Rahnavardi Mohammad, Hosseini Moghaddam Seyed Mohammadmehdi, Alavian Seyed Moayed
Urology and Nephrology Research Center, Shaheed Labbafinejad Medical Center, Shahid Beheshti University, MC, Tehran, IR Iran.
Am J Nephrol. 2008;28(4):628-40. doi: 10.1159/000117573. Epub 2008 Feb 19.
Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality in hemodialysis (HD) patients. The reported prevalence of HCV among the HD population has varied greatly from 1.9 to 84.6% in different countries in recent years. The length of time on HD is generally believed to be associated with HCV acquisition in HD subjects. Nevertheless, several recent reports failed to recognize any significant role of blood transfusion. Although there are some considerations about the accuracy of serologic testing in detecting HCV in HD patients, the accumulated data in this review suggest the false-negativity rate to be not more than 1.66% (153/9,220). Therefore, substituting virologic for serologic testing in the routine diagnosis of HCV infection in HD patients seems unreasonable. Several phylogenetic analyzes of viral isolates suggested nosocomial patient-to-patient transmission of HCV among HD patients for which the main potential source is believed to be contaminated hands and articles. However, isolation of HCV-infected HD patients and use of dedicated machines are currently unjustified while strict adherence to universal precautions seems to be enough to control disease spread in HD units. The present article is an update on epidemiological and clinical features of HCV in HD population.
丙型肝炎病毒（HCV）感染是血液透析（HD）患者发病和死亡的重要原因。近年来，不同国家报道的HD人群中HCV患病率差异很大，从1.9%到84.6%不等。一般认为HD治疗时间长短与HD患者感染HCV有关。然而，最近的几份报告并未认识到输血的任何重要作用。尽管对于HD患者血清学检测HCV的准确性存在一些考量，但本综述中的累积数据表明假阴性率不超过1.66%（153/9220）。因此，在HD患者HCV感染的常规诊断中用病毒学检测替代血清学检测似乎不合理。对病毒分离株的几项系统发育分析表明，HD患者之间存在HCV的医院内患者间传播，其主要潜在来源被认为是受污染的手和物品。然而，目前隔离HCV感染的HD患者并使用专用机器并不合理，而严格遵守普遍预防措施似乎足以控制HD单位内的疾病传播。本文是关于HD人群中HCV流行病学和临床特征的最新综述。
