Ballester José M, Rivero René A, Villaescusa Rinaldo, Merlín Julio C, Arce Ada A, Castillo Dunia, Lam Rosa M, Ballester Adalberto, Almaguer Miguel, Melians Silvia M, Aparicio José L
Institute of Hematology and Immunology, POB 8070, Havana, 10800 Cuba.
J Clin Virol. 2005 Dec;34 Suppl 2:S39-46. doi: 10.1016/s1386-6532(05)80033-2.
HCV was initially identified in 1989 when it was found to be the primary causative agent of non-A, non-B hepatitis,a condition associated with high rates of progressive and end-stage liver disease, cirrhosis, and hepatocellular carcinoma. Since then, appreciation of the significant worldwide health impact of HCV infection has grown. HCV infection was identified as a public health problem in Cuba in the 1990s. Despite universal blood donor screening, which was achieved in 1995 using the Cuban immunoassay system UMELISA HCV, the infection is still found in multi-transfused patients.
To determine the magnitude of HCV, HBV and HIV-1&2 infections among Cuban blood recipients and to assess the role of potential risk factors.
Cross-sectional study of 318 patients from Havana City, Pinar del Río and Villa Clara, who had been previously treated with 10 or more units of allogenic blood or blood components in at least two different occasions. The patients were evaluated for HCV Ab, HBsAg, anti-HBc Ab, and HIV-1&2 Ab. Data management and statistical analysis were performed using EpiInfo and SSPS software.
Prevalence rates were 51.6% for HCV Ab; 5.3% for HBsAg; 45.0% for anti-HBc and 0% for HIV-1&2 Ab. Ten (3.1%) patients were co-infected with HCV and HBV Blood transfusion was not identified as the main risk factor for HCV transmission. The number of blood units received by the patients was not statistically associated with the HCV Ab prevalence.
Infection with HCV was identified more frequently than HBV and HIV among our study population. Patients undergoing hemodialysis were at the highest risk of becoming infected. Medical procedures including surgery, transplantation, invasive odontology, and sharing or reuse of needles and syringes, are associated with higher HCV Ab seroprevalences compared with blood transfusion alone.
丙型肝炎病毒(HCV)于1989年首次被发现,当时它被确定为非甲非乙型肝炎的主要病原体,这种疾病与进展性和终末期肝病、肝硬化及肝细胞癌的高发病率相关。从那时起,人们对HCV感染对全球健康的重大影响的认识不断加深。HCV感染在20世纪90年代被确定为古巴的一个公共卫生问题。尽管在1995年使用古巴免疫分析系统UMELISA HCV实现了对所有献血者的筛查,但在多次输血的患者中仍发现有感染情况。
确定古巴输血受者中HCV、HBV和HIV-1&2感染的程度,并评估潜在危险因素的作用。
对来自哈瓦那市、比那尔德里奥省和圣克拉拉省的318名患者进行横断面研究,这些患者此前在至少两个不同场合接受过10个或更多单位的异体血液或血液成分治疗。对患者进行HCV抗体、HBsAg、抗-HBc抗体和HIV-1&2抗体检测。使用EpiInfo和SSPS软件进行数据管理和统计分析。
HCV抗体患病率为51.6%;HBsAg为5.3%;抗-HBc为45.0%;HIV-1&2抗体为0%。10名(3.1%)患者同时感染了HCV和HBV。输血未被确定为HCV传播的主要危险因素。患者接受的血液单位数量与HCV抗体患病率无统计学关联。
在我们的研究人群中,HCV感染比HBV和HIV感染更常见。接受血液透析的患者感染风险最高。与单纯输血相比,包括手术、移植、侵入性牙科学以及针头和注射器的共用或重复使用在内的医疗程序与更高的HCV抗体血清阳性率相关。