Katayama Keiko, Sato Tomoki, Do Son Huy, Yamada Hiroko, Tabuchi Ayako, Komiya Yutaka, Matsuo Junko, Nakashima Ayumu, Ohisa Masayuki, Akita Tomoyuki, Yorioka Noriaki, Miyakawa Yuzo, Yoshizawa Hiroshi, Tanaka Junko
Departments of Epidemiology, Infectious Disease Control and Prevention, Integrated Health Sciences, Tokyo, Japan.
Hiroshima Infectious Disease, Disease Control Center, Tokyo, Japan.
Hepatol Res. 2015 Dec;45(12):1211-9. doi: 10.1111/hepr.12492. Epub 2015 Feb 19.
A survey of hepatitis B virus (HBV) infection in hemodialysis (HD) patients was conducted to determine the burden and risk of infection and to suggest preventive measures against HBV infection among HD patients at nine hospitals in Hiroshima, Japan, from 1999 to 2003.
HBV markers were investigated for 1860 HD patients. The prevalence, incidence of HBV and prevalence of occult HBV were calculated.
The prevalence of hepatitis B surface antigen (HBsAg) was 2.6%, the positive rate of anti-hepatitis B core (HBc) was 20.6% and that of anti-hepatitis B surface (HBs) was 11.7%. Among 1372 patients who started HD after the approval of erythropoietin in Japan in 1991, the prevalence of HBsAg was 2.1%. The incidence rate of HBsAg positivity was 0/1000 person-years and the incidence of anti-HBc was 0.3/1000 person-years. Among 1812 HBsAg negative patients HBV DNA was detected in two: one case was negative for anti-HBc and anti-HBs, and the other was only positive for anti-HBc. Prevalence of occult HBV was 0.11%.
The incidence rate of HBV was much lower than that of hepatitis C virus (HCV) in the same cohort. We supposed that the discrepancy between incidence rate of HBV and that of HCV was caused by the difference of their carrier rates and of their characteristics for persistent infection. So, we concluded that it is prerequisite to grasp the burden of HBV carriers in the group to prevent new HBV infections in HD patients.
对日本广岛九家医院1999年至2003年期间血液透析（HD）患者的乙型肝炎病毒（HBV）感染情况进行调查，以确定感染负担和风险，并提出针对HD患者HBV感染的预防措施。
对1860例HD患者进行HBV标志物检测。计算HBV的患病率、发病率以及隐匿性HBV的患病率。
乙型肝炎表面抗原（HBsAg）的患病率为2.6%，抗乙型肝炎核心抗体（HBc）阳性率为20.6%，抗乙型肝炎表面抗体（HBs）阳性率为11.7%。在1991年日本批准使用促红细胞生成素后开始HD治疗的1372例患者中，HBsAg的患病率为2.1%。HBsAg阳性的发病率为0/1000人年，抗HBc的发病率为0.3/1000人年。在1812例HBsAg阴性患者中，有2例检测到HBV DNA：1例抗HBc和抗HBs均为阴性，另1例仅抗HBc阳性。隐匿性HBV的患病率为0.11%。
同一队列中HBV的发病率远低于丙型肝炎病毒（HCV）。我们推测HBV和HCV发病率的差异是由它们的携带率和持续感染特征的差异所致。因此，我们得出结论，掌握该群体中HBV携带者的负担是预防HD患者新发HBV感染的先决条件。
