Batchoun Raymond G, Al-Najdawi Malek A, Al-Taamary Sameh
Department of Pathology and Microbiology, Faculty of Medicine, Irbid, Jordan.
Saudi J Kidney Dis Transpl. 2011 Jul;22(4):682-8.
Infection with hepatitis C virus (HCV) is increasing all over the world, especially among hemodialysis patients. HCV is one of the major autoantibody inducing viruses, where anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (ASMA), anti-liver kidney microsome antibodies (LKM-1), and rheumatoid factor (RF) have been related to HCV. Few studies have investigated the presence of anti-extractable nuclear antigens (ENA) antibodies in chronic liver diseases, especially in chronic hepatitis C cases, but none investigated its immunostimulation role in hemodialysis units. The aim of the study was to assess the prevalence of HCV among chronic kidney disease- Stage 5 (CKD5) patients undergoing hemodialysis and the prevalence of ENA antibodies among them. Sera of 134 patients with chronic kidney disease undergoing hemodialysis, were screened for HCV antibodies and ENA antibodies profile, using ELISA and Immunoblot technique. 41 HCV-positive blood bank donors were used as controls. Sixty-four (47.7%) of 134 patients undergoing hemodialysis were infected with HCV. Thirty-three (51.6%) of 64 patients with HCV infection undergoing hemodialysis had anti-ENA antibodies: 9 (27.3%) showed anti-SSA antibodies and 22 (66.7%) had anti-SSB antibodies. The prevalence of anti-ENA antibodies was significantly higher in the patients with HCV infection, undergoing hemodialysis, compared with both control groups (hepatitis C-positive blood bank donors and hepatitis C-negative patients undergoing hemodialysis). Seventeen of 33 HCV antibodies-positive males undergoing hemodialysis had anti-ENA antibodies, compared with 16 of 31 females, indicating no sex related difference. This study emphasizes the high prevalence of HCV infection in our hemodialysis patients, comparable to that of other Middle Eastern countries, but higher than Western ones. A strong association was observed between anti-HCV positivity and hemodialysis duration, as well as anti-ENA antibody profile. However, these antibodies were gender independent.
丙型肝炎病毒（HCV）感染在全球范围内呈上升趋势，尤其是在血液透析患者中。HCV是主要的自身抗体诱导病毒之一，其中抗核抗体（ANA）、抗平滑肌抗体（ASMA）、抗肝肾微粒体抗体（LKM-1）和类风湿因子（RF）都与HCV有关。很少有研究调查慢性肝病中抗可提取核抗原（ENA）抗体的存在情况，特别是在慢性丙型肝炎病例中，但没有研究调查其在血液透析单位中的免疫刺激作用。本研究的目的是评估接受血液透析的慢性肾脏病5期（CKD5）患者中HCV的患病率以及其中ENA抗体的患病率。使用酶联免疫吸附测定（ELISA）和免疫印迹技术，对134例接受血液透析的慢性肾脏病患者的血清进行HCV抗体和ENA抗体谱筛查。41例HCV阳性的血库供者用作对照。134例接受血液透析的患者中有64例（47.7%）感染了HCV。64例接受血液透析的HCV感染患者中有33例（51.6%）有抗ENA抗体：9例（27.3%）显示抗SSA抗体，22例（66.7%）有抗SSB抗体。与两个对照组（HCV阳性血库供者和HCV阴性血液透析患者）相比，接受血液透析的HCV感染患者中抗ENA抗体的患病率显著更高。接受血液透析的33例HCV抗体阳性男性中有17例有抗ENA抗体，而31例女性中有16例，表明无性别差异。本研究强调了我们血液透析患者中HCV感染的高患病率，与其他中东国家相当，但高于西方国家。观察到抗HCV阳性与血液透析持续时间以及抗ENA抗体谱之间存在密切关联。然而，这些抗体与性别无关。
