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喀麦隆维持性血液透析患者中乙型肝炎、丙型肝炎和人类免疫缺陷病毒血清学转换阳性率及其潜在风险因素

Hepatitis B, Hepatitis C, and Human Immune deficiency Virus Seroconversion Positivity Rates and Their Potential Risk Factors Among Patients on Maintenance Hemodialysis in Cameroon.

作者信息

Halle Marie-Patrice, Choukem Simeon-Pierre, Kaze Francois Folefack, Ashuntantang Gloria, Tchamago Vanessa, Mboue-Djieka Yannick, Temfack Elvis, Luma Henry Namme

机构信息

Faculty of Medicine and Pharmaceutical Sciences, University of Douala; Department of Internal Medicine, Douala General Hospital, Douala, Cameroon.

出版信息

Iran J Kidney Dis. 2016 Sep;10(5):304-309.

Abstract

INTRODUCTION

Maintenance hemodialysis is a high-risk environment for transmission of blood-borne viruses. We aimed to assess the seroconversion rates of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immune deficiency virus (HIV) infections in patients on maintenance hemodialysis in a tertiary care hospital in Cameroon.

MATERIALS AND METHODS

Patients with serology records at initiation of hemodialysis, and a minimum duration on hemodialysis of 4 months were included. Baseline demographic and clinical data were recorded. Patients were tested with a third and fourth generation immune-enzymatic assay for hepatitis B surface antigen and anti-HCV antibodies, respectively. For HIV, a rapid Ag/Ab combo test and an ImmunoComb II HIV (for confirmation) were used.

RESULTS

Ninety-seven patients, 66% men, mean age of 51 ± 14 years and mean duration on hemodialysis of 32.8 ± 27.5 months, were included. Seroprevalence at dialysis initiation was 6.2%, 20.6%, and 9.3%, respectively, for HBV, HCV, and HIV. Ninety patients (92.8%) received blood transfusions while on hemodialysis. Seroconversion rates were 1.1% for hepatitis B surface antigen, 11.8%, for anti-HCV antibodies, and 0.0% for HIV. Longer duration on dialysis was associated with HCV seroconversion (62.7 months versus 29.2 months, P < .001).

CONCLUSIONS

Seroconversion rate in hemodialysis was high for HCV, low for HBV, and nil for HIV. Longer duration on dialysis was associated with HCV seroconversion. Our study suggests an urgent need to lay emphasis on universal precaution measures in order to reduce the risk of hepatitis seroconversion in the unit.

摘要

引言

维持性血液透析是血源性病毒传播的高风险环境。我们旨在评估喀麦隆一家三级医院中维持性血液透析患者的乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)和人类免疫缺陷病毒(HIV)感染的血清转化率。

材料与方法

纳入血液透析开始时具有血清学记录且血液透析最短持续时间为4个月的患者。记录基线人口统计学和临床数据。分别使用第三代和第四代免疫酶法检测患者的乙型肝炎表面抗原和抗HCV抗体。对于HIV,使用快速抗原/抗体联合检测和免疫组合II HIV检测(用于确认)。

结果

纳入97例患者,男性占66%,平均年龄51±14岁,平均血液透析时间32.8±27.5个月。透析开始时HBV、HCV和HIV的血清阳性率分别为6.2%、20.6%和9.3%。90例患者(92.8%)在血液透析期间接受过输血。乙型肝炎表面抗原的血清转化率为1.1%,抗HCV抗体的血清转化率为11.8%,HIV的血清转化率为0.0%。透析时间越长与HCV血清转化相关(62.7个月对29.2个月,P<.001)。

结论

血液透析中HCV的血清转化率高,HBV的血清转化率低,HIV的血清转化率为零。透析时间越长与HCV血清转化相关。我们的研究表明迫切需要强调普遍预防措施,以降低该科室肝炎血清转化的风险。

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