Anees Muhammad, Sarwar Nosheen, Ahmad Sajad, Elahii Irfan, Mateen Fazal E
Department of Nephrology, King Edward Medical University, Lahore, Pakistan.
J Coll Physicians Surg Pak. 2021 Sep;31(9):1040-1045. doi: 10.29271/jcpsp.2021.09.1040.
To determine patient and dialysis services-related factors associated with seroconversion of hepatitis C virus (HCV) in hemodialysis (HD) patients.
Cross-sectional study.
Department of Nephrology, Mayo Hospital, King Edward Medical University (KEMU), Lahore, from January to December, 2018.
All patients on regular HD for more than three months were enrolled. All patients who seroconverted from HCV-negative to positive status three months after starting HD, were included. Patient-related factors (age, gender, blood transfusion, duration and frequency of dialysis, history of dental treatment and surgical intervention) and dialysis services-related parameters (dedicated staff, isolated room, hemodialysis machine, reverse osmosis plant, compliance of universal infection control measure) were noted.
Out of 990 patients, 492 (49.7%) were reported as seroconverted for HCV during HD. Factors determined statistically significant for seroconversion were surgical intervention (p<0.001), history of dental procedure (p <0.001), blood transfusions (p <0.001), multiple sexual partner (p <0.001), age (p=0.035) and duration of hemodialysis (p <0.001). Factors not affecting seroconversion included frequency of dialysis (p=0.062), history of renal transplant (p =0.097) and family history of hepatitis (p=0.941). A significant negative correlation was observed between the rate of seroconversion of HCV and the score of universal infection control measures (r=-0.665, p=0.018).
There was a high rate of seroconversion of HCV in HD patients. Factors responsible for seroconversion were history of surgical intervention, dental treatment, blood transfusion, multiple sexual partners, age and duration of dialysis. The dialysis centres non-compliant with universal infection control measures were having high rate of seroconversion. Key Words: Hemodialysis, Seroconversion, HCV, Blood transfusion, Dental treatment, Surgical intervention, Infection, Isolation.
确定与血液透析（HD）患者丙型肝炎病毒（HCV）血清学转换相关的患者及透析服务相关因素。
横断面研究。
2018年1月至12月，拉合尔爱德华国王医科大学（KEMU）梅奥医院肾脏病科。
纳入所有接受规律血液透析超过三个月的患者。纳入所有在开始血液透析三个月后从HCV阴性转为阳性的患者。记录患者相关因素（年龄、性别、输血、透析时间和频率、牙科治疗史和手术干预史）以及透析服务相关参数（专职工作人员、隔离病房、血液透析机、反渗透设备、普遍感染控制措施的依从性）。
在990例患者中，有492例（49.7%）在血液透析期间被报告为HCV血清学转换。经统计学确定，血清学转换的显著因素为手术干预（p<0.001）、牙科治疗史（p<0.001）、输血（p<0.001）、多个性伴侣（p<0.001）、年龄（p=0.035）和血液透析时间（p<0.001）。不影响血清学转换的因素包括透析频率（p=0.062）、肾移植史（p=0.097）和肝炎家族史（p=0.941）。HCV血清学转换率与普遍感染控制措施得分之间存在显著负相关（r=-0.665，p=0.018）。
血液透析患者中HCV血清学转换率较高。导致血清学转换的因素为手术干预史、牙科治疗、输血、多个性伴侣、年龄和透析时间。不符合普遍感染控制措施的透析中心血清学转换率较高。关键词：血液透析、血清学转换、HCV、输血、牙科治疗、手术干预、感染、隔离
