Cao Ya-Li, Wang Shi-Xiang, Zhu Zuo-Min
Department of Blood Purification, Beijing Chaoyang Hospital, Affiliate of Capital Medical University, Beijing 100020, China.
World J Gastroenterol. 2007 Dec 7;13(45):6037-40. doi: 10.3748/wjg.v13.45.6037.
To observe the prevalence of hepatitis B virus (HBV) infection in maintenance hemodialysis patients.
Eighty-eight hemodialysis patients who had been receiving hemodialysis regularly for an average of 39.45 +/- 7.57 (range from 36 to 49) mo were enrolled in this study. HBV markers were measured in these patients before hemodialysis and in 100 healthy controls by the chemiluminescent microparticle immunoassay (CMI) method in order to compare the incidence of HBV infection in hemodialysis patients versus normal healthy people. All patients were then divided into two groups: patients positive for HBV markers (i.e. those positive for HBsAg, anti-HBc, HBeAg, anti-HBe, with or without positive anti-HBs) (n = 33), and patients negative for HBV markers (including those only positive anti-HBs) (n = 55). The following information was obtained for all patients: socio-demographic data, number of blood transfusions and some laboratory investigations. After 39.45 +/- 7.57 mo follow-up, HBV markers were measured in these patients by CMI.
The incidence of HBV infection in maintenance hemodialysis patients was 37.5%, which was higher than in controls (9%). In the patients positive for HBV markers, there were 13 patients (39.4%) who had a history of blood transfusion, which was more than the number [12 (21.8%), P = 0.04] of patients negative for HBV markers. Eight of the 88 patients negative for HBV markers turned out to be positive, while three of the 33 patients positive for HBV markers turned out to be negative. There was no cirrhosis of the liver or hepatoma occurring in these patients.
Maintenance hemodialysis patients have a higher risk of HBV infection than the average population. The number of blood transfusions is associated with an increased prevalence of HBV. While it is hard for hemodialysis patients to eliminate HBV, the prognosis of patients with positive HBV markers is good.
观察维持性血液透析患者中乙型肝炎病毒（HBV）感染的流行情况。
本研究纳入了88例平均接受规律血液透析39.45±7.57（范围36至49）个月的血液透析患者。采用化学发光微粒子免疫分析（CMI）法检测这些患者透析前及100名健康对照者的HBV标志物，以比较血液透析患者与正常健康人群中HBV感染的发生率。然后将所有患者分为两组：HBV标志物阳性患者（即HBsAg、抗-HBc、HBeAg、抗-HBe阳性，无论抗-HBs是否阳性）（n = 33），以及HBV标志物阴性患者（包括仅抗-HBs阳性者）（n = 55）。收集所有患者的以下信息：社会人口学数据、输血次数及一些实验室检查结果。经过39.45±7.57个月的随访后，采用CMI法检测这些患者的HBV标志物。
维持性血液透析患者中HBV感染的发生率为37.5%，高于对照组（9%）。在HBV标志物阳性患者中，有13例（39.4%）有输血史，多于HBV标志物阴性患者的数量[12例（21.8%），P = 0.04]。88例HBV标志物阴性患者中有8例转为阳性，而33例HBV标志物阳性患者中有3例转为阴性。这些患者中未发生肝硬化或肝癌。
维持性血液透析患者感染HBV的风险高于普通人群。输血次数与HBV感染率增加有关。虽然血液透析患者难以清除HBV，但HBV标志物阳性患者的预后良好。
