Zhejiang University School of Medicine, Hangzhou, China.
Hepatobiliary Pancreat Dis Int. 2012 Jun;11(3):302-6. doi: 10.1016/s1499-3872(12)60164-7.
Hemodialysis (HD) patients are at high risk of infection by hepatitis B virus (HBV) or hepatitis C virus (HCV). The present study was designed to determine the impact of quality control measures on the prevention of transmission of blood-borne viruses.
A total of 6182 adult maintenance HD patients from all HD units in Zhejiang Province were recruited on January 1, 2007. The baseline demographic and clinical characteristics were recorded and all patients were followed up until death or survival at 4 years later. The Quality Control Standards of Hemodialysis were gradually implemented in HD units. The HBV or HCV seroconversion rates of the recruited patients were calculated and compared every year during the observation period.
The prevalence of HBV was 8.3% at the beginning of the study, and 6.6% for HCV. With the implementation of the HD quality control measures, the HBV seroconversion rate tended to decrease year by year (X2=6.620, P=0.085), and the HCV seroconversion rate decreased significantly (X2=10.41, P=0.015). Compared with the data in 2007, the HBV seroconversion rate (X2=4.204, P=0.040, relative risk ratio 0.393, 95% CI 0.156-0.991) and the HCV seroconversion rate (X2=7.373, P=0.007, relative risk ratio 0.386, 95% CI 0.189-0.787) decreased significantly in 2010.
Quality control measures for HD decreased the seroconversion rates of HBV or HCV in HD patients, showing that updated quality control measures reduce the risk for transmission of blood-borne viruses in the HD population.
血液透析（HD）患者感染乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）的风险较高。本研究旨在确定质量控制措施对预防血源性病毒传播的影响。
2007 年 1 月 1 日，从浙江省所有 HD 单位招募了 6182 名成年维持性 HD 患者。记录了基线人口统计学和临床特征，并对所有患者进行了随访，直到死亡或生存 4 年后。逐步在 HD 单位实施《血液透析质量控制标准》。计算并比较观察期间每年招募患者的 HBV 或 HCV 血清转化率。
研究开始时 HBV 的患病率为 8.3%，HCV 为 6.6%。随着 HD 质量控制措施的实施，HBV 血清转化率呈逐年下降趋势（X2=6.620，P=0.085），HCV 血清转化率显著下降（X2=10.41，P=0.015）。与 2007 年的数据相比，HBV 血清转化率（X2=4.204，P=0.040，相对危险比 0.393，95%CI 0.156-0.991）和 HCV 血清转化率（X2=7.373，P=0.007，相对危险比 0.386，95%CI 0.189-0.787）在 2010 年显著降低。
HD 的质量控制措施降低了 HD 患者 HBV 或 HCV 的血清转化率，表明更新的质量控制措施降低了 HD 人群中血源性病毒传播的风险。
