Amin Elzorkany Khaled Mohamed, Zahran Ahmed
Department of Internal Medicine, Nephrology Unit, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Saudi J Kidney Dis Transpl. 2017 Sep-Oct;28(5):1126-1132. doi: 10.4103/1319-2442.215151.
There is a high prevalence of hepatitis C virus (HCV) infection in hemodialysis (HD) patients in Menoufia Governorate, Egypt. The aim of this cross-sectional study was to assess current HCV status and its seroconversion in HD patients after implementing preventative measures to limit transmission of HCV. All data were compared with our previous data collected in 2011 before implementation of isolation policy. There was a significant decrease in HCV infection in HD patients from 49.6% in year 2011 to 41.9% in year 2016 (P = 0.001). The seroconversion rate was significantly reduced from 14.5% in year 2011 to 4.9% in year 2016 (P = 0.001). Age, gender, body mass index, hemoglobin, and calcium did not show any significant difference whereas blood transfusion, serum phosphate, and urea reduction ratio showed a significant difference with much improvement in year 2016. When comparing seroconversion group with HCV-negative patients, blood transfusion did not show significant difference whereas seroconverted group showed significantly longer duration of dialysis (94.94 ± 82.87 months vs. 38.21 ± 31.55 months). Same result was obtained in year 2011; however, when all data analyzed the duration of dialysis and blood transfusion were higher significantly in seroconverted group. Binary logistic regression analysis for all data demonstrated that isolation reduced the likelihood of seroconversion while longer duration of dialysis increased the risk for seroconversion. HCV infection and its seroconversion in HD patients were significantly reduced in year 2016 compared to year 2011. Isolation policy is recommended for HD patients with HCV in dialysis units with high HCV prevalence in developing countries.
在埃及梅努菲亚省的血液透析（HD）患者中，丙型肝炎病毒（HCV）感染率很高。这项横断面研究的目的是评估在实施限制HCV传播的预防措施后，HD患者当前的HCV状况及其血清转化情况。所有数据均与我们在2011年实施隔离政策之前收集的先前数据进行了比较。HD患者中的HCV感染率从2011年的49.6%显著下降至2016年的41.9%（P = 0.001）。血清转化率从2011年的14.5%显著降低至2016年的4.9%（P = 0.001）。年龄、性别、体重指数、血红蛋白和钙没有显示出任何显著差异，而输血、血清磷酸盐和尿素清除率显示出显著差异，2016年有很大改善。将血清转化组与HCV阴性患者进行比较时，输血没有显示出显著差异，而血清转化组的透析时间显著更长（94.94±82.87个月对38.21±31.55个月）。2011年也得到了相同的结果；然而，当分析所有数据时，血清转化组的透析时间和输血次数显著更高。对所有数据进行二元逻辑回归分析表明，隔离降低了血清转化的可能性，而较长的透析时间增加了血清转化的风险。与2011年相比，2016年HD患者中的HCV感染及其血清转化显著减少。对于发展中国家HCV患病率高的透析单位中患有HCV的HD患者，建议采取隔离政策。
