Hepatitis virus infection in haemodialysis patients from Moldavia

被引:68
作者
Covic, A
Iancu, L
Apetrei, C
Scripcaru, D
Volovat, C
Mititiuc, I
Covic, M
机构
[1] CI Parhon Hosp, Med Clin 4, Iasi 6600, Romania
[2] Univ Med Gr T Popa, Dept Microbiol & Virusol, Iasi, Romania
[3] Ctr Blood Transfus, Iasi, Romania
关键词
epidemiology; haemodialysis; hepatitis B and C prevalence; risk factors;
D O I
10.1093/ndt/14.1.40
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. Although the epidemiology of hepatitis B (HBV) and C (HCV) now seems well established for Western European countries, in Central and Eastern Europe <50% of all dialysis centres routinely test for hepatitis C antibodies since testing is not available or is not applied to all patients. This study describes the prevalence, risk factors and clinical significance of HBV and HCV infection for the haemodialysis population of the North Eastern region of Romania, Moldavia. Methods. The presence of HBV antigens was determined with an ELISA kit (Wellcome. Abbot) and HCV antibodies with the ELISA-3 Ortho-HCV, third generation test. The following individual data were collected: gender, age, duration of dialysis, rural/urban domicile, actual and previous HBV status, actual HCV status, known acute, clinically evident hepatitis episodes in the last 3 years, monthly alanine aminotransferase (ALAT) and aspartate aminotransferase (ASAT) levels, complete biochemical hepatic assessment at the time of the study, transfusions for the past 3 years and family history. Results. HBV and HCV prevalences were 17% (stable over the last 3 years) and 75%, respectively; co-infection was seen in 10% of the subjects. Hospitalization (nosocomial infection) for HBV, blood transfusions and duration on dialysis for HCV, emerged as the main risk factors for hepatitis infection. Socio-economic conditions appear to be equally important for HCV infection, since the prevalence was significantly higher among patients from rural, underdeveloped areas than urban areas (80.8 vs 60.3%), and infection was already present in a large proportion of patients (47%) before starting dialysis, without being related to previous disease duration or blood transfusions. HBV and/or HCV was not associated with a worse clinical or biochemical profile at the time of the study. However, infected patients had significantly more previous cytolytic episodes, with higher, transient increases in ALAT and ASAT levels. Conclusions. HCV infection is endemic among dialysis centres in Moldavia. Apart from previously well-known risk factors for hepatitis infection, our study demonstrates the negative impact of socio-economic underdevelopment. Simple measures such as enforced general asepsia rules, careful disinfection and equipment sterilization, routine testing of patients from economically disadvantaged areas and monthly, serial determination of hepatic enzymes should be the common practice in dialysis centres in Romania.
引用
收藏
页码:40 / 45
页数:6
相关论文
共 44 条
[1]   PREVALENCE OF ANTI-HCV AMONG HEMODIALYSIS-PATIENTS IN TURKEY - A MULTICENTER STUDY [J].
AKPOLAT, T ;
ARIK, N ;
GUNAYDIN, M ;
UTAS, C ;
DILEK, K ;
CAGLAR, S ;
CANDAN, F ;
SULEYMANLAR, G ;
PAYDAS, S ;
SEN, S ;
KURSAT, S ;
YEKSAN, M ;
AKOGLU, E ;
BORAN, M ;
ARINSOY, T ;
BOZFAKIOGLU, S ;
CAMSARI, T ;
TONBUL, Z ;
VURAL, A ;
ATAMAN, R .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1995, 10 (04) :479-480
[2]  
ALTER MJ, 1983, DIALYSIS TRANSPLANT, V12, P860
[3]  
APETREI C, 1992, REV MED CHIR SOC MED, V3, P439
[4]   ANTIBODIES AGAINST HEPATITIS-C VIRUS IN HEMODIALYSIS-PATIENTS IN THE CENTRAL ITALIAN REGION OF UMBRIA - EVALUATION OF SOME RISK-FACTORS [J].
BRUGNANO, R ;
FRANCISCI, D ;
QUINTALIANI, G ;
GABURRI, M ;
NORI, G ;
VERDURA, C ;
GIOMBINI, L ;
BUONCRISTIANI, U .
NEPHRON, 1992, 61 (03) :263-265
[5]   TRANSMISSION OF ANTI-HCV WITHIN THE HOUSEHOLD OF HEMODIALYSIS-PATIENTS [J].
CALABRESE, G ;
VAGELLI, G ;
GUASCHINO, R ;
GONELLA, M .
LANCET, 1991, 338 (8780) :1466-1466
[6]   HBV INFECTION IN HEMODIALYSIS-PATIENTS - MONITORING AND PREVENTION [J].
CARLETTI, P ;
BIBIANO, L ;
BOGGI, R ;
BORDONI, E ;
RICCIATTI, AM ;
DELLABELLA, S ;
PAURI, P ;
SALVONI, G ;
MIOLI, VA .
NEPHRON, 1992, 61 (03) :269-270
[7]   PREVALENCE OF NON-A NON-B HEPATITIS AND ANTI-HCV ANTIBODIES IN A PORTUGUESE DIALYSIS POPULATION [J].
CARRERA, F ;
SILVA, JG ;
PIRES, C ;
OLIVEIRA, C .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1992, 7 (09) :913-916
[8]   HEPATITIS-C VIRUS IN DIALYSIS UNITS - A MULTICENTER STUDY [J].
DAPORTO, A ;
ADAMI, A ;
SUSANNA, F ;
CALZAVARA, P ;
POLI, P ;
CASTELLETTO, MR ;
AMICI, GP ;
TEODORI, T ;
OKOLICSANYI, L .
NEPHRON, 1992, 61 (03) :309-310
[9]  
DASILVA C, 1994, NEPHRON, V68, P517
[10]   HEPATITIS-C VIRUS IN HEMODIALYSIS-PATIENTS [J].
DENTICO, P ;
VOLPE, A ;
BUONGIORNO, R ;
CARLONE, A ;
CARBONE, M ;
MANNO, M .
NEPHRON, 1992, 61 (03) :307-308