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慢性肾脏病行血液透析患者丙型肝炎病毒感染及基因型流行情况。

Prevalence of hepatitis C virus infection and genotypes in patient with chronic kidney disease undergoing hemodialysis.

机构信息

University of the State of Pará, Belém, Pará, Brazil.

出版信息

J Med Virol. 2013 Oct;85(10):1741-5. doi: 10.1002/jmv.23654. Epub 2013 Jul 12.

Abstract

The prevalence of antibodies to HCV varies among Brazilian regions at rates of 8-16%. Since this virus is transmitted by the parenteral route through blood and blood products, patients receiving maintenance hemodialysis therapy are at an increased risk of infection. The study was conducted in seven dialysis centers in Belém, Pará, northern Brazil. Blood samples were collected from 798 patients with chronic renal disease treated by hemodialysis. The samples were tested for antibodies against HCV and the viral genotype was identified. Sixty-seven (8.4%) of the 798 patients studied were anti-HCV positive by ELISA, ranging from 4% to 14% in different centers. Viral RNA was detected in 5.3% (43/798) of the patients; of these, 42 also had anti-HCV antibodies. HCV genotyping revealed genotype 1 as the most common, detected in 86.1% (37/43) of the patients, followed by genotype 2 in 11.6% (5/43) and genotype 3 in one patient (2.3%). The findings of this study highlight the importance of control strategies for hepatitis C in hemodialysis patients. Molecular biology methods need to be available in these centers to screen for HCV on admission in order to establish effective infection control measures.

摘要

巴西不同地区抗 HCV 抗体的流行率为 8-16%。由于该病毒通过血液和血液制品的外途径传播,接受维持性血液透析治疗的患者感染风险增加。该研究在巴西北部帕拉州贝伦的 7 个透析中心进行。从 798 名接受血液透析治疗的慢性肾病患者中采集血样。对这些样本进行了 HCV 抗体检测,并确定了病毒基因型。798 名患者中,有 67 名(8.4%)通过 ELISA 检测抗 HCV 阳性,不同中心的阳性率从 4%到 14%不等。在 5.3%(43/798)的患者中检测到了病毒 RNA;其中,42 名患者也有抗 HCV 抗体。HCV 基因分型显示,1 型是最常见的基因型,在 86.1%(37/43)的患者中检测到,其次是 2 型(11.6%,5/43)和 3 型在一名患者中(2.3%)。这项研究的结果强调了对血液透析患者丙型肝炎控制策略的重要性。这些中心需要有分子生物学方法来筛查 HCV,以便在入院时采取有效的感染控制措施。

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