Kiani Ismaa Ghazanfar, Khan Adil Naseer, Butt Batool, Sabir Sohail, Ejaz Sundas, Perveen Adeeba, Ghani Eijaz
Military Hospital, Rawalpindi, Pakistan.
Department of Gastroenterology, Ayub Medical College Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2018 Jul-Sep;30(3):397-400.
It's estimated that almost 2.2% of the world's inhabitants suffer from hepatitis C virus (HCV). The most common cause of chronic liver disease in haemodialysis centres is due to HCV. In 1993, it was first described by Bukh and colleagues that HCV viremia can occur without any detectable antibodies to the HCV. Keeping this in mind the purpose of this cross-sectional study was to assess the frequency of HCV in haemodialysis patients by PCR who are serologically negative for HCV.
This cross-sectional study was conducted from 1st June to 31st December 2016 on all haemodialysis patients at MH Rawalpindi. Epidemiological data for gender, age, duration on haemodialysis, cause of chronic renal failure and any associated risk factor for acquiring hepatitis C infection was asked. Patients undergoing haemodialysis were investigated by fourth generation ELISA for Anti HCV antibodies, HCV DNA polymerase chain reaction, HCV genotype (where required) and liver function test were also done.
A total of 201 patients were undergoing haemodialysis. Among these patients 73 were hepatitis "C" negative and 128 were hepatitis "C" positive. Among the 73 patients who were hepatitis C negative by ELISA method 17 (23%) were PCR positive. Of the 17 patients 13 (76.5%) were men and 4 (23.5%) were women. The mean age of the patients was 49.7±18.0 years and mean duration of haemodialysis was 4.4±4.1 months. The most common cause of CKD requiring haemodialysis was hypertension (64.7%). The most common genotype was type 1 (58.8%) followed by genotype 3 (41.2%). The mean viral load was 23583615.70 IU.
HCV-RNA detection by PCR should be used as standard of care to detect HCV infection in patients undergoing haemodialysis.
据估计，全球近2.2%的居民感染丙型肝炎病毒（HCV）。血液透析中心慢性肝病最常见的病因是HCV。1993年，布赫及其同事首次描述了HCV病毒血症可在无任何可检测到的抗HCV抗体的情况下发生。基于此，本横断面研究的目的是通过PCR评估血清学HCV阴性的血液透析患者中HCV的感染率。
本横断面研究于2016年6月1日至12月31日对拉瓦尔品第MH医院的所有血液透析患者进行。询问了患者的性别、年龄、血液透析时间、慢性肾衰竭病因以及任何感染丙型肝炎的相关危险因素等流行病学数据。对接受血液透析的患者进行了第四代ELISA检测抗HCV抗体、HCV DNA聚合酶链反应、HCV基因型（必要时）检测，同时还进行了肝功能检查。
共有201名患者接受血液透析。其中73例HCV阴性，128例HCV阳性。在ELISA法检测为HCV阴性的73例患者中，17例（23%）PCR检测为阳性。在这17例患者中，13例（76.5%）为男性，4例（23.5%）为女性。患者的平均年龄为49.7±18.0岁，平均血液透析时间为4.4±4.1个月。需要血液透析的CKD最常见病因是高血压（64.7%）。最常见的基因型是1型（58.8%），其次是3型（41.2%）。平均病毒载量为23583615.70 IU。
PCR检测HCV - RNA应用作检测血液透析患者HCV感染的标准治疗方法。
