Isnard Bagnis Corinne, Couchoud Cécile, Bowens Marc, Sarraj Ayman, Deray Gilbert, Tourret Jérôme, Cacoub Patrice, Tezenas du Montcel Sophie
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.
Liver Int. 2017 Jun;37(6):820-826. doi: 10.1111/liv.13367. Epub 2017 Feb 11.
BACKGROUND & AIMS: Risk for HCV/HBV infection is increased in end-stage renal disease patients. We generate updated epidemiological data.
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.
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).
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.
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。
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。
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)。
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。