Vidales-Braz Beatris Maria, da Silva Naylê Maria Oliveira, Lobato Rubens, Germano Fabiana Nunes, da Mota Luiza Dias, Barros Elvino J G, de Martinez Ana Maria Barral
Federal University of Rio Grande (FURG), Rio Grande, Brazil.
Fluminense Federal University (UFF), Rio de Janeiro, Brazil.
Virol J. 2015 Feb 3;12:8. doi: 10.1186/s12985-015-0238-z.
Hepatitis C (HCV) is a serious public health issue, and it is estimated that 3% of the world's population is infected. Patients in hemodialysis units have an increased risk for contracting HCV, and high prevalence rates have been found in hemodialysis units around the world. This study is aimed at determining the prevalence of HCV in patients with terminal chronic renal disease (tCRD) who have been submitted to hemodialysis and peritoneal dialysis in southern Brazil to characterize the most prevalent genotypes, the viral load, and possible risk factors and to assess the validity between the ELISA and RT-PCR detection methods. Of 320 patients from three dialysis units, 318 participated in this study. According to the medical records, 55 patients were reactive to HCV, as determined via ELISA. All 318 samples were submitted to RT-PCR and genotyped using an Abbott Realtime m2000 system. Data obtained through a questionnaire and chemical variables were associated with the HCV.
The prevalence of HCV was 18.24% (58), and the concordance between the HCV serology and the RT-PCR was 94%. Three patients were diagnosed to be negative for HCV using the ELISA assay but positive when using RT-PCR. Genotype 1 was the most prevalent (46.7%) genotype, within which subtype 1a was the most frequent (74.1%). One of the risk factors associated with HCV infection was the length of time that the patient had been undergoing hemodialysis treatments (p < 0.001). Additionally, the viral load was found to vary when tested before and after hemodialysis (p < 0.001).
The prevalence of HCV in dialysis units continues to remain high, indicating nosocomial contamination. RT-PCR detected the presence of the hepatitis C virus in patients with a non-reactive serology, which highlights the importance of performing molecular tests on dialysis patients. The variation in the viral load in patients submitted to hemodialysis indicates a possible destruction or gripping of viral particles to the dialyzer membrane.
丙型肝炎（HCV）是一个严重的公共卫生问题，据估计全球3%的人口受到感染。血液透析单位的患者感染HCV的风险增加，世界各地的血液透析单位中均发现了较高的患病率。本研究旨在确定巴西南部接受血液透析和腹膜透析的终末期慢性肾病（tCRD）患者中HCV的患病率，以表征最常见的基因型、病毒载量及可能的危险因素，并评估酶联免疫吸附测定（ELISA）和逆转录聚合酶链反应（RT-PCR）检测方法之间的有效性。来自三个透析单位的320名患者中，318名参与了本研究。根据病历，经ELISA测定，55名患者对HCV呈反应性。所有318份样本均进行RT-PCR检测，并使用雅培实时m2000系统进行基因分型。通过问卷调查和化学变量获得的数据与HCV相关。
HCV患病率为18.24%（58例），HCV血清学与RT-PCR之间的一致性为94%。3例患者ELISA检测HCV为阴性，但RT-PCR检测为阳性。1型是最常见的基因型（46.7%），其中1a亚型最为常见（74.1%）。与HCV感染相关的危险因素之一是患者接受血液透析治疗的时间长度（p < 0.001）。此外，血液透析前后检测发现病毒载量有所变化（p < 0.001）。
透析单位中HCV的患病率仍然很高，表明存在医院感染。RT-PCR检测出血清学无反应性患者中存在丙型肝炎病毒，这凸显了对透析患者进行分子检测的重要性。接受血液透析患者的病毒载量变化表明病毒颗粒可能被透析器膜破坏或吸附。
