Prevalence of hepatitis e virus infection among hemodialysis patients in Japan: Evidence for infection with a genotype 3 HEV by blood transfusion
Prevalence of hepatitis e virus infection among hemodialysis patients in Japan: Evidence for infection with a genotype 3 HEV by blood transfusion
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DOI：
10.1002/jmv.20215
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发表时间：
2004-12-01
影响因子：
12.7
通讯作者：
Okamoto, H
中科院分区：
文献类型：
--
作者：
Mitsui, T;Tsukamoto, Y;Okamoto, H
为了解维持性血液透析患者中戊型肝炎病毒(HEV)感染情况，对2003年1月在日本某透析室接受血液透析7.6+/-6.3(平均+/-标准差)(0.3-26.0)年的416名患者的血清样本和血液透析开始时采集的血清样本，采用“室内”酶联免疫吸附试验(ELISA)检测HEV抗体(抗-HEV-IgG)。总体而言，2003年1月有39名患者(9.4%)检测到抗-HEV-Ig G，其中35名患者(8.4%)在血液透析开始时已呈抗-HEV-Ig G阳性，4名患者(1%)在血液透析开始后血清转换。对从4名血清转换患者采集的定期血清样本进行HEV抗体和HEV RNA检测。这4名患者在1979年、1980年、1988年或2003年成为抗-HEV抗体阳性，并一直保持血清阳性，直到观察期结束。虽然在4名患者中未检测到抗-HEV IgM，但有3名患者短暂感染了明显的日本本土HEV 3型毒株。1979年感染HEV的患者在发生一过性病毒血症前21天曾输血2U：其中一份储存的飞行员血清样本中有一份可检测到HEV RNA，与从患者身上提取的HEV RNA具有100%的同源性。我们的研究提供了1979年日本通过输血传播的HEV感染的证据，并且血液透析期间新生HEV感染的发生率很低(1.1%或4/374)。
To investigate the prevalence of hepatitis E virus (HEV) infection among patients on maintenance hemodialysis, serum samples collected in January 2003 from 416 patients who had been undergoing hemodialysis for 7.6 +/- 6.3 (mean +/- standard deviation) (range, 0.3-26.0) years in a dialysis unit in Japan and serum samples that had been collected from these patients at the start of hemodialysis were tested for IgG antibodies to HEV (anti-HEV IgG) by an "in-house" enzyme-linked immunosorbent assay (ELISA). Overall, 39 patients (9.4%) had anti-HEV IgG in January 2003, and included 35 patients (8.4%) who had already been positive for anti-HEV IgG at the start of hemodialysis and 4 patients (1%) who seroconverted after initiation of hemodialysis. Periodic serum samples that had been collected from the four seroconverted patients were tested for HEV antibodies and HEV RNA. The four patients became positive for anti-HEV IgG in 1979, 1980, 1988, or 2003, and continued to be seropositive until the end of the observation period. Although anti-HEV IgM was not detectable in the four patients, three were infected transiently with apparently Japanese indigenous HEV strains of genotype 3. The patient who contracted HEV infection in 1979 had been transfused with 2 U of blood 21 days before the transient viremia: one of the two stored pilot serum samples had detectable HEV RNA with 100% identity to that recovered from the patient. Our study provides evidence of transfusion-transmitted HEV infection in Japan in 1979, and that the prevalence of de novo HEV infection during hemodialysis was low (1.1% or 4/374).