Peng Hui-Ming, Wang Long-Chao, Zhai Ji-Liang, Weng Xi-Sheng, Fen Bin, Wang Wei
Department of Orthopedic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Arch Med Sci. 2020 Feb 11;16(2):308-312. doi: 10.5114/aoms.2020.92892. eCollection 2020.
Transfusion-transmitted infections (TTIs) continue to be a major challenge among hemophilia patients. This study was conducted to investigate the prevalence of TTIs including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis in patients with hemophilia who received surgical treatment due to bone or joint lesions in the Department of Orthopedics.
The present study was conducted from July 1996 to November 2016 in Beijing, China. A total of 189 patients who underwent orthopedic procedures were enrolled. Blood samples were obtained from the patients and were tested for hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCV Ab) and human immunodeficiency virus antibody (HIV Ab).
Among 189 hemophilia patients included in the study, 54 (28.6%) tested positive for TTI. Seroprevalence for HBsAg was found in 8 (4.2%) cases, HCV Ab in 48 (25.4%) cases, HIV Ab in 2 (1.1%) cases, and syphilis in 1 (0.5%) case. No statistically significant difference in the numbers of patients with positive HCV Ab was seen between hemophilia A (26.0%) and B (20.0%) ( = 0.786). The seroprevalence of HCV Ab (12.1%) in 66 hemophilia patients diagnosed after 1995 was significantly lower than that (32.5%) among hemophilia patients diagnosed before or in 1995 ( = 0.003).
Though few patients have become positive for HBsAg and HIV Ab, HCV is still the major virus of concern for hemophiliacs who have undergone orthopedic procedures. Hepatitis B vaccination should be given to the high-risk population including hemophilia patients as soon as possible.
输血传播感染(TTIs)仍是血友病患者面临的一项重大挑战。本研究旨在调查因骨科骨或关节病变接受手术治疗的血友病患者中包括乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、人类免疫缺陷病毒(HIV)和梅毒在内的输血传播感染的患病率。
本研究于1996年7月至2016年11月在中国北京进行。共纳入189例行骨科手术的患者。采集患者血样,检测乙型肝炎表面抗原(HBsAg)、丙型肝炎病毒抗体(HCV Ab)和人类免疫缺陷病毒抗体(HIV Ab)。
在纳入研究的189例血友病患者中,54例(28.6%)输血传播感染检测呈阳性。8例(4.2%)患者HBsAg血清阳性,48例(25.4%)患者HCV Ab阳性,2例(1.1%)患者HIV Ab阳性,1例(0.5%)患者梅毒阳性。甲型血友病(26.0%)和乙型血友病(20.0%)患者中HCV Ab阳性患者数量无统计学显著差异(P = 0.786)。1995年后诊断的66例血友病患者中HCV Ab血清阳性率(12.1%)显著低于1995年及以前诊断的血友病患者(32.5%)(P = 0.003)。
虽然仅有少数患者HBsAg和HIV Ab呈阳性,但HCV仍是接受骨科手术的血友病患者主要关注的病毒。应尽快对包括血友病患者在内的高危人群接种乙肝疫苗。