Gladziwa U, Schlipköter U, Lorbeer B, Cholmakow K, Roggendorf M, Sieberth H G
Department of Internal Medicine II, Technical University of Aachen, Germany.
Clin Nephrol. 1993 Jul;40(1):46-52.
The prevalence of antibodies to the hepatitis C virus (HCV) was determined in 333 peritoneal dialysis (PD) patients from 10 German dialysis units, using an enzyme-linked immunosorbent assay of the second generation (ELISA 2nd gen) which detects antibodies to a structural (C22) and to non-structural (C33c, C100, 5-1-1) recombinant antigens of HCV. Sera from 18/333 (5.4%) patients were anti-HCV positive versus 11/295 (3.7%) when the sera were tested by an ELISA of the first generation (ELISA 1st gen) containing only a nonstructural antigen (C100). In the 18 sera positive by ELISA 2nd gen, antibodies against at least one viral protein were found by recombinant immunoblot assay (RIBA) in 15/333 (4.5%) patients. In the sera of 11/15 (73.3%) patients HCV RNA was detected by nested PCR. Epidemiological evaluation of the patients revealed that the prevalence of anti-HCV was correlated to the female sex (p = 0.005), presence of anti-HBc (p = 0.006), duration of total dialysis (hemodialysis HD and PD) (p = 0.012), duration of HD alone (p = 0.025) and previous renal transplantation (p < 0.001). Only a weak correlation was found to blood transfusions (p = 0.041) and elevation of serum ALT concentration (p = 0.055). But no correlation was found to diagnoses of renal failure (p = 0.129), duration of PD (p = 0.963) and past surgical procedures (p = 1.0). Four of nine peritoneal dialysates of anti-HCV positive patients were found positive for HCV RNA.(ABSTRACT TRUNCATED AT 250 WORDS)
采用第二代酶联免疫吸附试验(ELISA 2nd gen),检测针对丙型肝炎病毒(HCV)结构(C22)和非结构(C33c、C100、5-1-1)重组抗原的抗体,以确定来自德国10个透析单位的333例腹膜透析(PD)患者中HCV抗体的流行情况。第一代ELISA(ELISA 1st gen)仅含一种非结构抗原(C100),检测结果显示,333例患者中有18例(5.4%)抗-HCV阳性,而295例患者中有11例(3.7%)阳性。在ELISA 2nd gen检测为阳性的18份血清中,重组免疫印迹试验(RIBA)发现15例(4.5%)患者的血清中存在针对至少一种病毒蛋白的抗体。在15例患者中的11例(73.3%)血清中,通过巢式PCR检测到HCV RNA。对患者的流行病学评估显示,抗-HCV的流行率与女性性别(p = 0.005)、抗-HBc的存在(p = 0.006)、总透析(血液透析HD和PD)时间(p = 0.012)、单独HD时间(p = 0.025)以及既往肾移植(p < 0.001)相关。与输血(p = 0.041)和血清ALT浓度升高(p = 0.055)仅存在弱相关性。但与肾衰竭诊断(p = 0.129)、PD时间(p = 0.963)和既往手术操作(p = 1.0)无相关性。抗-HCV阳性患者的9份腹膜透析液中有4份检测出HCV RNA阳性。(摘要截短于250字)