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拉丁美洲接受血液透析患者中丙型肝炎病毒感染的患病率。

Prevalence of hepatitis C virus infection among patients undergoing haemodialysis in Latin America.

作者信息

Gómez-Gutiérrez Cristina, Chávez-Tapia Norberto C, Ponciano-Rodríguez Guadalupe, Uribe Misael, Méndez-Sánchez Nahum

机构信息

Liver Research Unit. Medica Sur Clinic & Foundation, Mexico City, Mexico.

Public Health Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.

出版信息

Ann Hepatol. 2015 Nov-Dec;14(6):807-14. doi: 10.5604/16652681.1171751.

Abstract

Hepatitis C infection is a worldwide problem. The global prevalence of the hepatitis C virus (HCV) averages 3%. Moreover, its prevalence among patients undergoing haemodialysis (HD) varies worldwide, ranging from as low as 1% to up to 70%. There are few data on its prevalence in developing countries, and even less information is available on HD patients. A literature review revealed that the prevalence of HCV infection among patients undergoing HD in Latin America ranges from 4.2 to 83.9%, with most data stemming from Argentina, Brazil, Mexico, Peru, Chile, Venezuela and Cuba. The most common genotype was genotype 1, and subtype 1b was the most frequent. The risk factors associated with this condition were the duration of the HD treatment and blood transfusion before hepatitis C screening. In addition, HCV RNA detection by polymerase chain reaction is crucial for the diagnosis of HCV infection in HD patients. Trials using combinations of new oral antiviral drugs, such as sofosbuvir and combo (ombitasvir, paritaprevir, ritonavir and dasabuvir), should be the next step in the improvement of care among HD patients with HCV, because these therapeutic agents apparently do not require dose adjustment according to renal function. Finally, information on this subgroup of patients remains unavailable in some countries; therefore, additional studies are needed to determine the prevalence trend of HCV infection in these populations.

摘要

丙型肝炎感染是一个全球性问题。丙型肝炎病毒(HCV)的全球流行率平均为3%。此外,其在接受血液透析(HD)患者中的流行率在全球范围内各不相同,低至1%,高达70%。关于其在发展中国家的流行率数据很少,关于HD患者的信息更少。一项文献综述显示,拉丁美洲接受HD治疗的患者中HCV感染的流行率为4.2%至83.9%,大多数数据来自阿根廷、巴西、墨西哥、秘鲁、智利、委内瑞拉和古巴。最常见的基因型是1型,1b亚型最为常见。与这种情况相关的危险因素是HD治疗的持续时间和丙型肝炎筛查前的输血。此外,通过聚合酶链反应检测HCV RNA对于HD患者HCV感染的诊断至关重要。使用新的口服抗病毒药物组合(如索磷布韦和组合药物[奥比他韦、帕利哌韦、利托那韦和达沙布韦])进行试验应该是改善HCV感染HD患者护理的下一步措施,因为这些治疗药物显然不需要根据肾功能调整剂量。最后,在一些国家仍然没有关于这一亚组患者的信息;因此,需要进一步的研究来确定这些人群中HCV感染的流行趋势。

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