Seelig R, Renz M, Bottner C, Seelig H P
Institute of Immunology and Molecular Genetics, Karlsruhe, Germany.
Ann Med. 1994 Feb;26(1):45-52. doi: 10.3109/07853899409147326.
HCV infection causes serious complications in dialysis patients that lead to problems in management of patients in dialysis units. Determination of HCV-RNA is at present essential for monitoring the course of HCV infection. Reports concerning HCV-RNA in dialysis patients are mostly from Asian dialysis units; therefore, an analysis of dialysis patients in Europe was undertaken. From 1515 patients 2630 blood samples were screened for HCV-RNA and anti-HCV. Two-thirds of patients positive in an anti-HCV test containing a mixture of three antigens (EIA-II, Ortho) were further analysed for antibodies against these individual antigens. From 523 patients multiple samples were tested. Related on dialysis units from which all the attending patients were tested, mean prevalence of HCV-RNA was 8.4%, of anti-HCV 13.2%. Concerning all plasma samples from dialysis patients sent to our laboratory for investigation of HCV-RNA and anti-HCV the prevalence of HCV-RNA was 21.9%, of anti-HCV 23.1%, HCV-RNA was present in 76% of anti-HCV positive patients and in 4.1% of anti-HCV negative patients (1.3% of single and 6.8% of multiple tested patients). Acute and chronic infections with self-limited, persistent or intermittent viraemia were observed with changes and fluctuations of both HCV markers. With the exception of differences in onset of antibody production in some patients following acute infections, there were no major differences of dialysis patients compared to patients without dialysis treatment as far as antibody spectrum and detectability of HCV-RNA were concerned.
丙型肝炎病毒（HCV）感染会给透析患者带来严重并发症，进而导致透析单位在患者管理方面出现问题。目前，检测HCV-RNA对于监测HCV感染病程至关重要。关于透析患者HCV-RNA的报告大多来自亚洲的透析单位；因此，我们对欧洲的透析患者进行了分析。我们对1515名患者的2630份血样进行了HCV-RNA和抗HCV筛查。在一项使用包含三种抗原混合物的抗HCV检测（酶免疫测定-II，Ortho）呈阳性的患者中，三分之二的患者进一步接受了针对这些单个抗原的抗体分析。对523名患者的多个样本进行了检测。在对所有就诊患者均进行检测的透析单位中，HCV-RNA的平均患病率为8.4%，抗HCV为13.2%。在送至我们实验室检测HCV-RNA和抗HCV的所有透析患者血浆样本中，HCV-RNA的患病率为21.9%，抗HCV为23.1%，HCV-RNA存在于76%的抗HCV阳性患者和4.1%的抗HCV阴性患者中（单次检测患者中为1.3%，多次检测患者中为6.8%）。观察到急性和慢性感染伴有自限性、持续性或间歇性病毒血症，同时两种HCV标志物都有变化和波动。除了一些患者在急性感染后抗体产生的起始时间存在差异外，就抗体谱和HCV-RNA的可检测性而言，透析患者与未接受透析治疗的患者相比没有重大差异。
