Abu El Makarem Mona A, Abdel Hamid Mohammed, Abdel Aleem Ashraf, Ali Ahmed, Shatat Mohammed, Sayed Douaa, Deaf Ali, Hamdy Lamia, Tony Effat A
Department of Internal Medicine, Medical school, Minia University, Minia, Egypt.
Hepat Mon. 2012 Apr;12(4):253-8. doi: 10.5812/hepatmon.665. Epub 2012 Apr 30.
While prevalence of Hepatitis B virus (HBV) in patients with end-stage renal failure (ESRF) who are undergoing dialysis has decreased significantly during the past few decades, it still remains a distinct clinical problem. The immunosuppressive nature of renal disease often leads to chronicity of the HBV infection and an opportunity for nosocomial spread of the infection among dialysis patients. Egypt is among the countries with intermediate endemicity of HBsAg (range, 2%-7%). Large-scale geographic heterogeneity in HBV prevalence has been reported worldwide and HBV prevalence is especially heterogeneous in Egypt.
To assess the prevalence of occult HBV infection (OBI) in hemodialysis patients with or without chronic hepatitis C (HCV) from Minia and Assuit, Upper Egypt, using HBV DNA assays.
Sera from 145 hemodialysis patients with negative HbsAg were investigated for HBV DNA using real-time polymerase chain reaction (RT-PCR). Only serum samples with repeatedly detectable HBV DNA were considered positive. Patients were divided into 2 groups: HCV RNA positive and HCV RNA negative, based on the results of a third generation enzyme linked immunosorbent assay (ELISA) anti-HCV test and HCV RNA PCR.
HBV DNA was detected in 6 of the 145 patients (4.1%) and HBcAb was detected in 29/145 patients (20%). There were no statistically significant differences in the age, duration of hemodialysis, biochemical parameters, serological markers of HBV, or HBV DNA between patients with and without HCV infection.
Four percent of the hemodialysis patients had OBI. There was no significant difference in the prevalence of OBI between hemodialysis patients with or without HCV co-infection.
在过去几十年中，接受透析的终末期肾衰竭（ESRF）患者中乙肝病毒（HBV）的流行率显著下降，但它仍然是一个突出的临床问题。肾脏疾病的免疫抑制特性常常导致HBV感染的慢性化，并为感染在透析患者中进行医院内传播创造了机会。埃及是乙肝表面抗原（HBsAg）中度流行的国家之一（范围为2%-7%）。据报道，全球范围内HBV流行率存在大规模地理异质性，在埃及HBV流行率的异质性尤为明显。
使用HBV DNA检测方法评估埃及上埃及米尼亚和阿斯尤特地区有或无慢性丙型肝炎（HCV）的血液透析患者中隐匿性HBV感染（OBI）的流行率。
采用实时聚合酶链反应（RT-PCR）对145例HBsAg阴性的血液透析患者的血清进行HBV DNA检测。仅将多次检测到HBV DNA的血清样本视为阳性。根据第三代酶联免疫吸附测定（ELISA）抗-HCV检测和HCV RNA PCR的结果，将患者分为两组：HCV RNA阳性组和HCV RNA阴性组。
145例患者中有6例（4.1%）检测到HBV DNA，29/145例患者（20%）检测到HBcAb。HCV感染患者与未感染患者在年龄、血液透析时间、生化参数、HBV血清学标志物或HBV DNA方面无统计学显著差异。
4%的血液透析患者存在OBI。合并或未合并HCV感染的血液透析患者中OBI的流行率无显著差异。
