Makhlough A, Jamshidi M, Mahdavi M R
Department of Nephrology, Emam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Singapore Med J. 2008 Nov;49(11):921-3.
Patients on maintenance haemodialysis are known to have an elevated risk of acquiring hepatitis C virus (HCV) infection. The reported prevalence among haemodialysis patients in the United States ranges from eight percent to ten percent, and is considerably higher in many European and Middle Eastern countries. Therefore, a reliable diagnosis of HCV infection is essential in order to prevent the spread of the disease in dialysis units.
All haemodialysis patients were interviewed in two dialysis units in Sari and Ghaemshahr, Iran, in 2006. Blood samples were collected and serum samples screened for anti-HCV antibodies by enzyme-linked immunosorbent assay (ELISA). All samples were retested for confirmation with polymerase chain reaction (PCR).
A total of 186 haemodialysis patients (mean age 58.86 +/- 16.9 years) were studied. Mean duration of haemodialysis was 3.07 +/- 0.3 years. Mean of SGOT and SGPT were 30.64 +/- 6 and 32.01 +/- 8, respectively. Among the 186 patients, 39 (21 percent) were seropositive by ELISA and 21 (11.3 percent) were PCR positive. All PCR positive patients also had positive ELISA. Association between the duration of haemodialysis and HCV seropositivity was statistically significant (p-value is 0.0001), but there was no significant correlation between number of transfusions and HCV seropositivity.
Despite the growing demand for cost-effectiveness in the health system, tight control of HCV infection by PCR and ELISA examination must remain an essential part of the routine screening in haemodialysis patients.
已知维持性血液透析患者感染丙型肝炎病毒(HCV)的风险较高。美国报道的血液透析患者患病率在8%至10%之间,在许多欧洲和中东国家则要高得多。因此,为防止该疾病在透析单位传播,对HCV感染进行可靠诊断至关重要。
2006年,在伊朗萨里和加姆沙赫尔的两个透析单位对所有血液透析患者进行了访谈。采集血样,并用酶联免疫吸附测定(ELISA)法检测血清样本中的抗HCV抗体。所有样本均通过聚合酶链反应(PCR)进行复测以确认结果。
共研究了186例血液透析患者(平均年龄58.86±16.9岁)。血液透析的平均时长为3.07±0.3年。谷草转氨酶(SGOT)和谷丙转氨酶(SGPT)的平均值分别为30.64±6和32.01±8。在这186例患者中,ELISA检测血清学阳性的有39例(21%),PCR检测阳性的有21例(11.3%)。所有PCR检测阳性的患者ELISA检测也呈阳性。血液透析时长与HCV血清学阳性之间的关联具有统计学意义(p值为0.0001),但输血次数与HCV血清学阳性之间无显著相关性。
尽管卫生系统对成本效益的需求不断增加,但通过PCR和ELISA检测严格控制HCV感染仍必须是血液透析患者常规筛查的重要组成部分。