Mittal Garima, Gupta Pratima, Thakuria Bhaskar, Mukhiya Gulshan K, Mittal Manish
Department of Microbiology, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, India.
Department of Microbiology, Shubharti Medical College, Meerut, India.
J Clin Exp Hepatol. 2013 Mar;3(1):24-8. doi: 10.1016/j.jceh.2013.02.003. Epub 2013 Feb 9.
Viral hepatitis and human immunodeficiency virus (HIV) infection are important causes of morbidity and mortality in hemodialysis (HD) patients. The present study was performed to assess the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and HIV infections in hemodialysis patients of a tertiary care hospital in Uttarakhand.
All patients undergoing maintenance HD at our center were screened for hepatitis B surface antigen (HBsAg), antibody to HCV (anti-HCV), antibody to HDV (anti-HDV) and HIV antibody by ELISA. Detailed history regarding age, sex, duration of dialysis, blood transfusions, number of dialysis centers, dialyzer reuse and laboratory data was recorded.
A total of 118 patients (79 males and 39 females) were followed for 18 months with screening for the presence of HBV, HCV and HIV infections. At baseline, 12 (10.2%) patients were positive for HBsAg, 19 (16.1%) for anti-HCV and 2 (1.7%) for HIV antibody. Over 18 months, one additional patient became HBsAg positive and an additional 17 became anti-HCV-positive to give a total of 36 HCV-positive patients. Dual HBV and HCV infection was seen in 5 (4.2%) and anti-HDV antibodies were found in 1 (0.9%) patient. History of blood transfusions, duration of HD, dialyzer reuse and dialysis at multiple centers were found to be important risk factors for anti-HCV positivity.
Implementation and adherence to universal work precautions by dialysis staff is imperative to prevent transmission of these infections.
病毒性肝炎和人类免疫缺陷病毒(HIV)感染是血液透析(HD)患者发病和死亡的重要原因。本研究旨在评估北阿坎德邦一家三级护理医院血液透析患者中乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、丁型肝炎病毒(HDV)和HIV感染的患病率。
通过酶联免疫吸附测定法(ELISA)对在我们中心接受维持性血液透析的所有患者进行乙型肝炎表面抗原(HBsAg)、抗丙型肝炎病毒抗体(抗-HCV)、抗丁型肝炎病毒抗体(抗-HDV)和HIV抗体筛查。记录有关年龄、性别、透析时间、输血情况、透析中心数量、透析器复用情况和实验室数据的详细病史。
共对118例患者(79例男性和39例女性)进行了为期18个月的随访,筛查HBV、HCV和HIV感染情况。基线时,12例(10.2%)患者HBsAg呈阳性,19例(16.1%)抗-HCV呈阳性,2例(1.7%)HIV抗体呈阳性。在18个月期间,又有1例患者HBsAg转为阳性,另有17例抗-HCV转为阳性,使HCV阳性患者总数达到36例。5例(4.2%)患者同时感染HBV和HCV,1例(0.9%)患者检测到抗-HDV抗体。发现输血史、血液透析时间、透析器复用情况以及在多个中心进行透析是抗-HCV阳性的重要危险因素。
透析工作人员必须实施并遵守通用的职业防护措施,以防止这些感染的传播。