Shusterman N, Singer I
Am J Kidney Dis. 1987 Jun;9(6):447-55. doi: 10.1016/s0272-6386(87)80070-7.
Infectious hepatitis is a major problem for patients with end-stage renal disease and for staff caring for these patients. Initially hepatitis B was the major cause of hepatitis in dialysis patients and staff. Patients had a tendency to develop chronic hepatitis or become chronic carriers of the virus while staff either developed typical acute hepatitis or a primary antibody response. The discovery of the hepatitis B surface antigen (HBsAg), the screening of transfused blood for HBsAg, and the institution of infection control measures including isolation techniques have resulted in a remarkable decrease in the incidence of this disease. Nonetheless, the problem of infectious hepatitis continues as non-A, non-B hepatitis has become more commonplace among dialysis patients. Unfortunately, no viral markers have been discovered, and blood products remain the major vehicle of transmission. The institution of infection control measures similar to those used to control hepatitis B has probably been effective in controlling the spread of this disease. It is hoped that the discovery of the etiologic agent(s), with the eventual goal of screening blood products and the development of a vaccine, will lead to full control of this disorder.
感染性肝炎对于终末期肾病患者以及护理这些患者的工作人员来说是一个重大问题。最初，乙型肝炎是透析患者和工作人员患肝炎的主要原因。患者倾向于发展为慢性肝炎或成为病毒的慢性携带者，而工作人员则要么患上典型的急性肝炎，要么产生原发性抗体反应。乙型肝炎表面抗原（HBsAg）的发现、对输血进行HBsAg筛查以及包括隔离技术在内的感染控制措施的实施，已使该疾病的发病率显著下降。尽管如此，由于非甲非乙型肝炎在透析患者中变得更为常见，感染性肝炎问题依然存在。不幸的是，尚未发现病毒标志物，血液制品仍然是主要的传播媒介。采取与控制乙型肝炎类似的感染控制措施可能对控制该疾病的传播有效。人们希望病因的发现，最终目标是筛查血液制品并研发疫苗，将能全面控制这种疾病。
