Timofte Delia, Dragos Dorin, Balcangiu-Stroescu Andra-Elena, Tanasescu Maria-Daniela, Gabriela Balan Daniela, Avino Adelaida, Tulin Adrian, Stiru Ovidiu, Ionescu Dorin
Department of Dialysis, Emergency University Hospital, 050098 Bucharest, Romania.
Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Exp Ther Med. 2020 Jul;20(1):109-116. doi: 10.3892/etm.2020.8606. Epub 2020 Mar 17.
Increase in the number of patients with chronic kidney disease (CKD) calls for improved management of these patients. In stage 5 CKD, when the initiation of renal replacement therapy (RRT) becomes necessary, there is an increase in the infection risk of the patients and immunological tests for hepatitis C virus (HCV) detection turn positive at an alarmingly higher rate compared to general population. With the introduction into clinical practice of diagnostic tests, the increased prevalence of HCV among CKD patients has been known since the 1990s. Also, the negative impacts of HCV infection on CKD evolution as well as the unfavorable evolution of grafts received by HCV infected patients are known. Chronic hemodialysis patients are a category of patients whose risk of HCV infection is substantial. Currently, in the hemodialysis centers, at the base of the transmission of HCV infection there are a multitude of factors. Infection with HCV has a different impact on patient with end-stage renal disease (ESRD). Comorbidities in this case have significant sources of mortality and morbidity. It was proven that the post transplantations problems were prevented and mortality was reduced for patients who were diagnosed with HCV and in whom the infection was treated before the kidney transplant (KT). Consequently, early detection of the infection and the application of specific treatment has a considerable impact on the outcome of the patients. Another important component of the management of HCV infection in the chronic hemodialysis patients is the prevention of the infection transmission by applying specific methods.
慢性肾脏病（CKD）患者数量的增加需要改善对这些患者的管理。在CKD 5期，当有必要开始肾脏替代治疗（RRT）时，患者的感染风险增加，丙型肝炎病毒（HCV）检测的免疫学检查呈阳性的比率比普通人群高得多，令人担忧。自20世纪90年代以来，随着诊断检测引入临床实践，CKD患者中HCV患病率上升已为人所知。此外，HCV感染对CKD进展的负面影响以及HCV感染患者所接受移植物的不良进展也为人所知。慢性血液透析患者是HCV感染风险很高的一类患者。目前，在血液透析中心，HCV感染传播的根源有多种因素。HCV感染对终末期肾病（ESRD）患者有不同的影响。在这种情况下，合并症是死亡率和发病率的重要来源。事实证明，对于在肾移植（KT）前被诊断为HCV且感染得到治疗的患者，移植后问题得到了预防，死亡率降低。因此，感染的早期检测和特异性治疗的应用对患者的预后有相当大的影响。慢性血液透析患者HCV感染管理的另一个重要组成部分是通过应用特定方法预防感染传播。
