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台湾地区终末期肾病患者人类疱疹病毒 8 型的高血清阳性率。

High seroprevalence of human herpesvirus type 8 in patients with end-stage renal disease in Taiwan.

机构信息

Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.

出版信息

J Clin Virol. 2013 Sep;58(1):89-93. doi: 10.1016/j.jcv.2013.06.005. Epub 2013 Jul 2.

Abstract

BACKGROUND

Human herpesvirus type 8 (HHV-8) is the aetiologic agent of Kaposi's sarcoma (KS). The incidence of KS in renal transplant patients is much higher than in healthy controls. The risk is even higher among recipients seropositive for HHV-8 before transplantation. Patients with end-stage renal disease (ESRD) are immunocompromised and are candidates for renal transplantation, but HHV-8 seroprevalence in ESRD patients has not been well documented.

OBJECTIVES

This study aimed to evaluate HHV-8 seroprevalence in ESRD patients in a cohort in Taiwan.

STUDY DESIGN

Blood samples collected from 149 ESRD patients and 149 age- and sex-matched healthy controls were analysed for HHV-8 antibody with immunofluorescence assay (IFA) and enzyme-linked immunosorbent assay (ELISA) and for HHV-8 DNA with polymerase chain reaction.

RESULTS

Seropositivity and titres for HHV-8 antibodies with IFA as well as seropositivity with ELISA were significantly greater in ESRD patients than in healthy controls (P=0.006, 0.001 and 0.003, respectively). Patients with a history of taking herbal medicine had significantly greater ELISA positivity than those without such a history (P=0.004). ELISA positives, particularly patients, had much higher IFA antibody titres than ELISA negatives (P<0.0001). Seropositivity in ESRD patients was not related to lymphopaenia, monocytosis, dialysis duration or a history of transfusion. Two diabetic ESRD patients were positive for HHV-8 DNA.

CONCLUSIONS

ESRD patients had significantly greater HHV-8 seropositivity than healthy controls in Taiwan. This association seems to be related to the geographic location of the cohort and invites further studies for the early association of HHV-8 infection in ESRD patients and risk for KS.

摘要

背景

人类疱疹病毒 8 型(HHV-8)是卡波西肉瘤(KS)的病原体。肾移植患者 KS 的发病率远高于健康对照者。在移植前 HHV-8 血清阳性的受者中,风险更高。终末期肾病(ESRD)患者免疫功能低下,是肾移植的候选者,但 ESRD 患者的 HHV-8 血清流行率尚未得到很好的记录。

目的

本研究旨在评估台湾队列中 ESRD 患者的 HHV-8 血清流行率。

研究设计

用免疫荧光法(IFA)和酶联免疫吸附试验(ELISA)分析了 149 例 ESRD 患者和 149 例年龄和性别匹配的健康对照者的血液样本,以检测 HHV-8 抗体,并采用聚合酶链反应(PCR)检测 HHV-8 DNA。

结果

IFA 检测到的 HHV-8 抗体血清阳性率和滴度以及 ELISA 检测到的血清阳性率在 ESRD 患者中明显高于健康对照组(P=0.006、0.001 和 0.003)。有服用草药史的患者 ELISA 阳性率明显高于无此病史者(P=0.004)。ELISA 阳性者,特别是患者,IFA 抗体滴度明显高于 ELISA 阴性者(P<0.0001)。ESRD 患者的血清阳性率与淋巴细胞减少症、单核细胞增多症、透析时间或输血史无关。两名糖尿病 ESRD 患者 HHV-8 DNA 阳性。

结论

在台湾,ESRD 患者的 HHV-8 血清阳性率明显高于健康对照组。这种关联似乎与队列的地理位置有关,并邀请进一步研究 HHV-8 感染与 ESRD 患者 KS 风险的早期关联。

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