Shafi Salman Tahir, Hassan Muhammad Zaigham, Saleem Mohammed, Anjum Roshina, Abdullah Wajid, Shafi Tahir
Dr. Salman Tahir Shafi, Associate Professor of Nephrology, Department of Nephrology, Sharif Medical and Dental College, Sharif Medical City Road JatiUmra, Lahore, Pakistan.
Dr. Muhammad Zaigham Hassan, Post graduate Resident, Department of Nephrology, Sharif Medical and Dental College, Sharif Medical City Road JatiUmra, Lahore, Pakistan.
Pak J Med Sci. 2017 Jan-Feb;33(1):18-21. doi: 10.12669/pjms.331.11553.
Hepatitis C and chronic kidney disease (CKD) are major global health problems and are highly prevalent in Pakistan. There is limited information on prevalence of hepatitis C in patients with CKD not yet on dialysis. The objective of this study was to determine the frequency of hepatitis C in hospitalized chronic kidney disease patients at a tertiary care center in Pakistan.
The study design was cross-sectional in nature. Patients between ages of 20-80 years with CKD not previously on renal replacement therapy and who were admitted to nephrology ward at a tertiary care facility were included. Hepatitis C was tested using 3 generation enzyme linked immunosorbent assay (ELISA). Hepatitis C RNA was tested by polymerase chain reaction (PCR) in patients with positive ELISA.
A total of 180 patients were included in the study. Mean age of patients was 48.7±14.9 years. Of all patients, 105 (58.3%) were males and 75 (41.7%) were females, 152 (84.4%) had hypertension, 113 (62.8%) had diabetes mellitus and 26 (14.9%) had known cardiovascular disease. Mean eGFR of patients was 11.4±9.4 ml/min/1.73 m2. Of all patients with CKD, 49 (27.2%) had hepatitis C test positive by ELISA. Hepatitis C PCR testing was done in 39 patients with hepatitis C ELISA positive status and 29 (74.4%) tested positive. Risk factors and clinical characteristics of patients with and without positive hepatitis C antibody by ELISA were similar.
A significant proportion of hospitalized CKD patients have hepatitis C. Strict universal infection control measures should be implemented in nephrology wards to prevent transmission of hepatitis C infection.
丙型肝炎和慢性肾脏病(CKD)是全球主要的健康问题,在巴基斯坦极为普遍。关于尚未接受透析的CKD患者中丙型肝炎患病率的信息有限。本研究的目的是确定巴基斯坦一家三级医疗中心住院的慢性肾脏病患者中丙型肝炎的发生率。
本研究设计为横断面研究。纳入年龄在20 - 80岁之间、此前未接受肾脏替代治疗且入住三级医疗机构肾脏病病房的CKD患者。使用第三代酶联免疫吸附测定(ELISA)检测丙型肝炎。对ELISA检测呈阳性的患者通过聚合酶链反应(PCR)检测丙型肝炎病毒核糖核酸(HCV RNA)。
本研究共纳入180例患者。患者的平均年龄为48.7±14.9岁。所有患者中,105例(58.3%)为男性,75例(41.7%)为女性,152例(84.4%)患有高血压,113例(62.8%)患有糖尿病,26例(14.9%)患有已知的心血管疾病。患者的平均估算肾小球滤过率(eGFR)为11.4±9.4 ml/min/1.73 m²。在所有CKD患者中,49例(27.2%)ELISA检测丙型肝炎呈阳性。对39例ELISA检测丙型肝炎呈阳性的患者进行了HCV RNA检测,其中29例(74.4%)检测呈阳性。ELISA检测丙型肝炎抗体阳性和阴性患者的危险因素及临床特征相似。
相当一部分住院的CKD患者患有丙型肝炎。肾脏病病房应严格实施普遍的感染控制措施,以预防丙型肝炎感染的传播。