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埃及东北部慢性丙型肝炎患者及血液透析患者中的隐匿性乙肝病毒感染状况:区域及全国概况

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview.

作者信息

Mandour Mohamed, Nemr Nader, Shehata Atef, Kishk Rania, Badran Dahlia, Hawass Nashaat

机构信息

Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

出版信息

Rev Soc Bras Med Trop. 2015 May-Jun;48(3):258-64. doi: 10.1590/0037-8682-0037-2015.

Abstract

INTRODUCTION

Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region.

METHODS

Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR.

RESULTS

All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed significant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity.

CONCLUSIONS

OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods.

摘要

引言

隐匿性乙型肝炎感染(OBI)被认为是接受定期血液透析(HD)的终末期肾病(ESRD)患者和慢性丙型肝炎病毒(HCV)感染患者的主要风险之一。本研究比较了埃及东北部苏伊士运河地区这两个高危人群中OBI的患病率,以更好地了解该地区OBI的流行程度。

方法

收集了165例HD患者和210例慢性HCV感染患者的血清样本。采用酶联免疫吸附测定(ELISA)检测抗-HCV抗体、乙型肝炎表面抗原(HBsAg)、总乙型肝炎核心(抗-HBc)抗体和乙型肝炎表面抗体(抗-HBs)。使用定量实时逆转录聚合酶链反应(RT-PCR)检测HCV RNA,使用巢式PCR检测HBV。

结果

所有患者的HBsAg均为阴性。HD组和HCV组分别有49.1%和25.2%的患者抗-HBc呈阳性。此外,与HCV组相比,HD组中检测到更多抗-HBs呈阳性的患者(分别为52.1%和11.4%)。HD组有3例HBV DNA呈阳性,而HCV组检测到18例阳性病例。两个研究组在血清丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)水平以及抗-HBc、抗-HBs和HBV-DNA阳性方面均存在显著差异。

结论

在埃及苏伊士运河地区,慢性HCV患者中OBI的患病率高于HD患者,分别为8.5%和1.8%。然而,对这种感染进行更精确的评估需要使用HBV DNA检测方法对患者进行定期随访。

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