Borawski Jacek, Kovalchuk Oksana, Chlebińska Iwona, Naumnik Beata, Rydzewska-Rosołowska Alicja, Chyczewski Lech, Myśliwiec Michał
Kliniki Nefrologii i Transplantologii z Ośrodkiem Dializ Akademii Medycznej w Białymstoku.
Wiad Lek. 2006;59(11-12):751-6.
SEN virus (SENV) is a new, mostly parenterally transmitted, hepatotropic agent. The prevalence of SENV among patients undergoing maintenance hemodialysis (HD) in Poland, as well as risk factors for the infection are not established. Serum samples of 91 patients receiving maintenance HD in Białystok were tested for the presence of strain H SENV (SENV-H) DNA by means of polymerase chain reaction. Fifty-one non-dialysis subjects, age- and sex-matched with the HD patients, mostly with chronic kidney diseases (96%), without hepatitis B (HBV) and C (HCV) or the history of blood transfusion and donation served as controls. SENV-H viremia was prevalent in 40% of HD patients and in 2% of control subjects (p < 0.0001). On multivariable logistic analysis, neither age (63.1 +/- 13.2 years), gender (49% females), dialysis vintage (29, 2-200, months), previous transfusions of packed red blood cells (84%) or fresh frozen plasma (4%), seropositivity for HBs antigen (13%), HCV antibodies (23%) or HCV RNA (17%) were independently associated with SENV-H prevalence in HD patients (chi2 for the model = 13.3, p = 0.103). No associations between SENV-H status and clinical or biochemical markers of liver disease, including serum aminotransferases levels were observed. In conclusion, SENV-H viremia is widespread among patients receiving maintenance HD in north-eastern Poland. Risk factors for its occurrence are equivocal; the infection may well be transmitted by parenteral and feco-oral routes. SEN virus is not directly responsible for liver damage in maintenance HD patients.
SEN病毒(SENV)是一种新型的、主要经肠道外传播的嗜肝病原体。波兰维持性血液透析(HD)患者中SENV的流行情况以及感染的危险因素尚未明确。采用聚合酶链反应检测了比亚韦斯托克91例接受维持性HD患者的血清样本中H型SENV(SENV-H)DNA的存在情况。51名年龄和性别与HD患者匹配的非透析受试者作为对照,这些受试者大多患有慢性肾脏疾病(96%),无乙肝(HBV)和丙肝(HCV)感染,也无输血和献血史。HD患者中SENV-H病毒血症的患病率为40%,对照受试者中为2%(p<0.0001)。多变量逻辑分析显示,年龄(63.1±13.2岁)、性别(49%为女性)、透析时间(29,2 - 200个月)、既往输注浓缩红细胞(84%)或新鲜冰冻血浆(4%)、乙肝表面抗原血清阳性(13%)、丙肝抗体(23%)或丙肝RNA(17%)均与HD患者中SENV-H的流行无独立相关性(模型的卡方值=13.3,p = 0.103)。未观察到SENV-H状态与肝病临床或生化指标(包括血清转氨酶水平)之间的关联。总之,SENV-H病毒血症在波兰东北部接受维持性HD的患者中广泛存在。其发生的危险因素尚不明确;该感染很可能通过肠道外和粪-口途径传播。SEN病毒并非维持性HD患者肝损伤的直接原因。