Li Cavoli Gioacchino, Zagarrigo Carmela, Schillaci Onofrio, Servillo Francesca, Tralongo Angelo, Coglitore Mario, Spadaro Filippo, Scimeca Concetta, Li Destri Natalia, Rotolo Ugo
Nephrology and Dialysis, ARNAS Civico and Di Cristina Hospital, Via Francesco Cilea 43, 90144 Palermo, Italy.
Hepat Res Treat. 2012;2012:832021. doi: 10.1155/2012/832021. Epub 2012 Dec 4.
Hepatitis C virus infection is a persistent worldwide public health concern. The prevalence of HCV infection is much higher in patients on chronic haemodialysis (HD) than in the general population. HCV infection can detrimentally affect patients throughout the spectrum of chronic kidney disease. Despite the control of blood products, hepatitis C virus transmission is still being observed among patients undergoing dialysis. Detection systems for serum HCV antibodies are insensitive in the acute phase because of the long serological window. Direct detection of HCV depends on PCR test but this test is not suitable for routine screening. Recent studies have highlighted the importance of HCV core antigen detection as an alternative to PCR. Few studies exist about the efficacy of HCV core antigen test in dialysis population. We studied the utility of HCV core antigen test in routine monitoring of virological status of dialysis patients. We screened 92 patients on long-term dialysis both by PCR HCV-RNA and HCV core antigen test. The sensitivity of HCVcAg test was 90%, the specificity 100%, the positive predictive power 100%, the negative predictive power 97%, and the accuracy 97%. We think serological detection of HCV core antigen may be an alternative to NAT techniques for routine monitoring of patients on chronic dialysis.
丙型肝炎病毒感染是一个持续存在的全球性公共卫生问题。慢性血液透析（HD）患者中丙型肝炎病毒感染的患病率远高于普通人群。丙型肝炎病毒感染会对整个慢性肾脏病患者群体产生不利影响。尽管对血液制品进行了管控，但在透析患者中仍观察到丙型肝炎病毒传播。血清丙型肝炎病毒抗体检测系统在急性期不敏感，因为血清学窗口期较长。丙型肝炎病毒的直接检测依赖于聚合酶链反应（PCR）检测，但该检测不适用于常规筛查。最近的研究强调了丙型肝炎病毒核心抗原检测作为聚合酶链反应替代方法的重要性。关于丙型肝炎病毒核心抗原检测在透析人群中的功效的研究很少。我们研究了丙型肝炎病毒核心抗原检测在透析患者病毒学状态常规监测中的效用。我们通过丙型肝炎病毒核糖核酸（HCV-RNA）聚合酶链反应和丙型肝炎病毒核心抗原检测对92例长期透析患者进行了筛查。丙型肝炎病毒核心抗原检测的敏感性为90%，特异性为100%，阳性预测值为100%，阴性预测值为97%，准确性为97%。我们认为，丙型肝炎病毒核心抗原的血清学检测可能是一种替代核酸扩增技术（NAT）的方法，用于慢性透析患者的常规监测。
