Chan T M, Lok A S, Cheng I K, Chan R T
Department of Medicine, University of Hong Kong.
Hepatology. 1993 Jan;17(1):5-8.
We longitudinally studied 51 patients from two hemodialysis centers to determine the prevalence of hepatitis C virus infection in hemodialysis patients. Serum samples were tested for antibody to HCV by first- and second-generation enzyme immunoassays and for hepatitis C virus RNA by nested polymerase chain reaction assay. Antibody to hepatitis C virus was detected in the initial serum samples by first-generation enzyme immunoassay and second-generation enzyme immunoassay in 6 (11.8%) and 11 (21.6%) patients, respectively. First-generation enzyme immunoassay had a false-positive rate of 33.3% and a false-negative rate of 63.6%. Hepatitis C virus RNA was found in eight second-generation enzyme immunoassay-positive patients (72.7%) and in one patient negative for antibody to hepatitis C virus (2.5%) giving an overall positivity rate of 17.6%. After 19 mo, antibody to hepatitis C virus was detected in 15 patients (29.4%) on second-generation enzyme immunoassay; hepatitis C virus RNA was found in 13 patients (25.5%). Hepatitis C virus markers persisted in all 12 patients with initial evidence of hepatitis C virus infection. Three patients acquired hepatitis C virus infection during the interim, giving a new infection rate of 4.9% per patient-year. Antibody to hepatitis C virus, hepatitis C virus RNA or both was detected in 55.6% of patients with biochemical changes suggestive of non-A, non-B hepatitis. Of the 15 antibody to hepatitis C virus, second-generation enzyme immunoassay-positive patients, 66.7% had persistently normal serum transaminase levels. In summary, hepatitis C virus infection is common among hemodialysis patients. First-generation enzyme immunoassay is an unreliable assay for antibody to hepatitis C virus in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)
我们对来自两个血液透析中心的51名患者进行了纵向研究，以确定血液透析患者中丙型肝炎病毒感染的患病率。通过第一代和第二代酶免疫测定法检测血清样本中的抗HCV抗体，并通过巢式聚合酶链反应测定法检测丙型肝炎病毒RNA。在初始血清样本中，第一代酶免疫测定法和第二代酶免疫测定法分别检测出6名（11.8%）和11名（21.6%）患者的抗丙型肝炎病毒抗体。第一代酶免疫测定法的假阳性率为33.3%，假阴性率为63.6%。在8名第二代酶免疫测定法阳性患者（72.7%）和1名抗丙型肝炎病毒抗体阴性患者（2.5%）中发现了丙型肝炎病毒RNA，总体阳性率为17.6%。19个月后，第二代酶免疫测定法检测出15名患者（29.4%）的抗丙型肝炎病毒抗体；在13名患者（25.5%）中发现了丙型肝炎病毒RNA。所有12名最初有丙型肝炎病毒感染证据的患者中，丙型肝炎病毒标志物持续存在。在此期间，有3名患者感染了丙型肝炎病毒，新感染率为每人每年4.9%。在有提示非甲非乙型肝炎生化变化的患者中，55.6%检测出抗丙型肝炎病毒抗体、丙型肝炎病毒RNA或两者。在15名第二代酶免疫测定法抗丙型肝炎病毒抗体阳性患者中，66.7%的患者血清转氨酶水平持续正常。总之，丙型肝炎病毒感染在血液透析患者中很常见。第一代酶免疫测定法在这些患者中检测抗丙型肝炎病毒抗体是不可靠的检测方法。（摘要截短至250字）
