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[阿斯图里亚斯地区献血者中抗丙型肝炎病毒阳性的患病率。一项临床流行病学研究]

[The prevalence of anti-HCV positivity among blood donors in Asturias. A clinical-epidemiologic study].

作者信息

Suárez A, Rodríguez M, Riestra S, Navascués C A, San Román F S, Otero L, Martínez A, Rodrigo L

机构信息

Sección de Aparato Digestivo, Hospital Covadonga, Oviedo.

出版信息

Med Clin (Barc). 1994 Nov 12;103(16):606-10.

PMID:7996916
Abstract

BACKGROUND

The aim of this study was to know the prevalence, epidemiology, clinical manifestations and analytical changes present in anti-HCV positive blood donors detected in Asturias.

METHODS

A prospective analysis of the incidence and prevalence of anti-HCV positivity in the blood donations carried out in Asturias from October 1989 to October 1991 was performed, as was a clinical and analytical study of the anti-HCV positive cases who attended a clinic specifically created for the same.

RESULTS

The prevalence of the anti-HCV was 0.87% of the donors (372/42,789) and 0.50% of the donations (372/73,831) being higher among new donors (1.77%, 165/9,322). Of the 288 cases studied (77.4%), only 51 (17.7%) had been transfused and 105 (36.5%) lacked the previous parenteral risk factor. Only 31 (10.8%) presented symptoms or signs of liver disease and the positivity of the anti-HBc was not associated to any relevant analytical change. The existence of previous major surgery or transfusion was variable with the independent predictive value versus a negative anti-HCV control group. The mean follow up was 12.4 +/- 7.3 months (6-30 months) with an increase in aminotransferases (ALT) being detected in 108 cases (52.7%). A good correlation was found between this data, an ELISA-2 score greater than 5 and RIBA-2 positivity: of the 177 cases in whom RIBA-2 was determined this was found to be positive in 109 (61.6%); 84 cases (77.1%) had an increase in ALT and 100 (91.8%) an ELISA-2 score greater than 5.

CONCLUSIONS

In Asturias the prevalence of anti-HCV positivity among blood donors is almost 1% and is greater if new donors are considered, being confirmed by RIBA-2 in 61% of the cases. The subjects are usually asymptomatic and up to one third of the same lack any known risk factor, while almost half have hypertransaminasemia during follow up.

摘要

背景

本研究旨在了解在阿斯图里亚斯检测出的抗丙型肝炎病毒(HCV)阳性献血者的患病率、流行病学、临床表现及分析变化。

方法

对1989年10月至1991年10月在阿斯图里亚斯进行的献血中抗HCV阳性的发病率和患病率进行前瞻性分析,并对前往专门为此设立的诊所就诊的抗HCV阳性病例进行临床和分析研究。

结果

抗HCV在献血者中的患病率为0.87%(372/42,789),在献血中的患病率为0.50%(372/73,831),新献血者中的患病率更高(1.77%,165/9,322)。在研究的288例病例中(77.4%),仅有51例(17.7%)曾接受过输血,105例(36.5%)没有既往肠外危险因素。仅有31例(10.8%)出现肝病症状或体征,抗乙肝核心抗体(anti-HBc)阳性与任何相关分析变化均无关联。既往有大手术或输血史的情况各不相同,与抗HCV阴性对照组相比具有独立预测价值。平均随访时间为12.4±7.3个月(6 - 30个月),108例(52.7%)检测到转氨酶(ALT)升高。在该数据、酶联免疫吸附试验2(ELISA-2)评分大于5与重组免疫印迹法2(RIBA-2)阳性之间发现了良好的相关性:在177例检测RIBA-2的病例中,109例(61.6%)呈阳性;84例(77.1%)ALT升高,100例(91.8%)ELISA-2评分大于5。

结论

在阿斯图里亚斯,献血者中抗HCV阳性的患病率近1%,若考虑新献血者则更高,61%的病例经RIBA-2证实。这些受试者通常无症状,高达三分之一的人没有任何已知危险因素,而近一半的人在随访期间出现转氨酶升高。

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