Rajasekaran Arun, Franco Ricardo A, Overton Edgar T, McGuire Brendan M, Towns Graham C, Locke Jayme E, Sawinski Deirdre L, Bell Emmy K
Department of Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Kidney Int Rep. 2021 Apr 25;6(7):1788-1798. doi: 10.1016/j.ekir.2021.04.015. eCollection 2021 Jul.
Chronic hepatitis C virus (HCV) infection continues to be transmitted to hemodialysis (HD) patients within HD facilities globally. The goal of the World Health Organization to micro-eliminate HCV infection from the HD population by the year 2030 is not on target to be achieved. Obstacles to eliminate HCV in HD settings remain daunting due to a complex system created by a confluence of guidelines, legislation, regulation, and economics. HCV prevalence remains high and seroconversion continues among the HD patient population globally as a result of the HD procedure. Preventive strategies that effectively prevent HCV transmission, treatment-as-prevention, and rapid referral to treatment balanced with kidney transplant candidacy should be added to the current universal precautions approach. A safer system must be designed before HCV transmission can be halted and eliminated from the HD population.
慢性丙型肝炎病毒(HCV)感染在全球范围内的血液透析(HD)设施中持续传播给HD患者。世界卫生组织到2030年在HD人群中实现丙型肝炎病毒感染微观消除的目标未能按计划实现。由于指南、立法、监管和经济因素交汇形成的复杂系统,在HD环境中消除HCV的障碍仍然艰巨。由于HD程序,全球HD患者群体中HCV流行率仍然很高且血清转换仍在继续。应在当前的通用预防措施方法中增加有效预防HCV传播、治疗即预防以及在肾移植候选资格之间实现快速转诊治疗的预防策略。必须设计一个更安全的系统,才能在HD人群中停止并消除HCV传播。