Dussol B, Berthezène P, Brunet P, Roubicek C, Berland Y
Service de Néphrologie et Hémodialyse, Hôpital Sainte-Marguerite, Marseille, France.
Am J Kidney Dis. 1995 Mar;25(3):399-404. doi: 10.1016/0272-6386(95)90100-0.
During the last quarter of 1992, 984 patients from 13 dialysis centers in the Provence-Alpes-Côte-d'Azur region in France participated in a multicenter cross-sectional study to determine the prevalence, the risk factors, and the clinical consequences of infection by the hepatitis C virus (HCV). Serum samples were tested for anti-HCV antibodies using second-generation enzyme-linked immunosorbent assay (ELISA). In the case of a positive result, a combination test was performed using second-generation recombinant immunoblot (RIBA) or direct detection of HCV-RNA by nested polymerase chain reaction (PCR). Collected data included the patient's age, gender, cause of the kidney disease, type of dialysis treatment, number of years on dialysis, weekly dialysis time, drug addiction, co-infection with hepatitis B virus and human immunodeficiency virus (HIV), number of kidney transplants, number of blood transfusions, and history of acute or chronic hepatitis. Chronic HCV infection was detected in 232 (23.6%) patients, whereas only 71 (7.2%) were infected by HBV. Logistic-regression analysis showed that HCV infection was associated with dialysis over a long period, numerous blood transfusions, female gender, kidney grafts, HBV infection, hemodialysis, and acute as well as chronic hepatitis. Multiple-correspondence analysis confirmed that the contamination was both transfusional and nosocomial. These results underscore the need for a strict compliance with "universal precautions" (Centers for Disease Control [CDC], Atlanta) in dialysis units and raise the question as to whether anti-HCV-positive patients should be isolated.
1992年最后一个季度，来自法国普罗旺斯-阿尔卑斯-蓝色海岸地区13个透析中心的984名患者参与了一项多中心横断面研究，以确定丙型肝炎病毒（HCV）感染的患病率、危险因素及临床后果。血清样本采用第二代酶联免疫吸附测定（ELISA）检测抗-HCV抗体。若结果呈阳性，则采用第二代重组免疫印迹法（RIBA）或巢式聚合酶链反应（PCR）直接检测HCV-RNA进行联合检测。收集的数据包括患者的年龄、性别、肾病病因、透析治疗类型、透析年限、每周透析时间、药物成瘾情况、乙型肝炎病毒和人类免疫缺陷病毒（HIV）合并感染情况、肾移植次数、输血次数以及急慢性肝炎病史。232例（23.6%）患者检测到慢性HCV感染，而仅71例（7.2%）感染HBV。逻辑回归分析显示，HCV感染与长期透析、多次输血、女性、肾移植、HBV感染、血液透析以及急慢性肝炎相关。多重对应分析证实感染途径既有输血传播也有医院内传播。这些结果强调了透析单位严格遵守“通用预防措施”（美国疾病控制中心[CDC]，亚特兰大）的必要性，并提出了抗-HCV阳性患者是否应隔离的问题。
