Rigopoulou Eirini I, Stefanidis Ioannis, Liaskos Christos, Zervou Eleftheria K, Rizos Christos, Mina Paraskevi, Zachou Kalliopi, Syrganis Christos, Patsidis Eftichios, Kyriakopoulos George, Sdrakas Lambros, Tsianas Nikolaos, Dalekos Georgios N
Faculty of Health Sciences, Department of Medicine, Academic Liver Unit and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, 22 Papakiriazi str., 412 22 Larissa, Greece.
J Clin Virol. 2005 Sep;34(1):81-5. doi: 10.1016/j.jcv.2005.05.007.
End-stage renal disease patients (ESRD) on maintenance hemodialysis (HD) are at increased risk of acquiring hepatitis C virus (HCV) infection. An early and accurate diagnosis of HCV infection is important for the prevention of viral transmission and the management of ESRD patients on HD but conventional ELISA and PCR have often failed to reveal active HCV infection.
This study evaluated the prevalence of HCV infection in ESRD patients from all HD units in central Greece using a sensitive HCV-RNA transcription mediated amplification (TMA) assay and compared its sensitivity with that of anti-HCV ELISA.
Anti-HCV antibody (third generation ELISA), HCV-RNA (TMA) and HCV genotypes (HCV TMA-LiPA) were determined in 366 ESRD Greek patients.
In total, 132 (36%) ESRD patients were HCV positive by ELISA or TMA; 44 by TMA alone, 16 by ELISA alone and 72 positive by both assays. More than half of the viraemic patients had genotype 3a.
HCV-RNA (TMA) assay appears to increase the accuracy in the diagnosis of HCV infection in HD patients compared to the anti-HCV ELISA and could serve as an additional screening tool in these patients.
维持性血液透析（HD）的终末期肾病患者（ESRD）感染丙型肝炎病毒（HCV）的风险增加。HCV感染的早期准确诊断对于预防病毒传播以及HD的ESRD患者的管理很重要，但传统的酶联免疫吸附测定（ELISA）和聚合酶链反应（PCR）常常无法检测出活动性HCV感染。
本研究使用灵敏的HCV-RNA转录介导扩增（TMA）测定法评估希腊中部所有HD单位的ESRD患者中HCV感染的患病率，并将其敏感性与抗-HCV ELISA的敏感性进行比较。
对366例希腊ESRD患者测定抗-HCV抗体（第三代ELISA）、HCV-RNA（TMA）和HCV基因型（HCV TMA-线性探针分析）。
总计，132例（36%）ESRD患者通过ELISA或TMA检测为HCV阳性；仅TMA检测阳性的有44例，仅ELISA检测阳性的有16例，两种检测均阳性的有72例。超过一半的病毒血症患者为3a基因型。
与抗-HCV ELISA相比，HCV-RNA（TMA）测定法似乎提高了HD患者HCV感染诊断的准确性，可作为这些患者的额外筛查工具。
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