Dussol B, Chicheportiche C, Cantaloube J F, Roubicek C, Biagini P, Berthézène P, Berland Y
Service de Néphrologie et d'Hémodialyse, Hôpital Sainte-Marguerite, Marseille, France.
Am J Kidney Dis. 1993 Oct;22(4):574-80. doi: 10.1016/s0272-6386(12)80931-0.
One hundred forty-five patients on regular hemodialysis (HD) at our institution were evaluated for the presence of hepatitis C virus (HCV) infection. Forty-three patients (29%) were found to have detectable antibodies to HCV using second-generation enzyme-linked immunosorbent and recombinant immunoblot assays. Forty positive patients (anti-HCV+) and 10 negative patients (anti-HCV-) were tested for direct detection of the HCV genome by the polymerase chain reaction (PCR). Twenty-one anti-HCV+ patients (52%) had detectable RNA HCV in plasma (PCR+). No anti-HCV- patient had viremia. In addition, we compared the 43 anti-HCV+ patients with the 102 anti-HCV- patients for duration of HD, history of blood transfusion, serologic markers of hepatitis B virus, and acute and chronic liver disease. On retrospective univariate analysis, statistically significant associations with anti-HCV+ were duration of HD (P = 0.0001), blood transfusions (P = 0.0005), co-infection with hepatitis B virus (P = 0.01), and acute and chronic liver disease (P = 0.06 and 0.01, respectively). Three significant variables (duration of HD, chronic hepatitis, and blood transfusions) of the multivariate analysis permit the classification of 65% of anti-HCV+ patients and 81% of anti-HCV- patients. In the anti-HCV+ group, when the same parameters were compared in PCR+ or PCR- patients, no statistical difference appeared. These results reveal that 52% of anti-HCV+ HD patients have HCV infection. The clinical consequences of HCV infection in that population are not characterized since no difference has been documented between PCR+ and PCR- results.
我们机构对145例接受定期血液透析（HD）的患者进行了丙型肝炎病毒（HCV）感染情况评估。采用第二代酶联免疫吸附试验和重组免疫印迹法检测，发现43例患者（29%）可检测到抗HCV抗体。对40例阳性患者（抗HCV+）和10例阴性患者（抗HCV-）进行聚合酶链反应（PCR）直接检测HCV基因组。21例抗HCV+患者（52%）血浆中可检测到HCV RNA（PCR+）。无抗HCV-患者出现病毒血症。此外，我们比较了43例抗HCV+患者和102例抗HCV-患者的血液透析时间、输血史、乙型肝炎病毒血清学标志物以及急慢性肝病情况。回顾性单因素分析显示，与抗HCV+有统计学显著关联的因素为血液透析时间（P = 0.0001）、输血（P = 0.0005）、乙型肝炎病毒合并感染（P = 0.01）以及急慢性肝病（分别为P = 0.06和0.01）。多因素分析中的三个显著变量（血液透析时间、慢性肝炎和输血）可对65%的抗HCV+患者和81%的抗HCV-患者进行分类。在抗HCV+组中，对PCR+或PCR-患者比较相同参数时，未出现统计学差异。这些结果表明，52%的抗HCV+血液透析患者存在HCV感染。由于PCR+和PCR-结果之间未发现差异，该人群中HCV感染的临床后果尚不明确。
