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肾移植受者中戊型肝炎病毒感染的患病率及特征:日本单中心经验

Prevalence and characteristics of hepatitis E virus infection in kidney transplant recipients: A single-center experience in Japan.

作者信息

Nanmoku Koji, Owada Yohei, Oshiro Yukio, Kurosawa Akira, Kubo Taro, Shinzato Takahiro, Shimizu Toshihiro, Kimura Takaaki, Sakuma Yasunaru, Ishikawa Nobuo, Ohkohchi Nobuhiro, Okamoto Hiroaki, Yagisawa Takashi

机构信息

Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan.

Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.

出版信息

Transpl Infect Dis. 2019 Apr;21(2):e13033. doi: 10.1111/tid.13033. Epub 2018 Dec 14.

Abstract

BACKGROUND

Hepatitis E virus (HEV) infection can lead to chronic hepatitis in solid organ transplant recipients. To investigate whether HEV infection influences outcomes following kidney transplantation, we examined the prevalence of HEV infection and clinical characteristics of kidney transplant recipients in our hospital.

METHODS

Our cross-sectional study included 184 kidney transplant recipients. Blood samples were obtained from all patients to detect anti-HEV immunoglobulin (Ig)A, IgM, and IgG by enzyme-linked immunosorbent assay and HEV RNA by reverse transcription polymerase chain reaction. Clinical data were collected from medical charts for all patients.

RESULTS

The prevalence of anti-HEV IgG was 8/184 (4.3%). Anti-HEV IgA, anti-HEV IgM, and HEV RNA were not detected in any patients. Compared to their anti-HEV IgG-negative counterparts, anti-HEV IgG-positive patients were significantly older at the time of transplantation, and they were more likely to receive kidneys from deceased donors. No significant differences in other characteristics such as the prevalence of primary cause of end-stage renal disease, blood transfusion, and immunosuppressive therapy use; liver and renal function; and the frequencies of hepatitis B and hepatitis C virus infection were observed according to the patients' anti-HEV IgG status.

CONCLUSION

HEV infection had no significant influence on the outcomes of kidney transplantation at our institution. However, HEV infection should be recognized in kidney transplant recipients similarly as hepatitis B and hepatitis C virus infection in cases of liver dysfunction.

摘要

背景

戊型肝炎病毒(HEV)感染可导致实体器官移植受者发生慢性肝炎。为了研究HEV感染是否会影响肾移植后的结局,我们调查了我院肾移植受者中HEV感染的患病率及临床特征。

方法

我们的横断面研究纳入了184例肾移植受者。采集所有患者的血液样本,采用酶联免疫吸附试验检测抗HEV免疫球蛋白(Ig)A、IgM和IgG,并采用逆转录聚合酶链反应检测HEV RNA。从所有患者的病历中收集临床数据。

结果

抗HEV IgG的患病率为8/184(4.3%)。未在任何患者中检测到抗HEV IgA、抗HEV IgM和HEV RNA。与抗HEV IgG阴性的患者相比,抗HEV IgG阳性的患者在移植时年龄显著更大,且更有可能接受来自已故供者的肾脏。根据患者的抗HEV IgG状态,在其他特征方面未见显著差异,如终末期肾病的主要病因患病率、输血情况及免疫抑制治疗的使用情况;肝肾功能;以及乙型和丙型肝炎病毒感染的频率。

结论

在我们机构,HEV感染对肾移植结局无显著影响。然而,在肝功能异常的情况下,肾移植受者中的HEV感染应与乙型和丙型肝炎病毒感染一样得到重视。

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