Veneto Region, Italian Co-operation, Peja Training Project Team, Venice, Italy.
Euro Surveill. 2009 Dec 10;14(49):19439.
The serological status of hepatitis viruses and other infectious diseases in the 66 dialysed patients of one haemodialysis unit in Kosovo were studied, comparing the data with a large group of blood donors and out-patients. All dialysed patients were hepatitis A virus (HAV) positive. Prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (anti-HBs), and hepatitis B core antibodies (anti-HBc) was 14 of 66, 21% (95% confidence interval (CI): 12-33%), 5 of 66, 8% (95%CI: 5-22%), and 50 of 66, 76% (95%CI: 64-85%), respectively. Antibodies to hepatitis C virus (anti-HCV) prevalence was 57 of 66, 86% (95%CI: 76-94%). No human immunodeficiency virus (HIV) positive case was found. Prevalence of past herpes simplex virus type 2 (HSV-2) infection was 29% (95%CI: 18-41%). Two patients (3%, 95%CI: 0-10%) were positive for Treponema pallidum and 18% (95%CI: 10-30%) were human herpesvirus 8 (HHV-8) antibody positive. Four hundred and fifty-two subjects were recruited for comparison. Markers of past HAV infection was associated with haemodialysis (Fisher s exact test p-value=0.037). Dialysed patients were at a higher risk of being HBsAg positive than others: the sex- and age-adjusted odds ratio (OR) was 5.18 (95%CI: 1.87-14.32). Anti-HBc positivity was strongly associated with haemodialysis: the sex- and age-adjusted OR was 6.43 (95%CI: 3.22-12-85). Anti-HCV positivity was 86% and 1% in presence and absence of haemodialysis, respectively. The Fisher s exact test for association proved a strong association between haemodialysis and HCV (p-value<0.0001). The OR for association between haemodialysis and HSV-2 positivity was 3.20 (95%CI: 1.46-7.00). Significant associations were also observed between haemodialysis status and antibodies to Treponema pallidum (Fisher s exact test p-value=0.044). In Kosovo, the prevalence of viral hepatitis infection and other viral infections and Treponema pallidum among dialysed patients is high, indicating major ongoing nosocomial transmission.
在科索沃的一个血液透析单位的 66 名透析患者中，研究了肝炎病毒和其他传染病的血清学状况，并将数据与一大组献血者和门诊患者进行了比较。所有透析患者均为甲型肝炎病毒 (HAV) 阳性。乙型肝炎表面抗原 (HBsAg)、乙型肝炎表面抗体 (抗-HBs) 和乙型肝炎核心抗体 (抗-HBc) 的流行率分别为 66 例中的 14 例（95%置信区间 (CI)：12-33%）、66 例中的 21%（95%CI：12-33%）、66 例中的 5 例（95%CI：5-22%）和 66 例中的 50 例（95%CI：64-85%）。丙型肝炎病毒 (抗-HCV) 的抗体流行率为 66 例中的 57 例（95%CI：76-94%）。未发现人类免疫缺陷病毒 (HIV) 阳性病例。单纯疱疹病毒 2 型 (HSV-2) 既往感染的流行率为 29%（95%CI：18-41%）。2 例（3%，95%CI：0-10%）患者梅毒螺旋体阳性，18%（95%CI：10-30%）患者人类疱疹病毒 8 型 (HHV-8) 抗体阳性。共招募了 452 名受试者进行比较。既往 HAV 感染标志物与血液透析相关（Fisher 确切检验 p 值=0.037）。与其他患者相比，透析患者 HBsAg 阳性的风险更高：性别和年龄调整后的优势比（OR）为 5.18（95%CI：1.87-14.32）。抗-HBc 阳性与血液透析密切相关：性别和年龄调整后的 OR 为 6.43（95%CI：3.22-12.85）。抗-HCV 阳性在存在和不存在血液透析的情况下分别为 86%和 1%。Fisher 确切检验证明血液透析与 HCV 之间存在强烈关联（p 值<0.0001）。血液透析与 HSV-2 阳性之间的关联的 OR 为 3.20（95%CI：1.46-7.00）。血液透析状态与梅毒螺旋体抗体之间也存在显著关联（Fisher 确切检验 p 值=0.044）。在科索沃，透析患者的病毒性肝炎感染和其他病毒感染以及梅毒螺旋体的流行率很高，表明存在持续的医院内传播。
