Fabrizi F, Lunghi G, Bacchini G, Corti M, Pagano A, Locatelli F
Nephrology Department, Hospital, Lecco, Italy.
Nephrol Dial Transplant. 1997 Jan;12(1):133-6. doi: 10.1093/ndt/12.1.133.
Hepatitis E virus (HEV) is the causative agent for enteric non-A, non-B hepatitis. Transmission is via the faecal route but the possibility of transmission by blood has been raised. Data concerning anti-HEV prevalence among chronic haemodialysis (HD) patients are few and give conflicting results.
We tested for anti-HEV antibody 204 chronic HD patients attending a single dialysis unit. A specific solid-phase enzyme-linked immunoassay (Abbott HEV EIA) was used.
We found six anti-HEV-positive patients, the anti-HEV prevalence was 3% (95% CI 0-6%). The prevalence rates of HBV and HCV infections were 39% (31-45%) and 22% (16-28%) respectively. No anti-HEV-positive patient showed past or current biochemical signs of liver damage. One of six (17%) anti-HEV-positive patients was an immigrant; no risk factor for anti-HEV antibody was identified in the other anti-HEV-positive individuals.
We observed a low anti-HEV prevalence: there was no association between HEV and blood-borne infections (HBV, HCV, and HIV) in our HD patients; most anti-HEV-positive patients we found were probably related to a local infection by HEV. This is one of the first reports concerning seroepidemiology of HEV infection in a large cohort of chronic HD individuals.
戊型肝炎病毒(HEV)是肠道非甲非乙型肝炎的病原体。传播途径为粪口途径,但也有人提出了经血传播的可能性。关于慢性血液透析(HD)患者中抗HEV流行率的数据较少,且结果相互矛盾。
我们对在一个透析单元就诊的204例慢性HD患者进行了抗HEV抗体检测。使用了一种特异性固相酶联免疫吸附测定法(雅培HEV EIA)。
我们发现6例抗HEV阳性患者,抗HEV流行率为3%(95%可信区间0 - 6%)。HBV和HCV感染的流行率分别为39%(31 - 45%)和22%(16 - 28%)。没有抗HEV阳性患者表现出过去或当前肝脏损伤的生化迹象。6例抗HEV阳性患者中有1例(17%)是移民;在其他抗HEV阳性个体中未发现抗HEV抗体的危险因素。
我们观察到抗HEV流行率较低;在我们的HD患者中,HEV与血源性感染(HBV、HCV和HIV)之间没有关联;我们发现的大多数抗HEV阳性患者可能与HEV的局部感染有关。这是关于一大群慢性HD个体中HEV感染血清流行病学的首批报告之一。