Department of Microbiology, Islamic Azad University, Shiraz Branch, Shiraz, Iran.
Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
Int J Artif Organs. 2021 Oct;44(10):658-663. doi: 10.1177/03913988211027177. Epub 2021 Jul 24.
Hepatitis E virus (HEV) is one of the prevalent nosocomially transmitted agents among patients on maintenance hemodialysis due to parenteral transmission of HEV and immunocompromised condition of chronic hemodialysis patients. Therefore, this study aimed to investigate prevalence, risk factors, and genotypic pattern of HEV infection among hemodialysis patients in South of Iran.
All patients on maintenance hemodialysis attending the hemodialysis centers of Bushehr, Borazjan, and Genaveh cities for regular hemodialysis were enrolled in this study. Serum samples were tested for the presence of anti-HEV antibodies using ELISA kit. The serum samples were further tested for detection of HEV RNA using nested RT-PCR.
Of 226 hemodialysis patients, 155 patients (68.6%, 95% CI: 62.3%-74.3%) were positive for anti-HEV IgG antibody, of which 33 patients (14.6%, 95% CI: 10.6%-19.8%) had anti-HEV IgM antibody. The prevalence of anti-HEV IgG and anti-IgM antibodies in non-hemodialysis controls were 65.1% and 9.6%, respectively. Although the hemodialysis patients had higher prevalence of HEV than the controls, the difference was not significant. All samples were negative for HEV RNA. HEV seroprevalence among hemodialysis patients was not significantly associated with place of residency, ethnicity, level of education, gender distribution, hemodialysis duration, and levels of liver enzymes. HEV seropositive patients had significantly higher mean age compared to seronegative patients.
This study reports the highest seroprevalence of HEV among hemodialysis patients in Iran. Inapparent HEV infection in the dialysis setting calls for regular screening of hemodialysis patients regardless of the hemodialysis duration, clinical symptoms, and liver function parameters.
戊型肝炎病毒（HEV）是在维持性血液透析患者中传播的主要医院获得性病原体之一，这是由于 HEV 的经肠道传播和慢性血液透析患者的免疫功能受损。因此，本研究旨在调查伊朗南部血液透析患者中 HEV 感染的流行率、危险因素和基因型模式。
本研究纳入了所有在布什尔、博尔扎詹和热纳维市的血液透析中心接受常规血液透析的维持性血液透析患者。使用酶联免疫吸附试验（ELISA）试剂盒检测血清样本中抗-HEV 抗体的存在。进一步使用巢式 RT-PCR 检测血清样本中 HEV RNA 的存在。
在 226 名血液透析患者中，155 名患者（68.6%，95%置信区间：62.3%-74.3%）抗-HEV IgG 抗体阳性，其中 33 名患者（14.6%，95%置信区间：10.6%-19.8%）抗-HEV IgM 抗体阳性。非血液透析对照组的抗-HEV IgG 和抗-IgM 抗体的流行率分别为 65.1%和 9.6%。尽管血液透析患者的 HEV 流行率高于对照组，但差异无统计学意义。所有样本均未检测到 HEV RNA。血液透析患者的 HEV 血清流行率与居住地、种族、教育水平、性别分布、血液透析时间和肝功能酶水平无关。HEV 血清阳性患者的平均年龄明显高于血清阴性患者。
本研究报告了伊朗血液透析患者中 HEV 最高的血清流行率。在透析环境中，无症状的 HEV 感染呼吁定期筛查血液透析患者，无论血液透析时间、临床症状和肝功能参数如何。
