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Eighteen-year follow-up cohort study on hepatitis B and C virus infections related long-term prognosis among hemodialysis patients in Hiroshima.
Journal of Medical Virology ( IF 12.7 ) Pub Date : 2020-06-24 , DOI: 10.1002/jmv.26215
Ko Ko 1 , Shintaro Nagashima 1 , Chikako Yamamoto 1 , Kazuaki Takahashi 1 , Junko Matsuo 1 , Masayuki Ohisa 1 , Tomoyuki Akita 1 , Jamshid Matyakubov 1, 2 , Ulugbek Mirzaev 1, 3 , Keiko Katayama 1 , Takao Masaki 4 , Junko Tanaka 1
Affiliation  

This study aimed to investigate the prevalence trend of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and their genotype distribution among hemodialysis patients, determining their long‐term prognosis and the risk factors to the mortality. This cohort study used both the medical data and the blood samples of hemodialysis patients at nine dialysis centers in Hiroshima from 1999 to 2017. Hepatitis B surface antigen (HBsAg) and anti‐HCV were screened and then amplification was done to positive sera by polymerase chain reaction for genotyping. Data were employed for multiple regressions to determine the associated risk factors. A total of 3968 patients were subdivided into three groups: who started hemodialysis before 1990, during 1991 to 2001, and after 2002. The periodic prevalence of HBsAg decreased from 2.8% to 1.3% and that of anti‐HCV from 33.3% to 9.5% in the three groups. By multiple regressions, the adjusted hazard ratio of diabetes mellitus (DM) ranges from 1.59 to 2.12 and that of HCV RNA positivity ranges from 1.18 to 1.48 (P < .05). Heart failure is the primary cause of death in all groups. Genotype C2 is predominant for HBV and genotype 1b is predominant for HCV. The decreasing trend of both HBV and HCV was found in the cohort. DM and HCV RNA were the significant risk factors leading to poor prognosis among hemodialysis patients. The similar genotype distribution of both HBV and HCV was found as general population. This alarmed to provide early diagnosis, prompt, and adequate treatment to HCV infection among hemodialysis patients.

中文翻译:

关于广岛血液透析患者的乙型和丙型肝炎病毒感染与长期预后相关的十八年随访队列研究。

本研究旨在调查血液透析患者乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)感染的流行趋势及其基因型分布,以确定其长期预后和死亡的危险因素。本队列研究使用了1999年至2017年广岛九个透析中心的血液透析患者的医疗数据和血液样本,筛选乙型肝炎表面抗原(HBsAg)和抗HCV,然后通过聚合酶链扩增为阳性血清基因分型反应。使用数据进行多重回归以确定相关的风险因素。共有3968名患者被分为三组:1990年之前、1991年至2001年和2002年之后开始血液透析的患者。HBsAg的周期性患病率从2.8%下降到1.3%,抗HCV的周期性患病率从33.3%下降到9.5%在三组中。通过多元回归,糖尿病(DM)的调整风险比范围为1.59至2.12,HCV RNA阳性的调整风险比范围为1.18至1.48(P  < .05)。心力衰竭是所有人群死亡的主要原因。基因型 C2 主要针对 HBV,基因型 1b 主要针对 HCV。该队列中发现 HBV 和 HCV 均呈下降趋势。DM和HCV RNA是导致血液透析患者预后不良的重要危险因素。一般人群中 HBV 和 HCV 的基因型分布相似。这对血液透析患者中​​丙型肝炎病毒感染的早期诊断、及时和充分治疗敲响了警钟。
更新日期:2020-06-24
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