Zekavat Omid R, Makarem Alireza, Karami Mohammad Y, Amanat Aida, Mohandes Maesoomeh, Habibagahi Mojtaba
Department of Pediatrics, Hematology Research Centre, School of Medicine, University of Medical Sciences, Jahrom, Iran.
Asian J Transfus Sci. 2013 Jan;7(1):21-5. doi: 10.4103/0973-6247.106724.
A global distribution has been shown for hepatitis E virus (HEV) infection. Although the fecal-oral was considered as the primary infection route, there is controversial evidence for increased risk of the infection and consequent problems in patients on maintenance hemodialysis (HD) with suppressed immunity. The aim is to find if the prevalence of anti-HEV IgG, in patients with maintenance HD is higher than normal population in southwest of Iran.
During November and December 2010, in a cross-sectional study we compared the seroprevalence of HEV among 80 patients with maintenance HD and 276 healthy individuals from Jahrom and Shiraz, Southwest of Iran. In addition to the clinical and laboratory records, serum samples were tested for the presence of IgG anti-HEV antibody by enzyme immunoassay (ELISA) test. The Chi-square, the Student's 't' and Fisher's exact tests were used for the statistical analysis.
ELISA tests detected anti-HEV antibody in five males of the patients (6.3%) and in eight of the healthy controls (2.9%, 6 males and 2 female) which statistically were not different. The mean levels of the aspartate aminotransferase and the alanine aminotransferase in the sera of the patients were 19.96±11.08U/L and 23.93±14.26 IU/L, respectively. However, no one of the individuals with positive anti-HEV antibody showed elevated liver enzymes. Moreover, there was not a significant association between positive anti-HEV antibody result, age and the history of the hemodialysis.
We did not observe statistically significant higher anti-HEV prevalence among patients with chronic HD; however, more safety precaution is needed to keep HD patients from the risk of possible exposure to HEV infection.
戊型肝炎病毒（HEV）感染呈全球分布。尽管粪-口途径被认为是主要感染途径，但有争议的证据表明，免疫功能受抑制的维持性血液透析（HD）患者感染风险增加及由此引发的问题。目的是确定伊朗西南部维持性HD患者中抗HEV IgG的流行率是否高于正常人群。
2010年11月至12月期间，在一项横断面研究中，我们比较了伊朗西南部贾赫罗姆和设拉子的80例维持性HD患者与276名健康个体中HEV的血清流行率。除临床和实验室记录外，采用酶免疫测定（ELISA）法检测血清样本中抗HEV抗体的存在。采用卡方检验、学生t检验和费舍尔精确检验进行统计分析。
ELISA检测发现患者中有5名男性（6.3%）和健康对照中有8名（2.9%，6名男性和2名女性）存在抗HEV抗体，统计学上无差异。患者血清中天冬氨酸转氨酶和丙氨酸转氨酶的平均水平分别为19.96±11.08U/L和23.93±14.26IU/L。然而，抗HEV抗体阳性的个体中没有一人出现肝酶升高。此外，抗HEV抗体阳性结果、年龄与血液透析史之间无显著关联。
我们未观察到慢性HD患者中抗HEV流行率有统计学意义的升高；然而，需要采取更多安全预防措施，以防止HD患者面临可能接触HEV感染的风险。
