Kumagai Junko, Komiya Yutaka, Tanaka Junko, Katayama Keiko, Tatsukawa Yorimitsu, Yorioka Noriaki, Miyakawa Yuzo, Yoshizawa Hiroshi
Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
J Med Virol. 2005 Aug;76(4):498-502. doi: 10.1002/jmv.20389.
Patients on maintenance hemodialysis (HD) are at increased risk of infection with hepatitis C virus (HCV). A prospective follow-up study on HCV infection from November 1999 to February 2003 was conducted in nine hemodialysis (HD) units in Hiroshima. A total of 2,744 HD patients were surveyed regularly for HCV RNA in serum. The prevalence of HCV RNA decreased from 15.7% (262/1,664) on the first survey to 12.9% (242/1,882) in the last one (P<0.05). This decrease may be attributed to the inclusion of patients with a lower prevalence of HCV RNA compared to patients leaving dialysis centers (111/1,080 [10.3%] vs. 132/862 [15.3%], P<0.01). During the 40 months of this study, 16 de novo HCV infections were documented in the nine HD units corresponding to an incidence of 0.33% per year. These cases included eight new HCV infections, three re-infections, and five infections that presumably occured in the window period when tested during the first survey. Our study shows that the annual incidence of de novo HCV infection during HD was 0.33%, and emphasizes the need for frequent serum HCV RNA testing and for stringent disinfection procedures in order to prevent the transmission of HCV in these settings.
维持性血液透析（HD）患者感染丙型肝炎病毒（HCV）的风险增加。1999年11月至2003年2月，在广岛的9个血液透析（HD）单位进行了一项关于HCV感染的前瞻性随访研究。共对2744例HD患者定期检测血清中的HCV RNA。HCV RNA的患病率从第一次调查时的15.7%（262/1664）降至最后一次调查时的12.9%（242/1882）（P<0.05）。这种下降可能归因于与离开透析中心的患者相比，纳入的患者HCV RNA患病率较低（111/1080 [10.3%] 对132/862 [15.3%]，P<0.01）。在本研究的40个月期间，9个HD单位记录了16例新发HCV感染，每年发病率为0.33%。这些病例包括8例新的HCV感染、3例再感染以及5例可能在首次调查检测时处于窗口期发生的感染。我们的研究表明，HD期间新发HCV感染的年发病率为0.33%，并强调需要频繁检测血清HCV RNA以及采取严格的消毒程序，以防止HCV在这些环境中传播。
