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法国终末期肾病中丙型肝炎病毒和乙型肝炎病毒的流行病学更新

Epidemiology update for hepatitis C virus and hepatitis B virus in end-stage renal disease in France.

作者信息

Isnard Bagnis Corinne, Couchoud Cécile, Bowens Marc, Sarraj Ayman, Deray Gilbert, Tourret Jérôme, Cacoub Patrice, Tezenas du Montcel Sophie

机构信息

Department of Nephrology, Urology and Transplantation, Pitié-Salpêtrière Hospital, Sorbonne University, Univ. Paris 6, Paris, France.

REIN Registry, Agence de Biomedecine, Saint Denis La Plaine, France.

出版信息

Liver Int. 2017 Jun;37(6):820-826. doi: 10.1111/liv.13367. Epub 2017 Feb 11.

Abstract

BACKGROUND & AIMS: Risk for HCV/HBV infection is increased in end-stage renal disease patients. We generate updated epidemiological data.

METHODS

Based on the National French registry for end-stage renal disease patients, we extracted data for patients who started dialysis or pre-emptive transplantation between January 2005 and December 2013. A positive serum HBs Ag and/or a positive HCV RNA defined HBV and HCV infections, respectively.

RESULTS

In all, 72 948 patients were included among which 62.5% were men. At inclusion, 615 patients were HBV+ and 1026 HCV+. The prevalence of HBV and HCV infections were 0.84% (95% PI: 0.78-0.91) and 1.41% (95% PI: 1.32-1.49), respectively. The prevalence of HBV infection by age group increased progressively until a maximum rate at 1.80% (95% PI: 1.46-2.20) in the 4th decade, then regularly decreased. Same profile was observed for HCV prevalence, with a maximum rate at 3.14% (95% PI: 2.68-3.65) in the 4th decade. During the follow-up, we identified new HBV or HCV infections in 117 and 81 patients, respectively, with an overall incidence of 0.076% (95% PI: 0.062-0.090) and 0.053% (95%PI: 0.041-0.065) between 2005 and 2013, respectively. During the first dialysis year, HBV incidence was 0.35% (95% PI: 0.28-0.43) and that of HCV 0.21% (95% PI: 0.16-0.28).

CONCLUSION

Our data highlight the need for HCV therapy for more than 1000 end-stage renal disease patients in France, sustained systematic immunization campaigns (HBV) and underlines the persistence of HBV/HCV new hand-borne nosocomial cases.

摘要

背景与目的

终末期肾病患者感染丙肝病毒(HCV)/乙肝病毒(HBV)的风险增加。我们生成了最新的流行病学数据。

方法

基于法国全国终末期肾病患者登记系统,我们提取了2005年1月至2013年12月期间开始透析或接受先发制移植的患者的数据。血清乙肝表面抗原(HBs Ag)阳性和/或丙肝病毒核糖核酸(HCV RNA)阳性分别定义为HBV和HCV感染。

结果

共纳入72948例患者,其中62.5%为男性。纳入时,615例患者HBV阳性,1026例患者HCV阳性。HBV和HCV感染的患病率分别为0.84%(95%预测区间:0.78 - 0.91)和1.41%(95%预测区间:1.32 - 1.49)。按年龄组划分的HBV感染患病率逐渐上升,在第4个十年达到最高值1.80%(95%预测区间:1.46 - 2.20),然后逐渐下降。HCV患病率也呈现相同的趋势,在第4个十年达到最高值3.14%(95%预测区间:2.68 - 3.65)。在随访期间,我们分别在117例和81例患者中发现了新的HBV或HCV感染,2005年至2013年期间总体发病率分别为0.076%(95%预测区间:0.062 - 0.090)和0.053%(95%预测区间:0.041 - 0.065)。在透析的第一年,HBV发病率为0.35%(95%预测区间:0.28 - 0.43),HCV发病率为0.21%(95%预测区间:0.16 - 0.28)。

结论

我们的数据凸显了法国有超过1000例终末期肾病患者需要进行HCV治疗,需要持续开展系统性免疫接种活动(针对HBV),并强调了HBV/HCV新的经手传播的医院感染病例持续存在。

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