Vinelli Elizabeth, Lorenzana Ivette
Programa Nacional de Sangre, Cruz Roja Hondureña, 2da avenida de Comayaguela, M.D.C., Honduras.
J Clin Virol. 2005 Dec;34 Suppl 2:S53-60. doi: 10.1016/s1386-6532(05)80035-6.
Monitoring infectivity markers in multi-transfused patients is an important indicator of the efficiency and quality of testing in blood centers. This study is part of a regional initiative to bring both national and regional attention to the problem of hepatitis C, compare the threat of HCV to that of HBV and HIV; assess the risks for viral infection of using different blood products and implementing different transfusion practices, and contribute to a better understanding of the state of blood safety in the region.
A cross sectional study was conducted from September 2002 to August 2003 and included multi-transfused patients from eight private, public and Social Security hospitals from Tegucigalpa and San Pedro Sula, Honduras. A survey was completed for each patient which included demographic and clinical data. Patients were tested for HBsAg, anti-HBc, anti-HIV and anti-HCV Effects of the exposure to blood products, to whole blood; to lyophilized factor VIII in patients living with hemophilia on the prevalence of HBV, HCV and HIV infection were evaluated.
Five hundred and two patients were enrolled in the study; 11% were positive for HBsAg; 27% for anti-HBc; 7% for HCV and 1% for HIV One point six percent of hemophilia patients were positive for HBsAg; 38% were positive for anti-HBc and 26.9% for HCV A dose effect between the exposure to blood products and prevalence of HCV was found (p < 0.05). It was not possible to show a dose effect between the exposure to blood products and prevalence of either HBV or HIV in any of the subpopulations studied.
The transfusion of blood products seems to be the main factor for HCV seropositivity in the subpopulation of patients studied. Additional work is needed to elucidate the risk factors associated with HBV infection in Honduras.
监测多次输血患者的感染性标志物是血液中心检测效率和质量的重要指标。本研究是一项区域倡议的一部分,旨在引起国家和地区对丙型肝炎问题的关注,比较丙型肝炎病毒(HCV)与乙型肝炎病毒(HBV)和人类免疫缺陷病毒(HIV)的威胁;评估使用不同血液制品和实施不同输血操作的病毒感染风险,并有助于更好地了解该地区的血液安全状况。
2002年9月至2003年8月进行了一项横断面研究,纳入了来自洪都拉斯特古西加尔巴和圣佩德罗苏拉的8家私立、公立和社会保障医院的多次输血患者。为每位患者完成了一项调查,包括人口统计学和临床数据。对患者进行了HBsAg(乙肝表面抗原)、抗-HBc(乙肝核心抗体)、抗-HIV(艾滋病病毒抗体)和抗-HCV(丙肝抗体)检测。评估了血液制品、全血、冻干凝血因子VIII暴露于血友病患者中对HBV、HCV和HIV感染患病率的影响。
502名患者纳入研究;11%的患者HBsAg呈阳性;27%的患者抗-HBc呈阳性;7%的患者HCV呈阳性,1%的患者HIV呈阳性。1.6%的血友病患者HBsAg呈阳性;38%的患者抗-HBc呈阳性,26.9%的患者HCV呈阳性。发现血液制品暴露与HCV患病率之间存在剂量效应(p<0.05)。在所研究的任何亚组中,均未发现血液制品暴露与HBV或HIV患病率之间存在剂量效应。
在所研究的患者亚组中,输血制品似乎是HCV血清学阳性的主要因素。需要开展更多工作以阐明洪都拉斯与HBV感染相关的危险因素。