%至6%）、西班牙（5%至12%）和波兰（42%至44%）参与单位的流行率未变化（无显著性差异）。在比利时队列中，HD开始时（重新开始时）抗HCV（+）的流行率在1991 - 2000年期间无显著变化。