Hussein Magdi M, Mooij Jaap M, Hegazy Mohamed S, Bamaga Mohammed S
Department of Nephrology and Dialysis, Al Hada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia.
Saudi J Kidney Dis Transpl. 2007 Mar;18(1):107-13.
Hepatitis C virus (HCV) infection is most often diagnosed by detection of antibodies against the virus (HCV Ab). However, it has been reported that some HCV Ab negative patients test positive for HCV-RNA. Over a study period of 30 months, all patients on hemodialysis at the Al Hada Armed Forces Hospital in Taif, Saudi Arabia were tested monthly for HCV Ab and twice per year for HCV-RNA. HCV Ab was tested by a third generation microparticle enzyme immunoassay (MEIA), and HCV-RNA by a qualitative hepatitis-RNA assay, second version (COBAS Amplicor PCR), which was recently introduced in the Molecular Pathology Laboratory of our hospital. Of the 180 patients studied, 34 (18.9%) had positive HCV Ab, and of the 146 HCV Ab negative patients, five patients tested positive for HCV-RNA (3.42%). Our study further finds that, when applying HCV Ab testing only, some patients with HCV viremia may be undetected. For better HCV infection control, routine HCV-RNA testing of dialysis patients should be considered, particularly in areas where the infection is common and in units applying isolation policies.
丙型肝炎病毒（HCV）感染大多通过检测抗病毒抗体（HCV Ab）来诊断。然而，据报道，一些HCV Ab阴性患者的HCV-RNA检测呈阳性。在沙特阿拉伯塔伊夫的阿卜杜勒阿齐兹国王医疗城哈达武装部队医院，对所有接受血液透析的患者进行了为期30个月的研究，每月检测HCV Ab，每年检测两次HCV-RNA。HCV Ab采用第三代微粒酶免疫测定法（MEIA）检测，HCV-RNA采用定性肝炎RNA测定法第二版（COBAS Amplicor PCR）检测，该方法最近已引入我院分子病理实验室。在180例研究患者中，34例（18.9%）HCV Ab呈阳性，在146例HCV Ab阴性患者中，5例HCV-RNA检测呈阳性（3.42%）。我们的研究进一步发现，仅采用HCV Ab检测时，一些HCV病毒血症患者可能未被检测到。为了更好地控制HCV感染，应考虑对透析患者进行常规HCV-RNA检测，特别是在感染常见的地区以及实施隔离政策的单位。
