Fabrizi Fabrizio, Messa Piergiorgio, Martin Paul
Division of Nephrology and Dialysis, Maggiore Hospital, IRCCS, Milan, Italy.
Semin Dial. 2008 Sep-Oct;21(5):440-6. doi: 10.1111/j.1525-139X.2008.00437.x. Epub 2008 Apr 3.
Prevention of nosocomial transmission of hepatitis B virus (HBV) has been a signal achievement in the management of chronic kidney disease. The rate of serum hepatitis B surface antigen (HBsAg) seropositivity in patients on maintenance hemodialysis in the developed world is currently low (0-10%) but outbreaks of acute HBV infection continue to occur in this setting. The prevalence of HBV infection within dialysis units in developing countries appears higher (2-20%) based on relatively few reports. Although data are limited, HBV infection in dialysis population diminishes survival; HBV viral load in HBsAg-positive dialysis patients is reportedly low and stable over time. Updated recommendations for the management of HBsAg chronic carriers on maintenance dialysis have been issued. No rigorously controlled treatment trials for treatment of hepatitis B with either interferon or lamivudine therapy in dialysis patients are currently available.
预防医院内乙型肝炎病毒（HBV）传播是慢性肾脏病管理方面的一项重大成就。目前，在发达国家，维持性血液透析患者中血清乙肝表面抗原（HBsAg）血清阳性率较低（0-10%），但在此情况下急性HBV感染暴发仍时有发生。基于相对较少的报告，发展中国家透析单位内HBV感染的患病率似乎更高（2-20%）。尽管数据有限，但透析人群中的HBV感染会降低生存率；据报道，HBsAg阳性透析患者的HBV病毒载量随时间推移较低且稳定。已发布关于维持性透析的HBsAg慢性携带者管理的更新建议。目前尚无针对透析患者使用干扰素或拉米夫定治疗乙型肝炎的严格对照治疗试验。
