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阿曼血液透析患者丙型肝炎病毒(HCV)的血清流行率:一项全国性横断面研究。

The Seroprevalence of Hepatitis C Virus (HCV) in Hemodialysis Patients in Oman: A National Cross-Sectional Study.

机构信息

Directorate General for Disease Surveillance and Control, Central Public Health Laboratories, Ministry of Health, Muscat, Oman.

Department of Surveillance, Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman.

出版信息

J Epidemiol Glob Health. 2023 Dec;13(4):774-781. doi: 10.1007/s44197-023-00149-6. Epub 2023 Sep 12.

Abstract

BACKGROUND

HCV infection in hemodialysis units is a significant cause of morbidity and mortality. The risk of HCV infection among dialysis patients is higher compared to the general population due to high potential blood exposures in hemodialysis settings. This study aims to assess the national HCV seroprevalence in selected dialysis units and to determine the risk factors for acquiring HCV infection.

METHODS

This cross-sectional study was conducted from 1 January to 31 March 2021. A total of 734 patients from 11 hemodialysis centers in Oman were included. Samples were tested simultaneously for HCV antibodies and HCV RNA. HCV genotyping was determined in all viremic patients. Demographic and hemodialysis center related data were gathered and their association with the positive HCV serology were explored using univariate and multivariate logistic regression analysis.

RESULTS

Out of 800 patients selected from 11 dialysis units for the study, 734 patients (91.8%) were included. The overall seroprevalence of HCV infection among hemodialysis patients was 5.6%. (41/734). HCV RNA was detected in 31.7% (13/41) of seropositive hemodialysis patients. The most common genotype was subtype 1a, followed by subtype 3. Variables associated with high HCV prevalence were family history of HCV and duration of dialysis.

CONCLUSION

The prevalence of infection within hemodialysis patients in Oman has significantly decreased but remained higher than the general population. Continuous monitoring and follow-up, including periodic serosurvey and linkage to care and treatment are recommended. Additionally, practice audits are recommended for identifying gaps and ensuring sustainability of best practices and further improvement.

摘要

背景

血液透析单位中的 HCV 感染是发病率和死亡率的重要原因。与普通人群相比,透析患者感染 HCV 的风险更高,因为在血液透析环境中存在较高的潜在血液暴露风险。本研究旨在评估选定透析单位中 HCV 的全国血清流行率,并确定获得 HCV 感染的危险因素。

方法

本横断面研究于 2021 年 1 月 1 日至 3 月 31 日进行。共纳入来自阿曼 11 个血液透析中心的 734 名患者。同时对所有样本进行 HCV 抗体和 HCV RNA 检测。对所有病毒血症患者进行 HCV 基因分型。收集人口统计学和血液透析中心相关数据,并使用单变量和多变量逻辑回归分析探讨其与 HCV 血清学阳性的相关性。

结果

从 11 个透析单位中选择了 800 名患者进行研究,其中 734 名(91.8%)患者纳入本研究。血液透析患者中 HCV 感染的总血清流行率为 5.6%(41/734)。在 41 名 HCV 血清阳性的血液透析患者中,有 31.7%(13/41)检测到 HCV RNA。最常见的基因型是 1a 亚型,其次是 3 亚型。与 HCV 高流行率相关的变量是 HCV 家族史和透析时间。

结论

在阿曼,血液透析患者的感染率显著下降,但仍高于普通人群。建议持续监测和随访,包括定期血清学调查以及与护理和治疗的联系。此外,建议进行实践审核,以确定差距,并确保最佳实践的可持续性和进一步改进。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbc4/10686920/6718e49bbf68/44197_2023_149_Fig1_HTML.jpg

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