Utsumi Takako, Lusida Maria I, Yano Yoshihiko, Wahyuni Rury M, Istimagfiroh Anittagwa, Amin Mochamad, Rinonce Hanggoro T, Wardana Aditia, Tjempakasari Artaria, Basuki Widodo, Hotta Hak, Hayashi Yoshitake
Southeast Asian J Trop Med Public Health. 2016 Sep;47(5):927-34.
The aims of the present study were to profile seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and possible risk factors among hemodialysis (HD) patients in private hemodialysis units (HDU) in Surabaya, Indonesia. Sera were obtained from 180 HD patients in 4 different private HDUs and tested for hepatitis B surface antigen (HBsAg) and antibody to HCV (anti-HCV). Patients without HBsAg and anti-HCV at first sampling were followed serologically every 3 months for 9 months, while those with HBsAg or anti-HCV positive sera were subjected continually to PCR to detect HBV DNA and HCV RNA. The prevalence of hepatitis infections varied widely between the HDUs, from 0% to 8.1% of patients positive for HBsAg and 0% to 60.6% of those positive for anti-HCV, respectively. These values were markedly higher than those among the general population, but not as high as in governmental HDUs in Indonesia. New incidence of HBV was not detected in any HDU, whereas that of HCV was found in two HDUs, HCV-1b in one HDU and HCV-1a in the other. Inappropriate practices were observed, such as shortage of medical staff and malfunctions in infection-control committees. Prevalence of HBV and HCV infection among HD patients in private HDUs were high and varied among the HDUs. Isolation of both HBV- and HCV-infected patients and staff education should help to reduce the prevalence of hepatitis infections in HDUs.
本研究的目的是剖析印度尼西亚泗水市私立血液透析单位（HDU）中血液透析（HD）患者的乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染血清流行率及可能的危险因素。从4个不同私立HDU的180例HD患者中采集血清，检测乙型肝炎表面抗原（HBsAg）和抗HCV抗体。首次采样时无HBsAg和抗HCV的患者每3个月进行一次血清学随访，为期9个月，而HBsAg或抗HCV血清阳性的患者则持续进行PCR检测以检测HBV DNA和HCV RNA。HDU之间肝炎感染的流行率差异很大，HBsAg阳性患者的比例从0%到8.1%，抗HCV阳性患者的比例从0%到60.6%。这些数值明显高于普通人群，但低于印度尼西亚政府HDU中的数值。在任何HDU中均未检测到HBV的新发病例，而在两个HDU中发现了HCV新发病例，一个HDU中为HCV-1b，另一个为HCV-1a。观察到一些不当做法，如医务人员短缺和感染控制委员会故障。私立HDU中HD患者的HBV和HCV感染流行率较高，且各HDU之间存在差异。隔离HBV和HCV感染患者以及对工作人员进行教育应有助于降低HDU中肝炎感染的流行率。
