Hepatitis C infection is acquired pre-ESRD
Hepatitis C infection is acquired pre-ESRD
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DOI：
10.1053/j.ajkd.2004.12.014
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发表时间：
2005-04-01
影响因子：
13.2
通讯作者：
Glaze, J
中科院分区：
文献类型：
--
作者：
Bergman, S;Accortt, N;Glaze, J
背景：丙型肝炎在终末期肾病 (ESRD) 患者中比在普通人群中更常见。此前，院内感染是造成这一增长的重要原因。在过去的十年中，这些来源的风险有所降低，但携带丙型肝炎病毒 (HCV) 抗体（抗 HCV）的 ESRD 患者的估计百分比并未改变。方法：这是一项针对阿拉巴马州伯明翰 4 个城市单位的血液透析患者的前瞻性观察研究。在透析治疗开始时进行抗 HCV 检测，然后从 1998 年 8 月到 2004 年 8 月每年进行一次。记录种族、性别、年龄、ESRD 日期、合并症和结果。结果：860 名患者（89% 为黑人）中抗 HCV 感染率为 16.8%。新发 ESRD 患者的患病率为 14.4%。既往抗 H CV 阴性患者的血清转化率为 2.5%。黑人男性中抗 HCV 的发生率是黑人女性的 3 倍（比值比，3.3；95% 置信区间，2.2 至 5.0）。抗 HCV 阳性患者的 ESRD 平均年龄明显低于 HCV 阴性患者（47.3 岁 vs 54.1 岁；P < 0.0001）。年龄、种族、性别和药物滥用史是抗 HCV 阳性的预测因素。结论。 ESRD 患者中抗 HCV 的患病率因社区而异。新患者是 ESRD 患者抗 HCV 流行的主要原因，尤其是那些年轻、男性、黑人或有吸毒史的患者。测量慢性肾病患者的抗 HCV 水平可能有助于识别那些有患其他疾病风险的人。 (c) 2005 年，国家肾脏基金会 (National Kidney Foundation, Inc.)
Background: Hepatitis C is more prevalent in patients with end-stage renal disease (ESRD) than in the general population. Previously, infection from nosocomial sources was an important cause for this increase. In the past decade, the risk from these sources has lessened, but the estimated percentage of patients with ESRD with hepatitis C virus (HCV) antibody (anti-HCV) has not changed. Methods: This is a prospective observational study of hemodialysis patients in 4 urban units in Birmingham, AL. Testing for anti-HCV was performed at the initiation of dialysis therapy and then yearly from August 1998 through August 2004. Race, sex, age, ESRD date, comorbid conditions, and outcomes were recorded. Results: The prevalence of anti-HCV was 16.8% in 860 patients (89% black). Patients new to ESRD had a prevalence of 14.4%. Seroconversion in previously anti-H CV-negative patients was 2.5%. Anti-HCV occurred in black men 3 times more than in black women (odds ratio, 3.3; 95% confidence interval, 2.2 to 5.0). Mean age at ESRD was significantly younger in anti-HCV-positive than HCV-negative patients (47.3 versus 54.1 years; P < 0.0001). Age, race, sex, and history of drug abuse were predictors of anti-HCV positivity. Conclusion. The prevalence of anti-HCV among patients with ESRD varies from community to community. New patients are major contributors to the prevalence of anti-HCV in patients with ESRD, particularly those who are younger, male, black, or have a history of drug use. Measuring anti-HCV levels in patients with chronic kidney disease may help identify those at risk for additional disorders. (c) 2005 by the National Kidney Foundation, Inc.