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1.
To examine whether hepatitis C virus (HCV) infection still occurs in haemodialysis units even after a decrease in the number of blood transfusions and in those contaminated with HCV, we tested anti-HCV antibodies and HCV RNA in 142 patients from Japanese haemodialysis units, and examined the serial prevalence of anti-HCV antibodies in 86 patients from 1992 to 1997. A high prevalence of HCV infection was observed: 34 (23.9%) and 38 (26.8%) of the 142 patients were positive for serum anti-HCV antibodies and HCV RNA, respectively. These positive rates were related to the duration of haemodialysis. We found that five patients treated in the same unit seroconverted from 1993 to 1995. Four of the five patients had been treated at the same shift and were affected at the same time. Phylogenetic analysis of the hypervariable region 1 (HVR1) sequence of HCV from serum of these patients showed that three of the four patients' sequences were phylogenetically clustered and that two of the three were closely related. Thus, an occasional transmission of HCV occurred in the haemodialysis unit. The universal precautions by staff such as carefully changing gloves may be important in inhibiting spread of HCV because no instances of infection have been seen since the instigation of educational measures for unit staff.  相似文献   

2.
目的:了解血液透析患者输血前后HCV感染情况。方法:采用ELISA法进行抗-HCV检测。结果:116例血液透析患者抗-HCV阳性率为13.79%,输血组输血前与未输血组比较无显著性差异,追踪检测输血后6、12、18、24个月病例,随着血液透析时间延长,抗-HCV阳性率增高,但输血组与未输血组比较仍无差异。结论:血液透析患者与输血前后抗-HCV阳性率无明显差异,输血不增加感染HCV的风险。  相似文献   

3.
OBJECTIVE: To identify the routes of transmission during an outbreak of infection with hepatitis C virus (HCV) genotype 2a/2c in a hemodialysis unit. DESIGN: A matched case-control study was conducted to identify risk factors for HCV seroconversion. Direct observation and staff interviews were conducted to assess infection control practices. Molecular methods were used in a comparison of HCV infecting isolates from the case-patients and from patients infected with the 2a/2c genotype before admission to the unit. SETTING: A hemodialysis unit treating an average of 90 patients. PATIENTS: A case-patient was defined as a patient receiving hemodialysis with a seroconversion for HCV genotype 2a/2c between January 1994 and July 1997 who had received dialysis in the unit during the 3 months before the onset of disease. For each case-patient, 3 control-patients were randomly selected among all susceptible patients treated in the unit during the presumed contamination period of the case-patient. RESULTS: HCV seroconversion was associated with the number of hemodialysis sessions undergone on a machine shared with (odds ratio [OR] per additional session, 1.3; 95% confidence interval [CI95], 0.9 to 1.8) or in the same room as (OR per additional session, 1.1; CI95, 1.0 to 1.2) a patient who was anti-HCV (genotype 2a/2c) positive. We observed several breaches in infection control procedures. Wetting of transducer protectors in the external pressure tubing sets with patient blood reflux was observed, leading to a potential contamination by blood of the pressure-sensing port of the machine, which is not accessible to routine disinfection. The molecular analysis of HCV infecting isolates identified among the case-patients revealed two groups of identical isolates similar to those of two patients infected before admission to the unit. CONCLUSIONS: The results suggest patient-to-patient transmission of HCV by breaches in infection control practices and possible contamination of the machine. No additional cases have occurred since the reinforcement of infection control procedures and the use of a second transducer protector.  相似文献   

4.
Hepatitis C virus (HCV) infection is becoming a substantial problem in long-term hospitalized patients. Onco-haematological patients undergoing chemotherapy are especially prone to HCV infection. These patients are usually immunosuppressed and therefore antibodies to HCV are not produced despite the presence of HCV RNA in peripheral blood. The aim of the study was to see how often long-term hospitalized patients acquired HCV infection, and what were the possible sources and routes of virus transmission. The study involved 129 children with lymphoproliferative diseases, 36 patients with solid tumours, and 61 healthcare workers from onco-haematological wards. All were HCV RNA and anti-HCV negative at the time of first hospitalization. During a two and a half-year follow-up study among 165 onco-haematological patients, HCV RNA appeared in 87 in subsequent hospitalizations. The majority of infections were (82/87) were 1a genotype, 2 were 1b, 1 was 1a + 1b and 1 was 1a + 3a. In an attempt to establish the origin of HCV infection, healthcare workers were screened for HCV genotyping. All HCV-infected staff working on wards had the same genotype (1a). None of the staff was infected with 1b genotype. As the most prevalent genotype in Polish blood donors is 1b, HCV infection in onco-haematological patients is most likely due to horizontal transmission, probably involving genotype 1a, and potential horizontal transmission of HCV is implied by the presence of 1a genotype of HCV in saliva and urine of selected patients. Spread of hospital HCV infection among children may be facilitated by micro-injury of the skin and mucosa. Early detection of HCV RNA is important in such immunosuppressed patients, as they are not able to produce anti-HCV antibodies. This may enable the introduction of prophylactic steps to prevent the spread of HCV infection by horizontal transmission.  相似文献   

5.
血液病患者HBV和HCV感染现况调查   总被引:8,自引:0,他引:8       下载免费PDF全文
对144例血液病患者HBV和HCV感染状况进行调查,HBsAg、抗-HBc和抗-HCV检出率分别为9.72%、36.81%及24.31%,而健康对照组分别为12.03%、46.30%和0.93%。HCV感染率与年龄、性别无关,但与受血史,受血次数密切相关。抗-HCV阳性者血清ALT水平明显高于抗-HCV阴性者,HBV/HCV重叠感染时ALT升高尤为明显,本组调查提示输血及应用血液制品是血液病患者感  相似文献   

6.
OBJECTIVE: To identify modes of HCV transmission during an outbreak of HCV infection in a hemodialysis unit. DESIGN: An epidemiologic study, virologic analysis, assessment of infection control practices and procedures, and technical examination of products and dialysis machines. SETTING: A private hemodialysis unit treating approximately 70 patients. PATIENTS: Detection of HCV RNA by PCR was performed among patients receiving dialysis in 2001. Case-patients were patients who had a first positive result for HCV RNA between January 2001 and January 2002 and either acute hepatitis, a seroconversion for HCV antibodies, or a previous negative result. Three control-patients were randomly selected per case-patient. RESULTS: Of the 61 patients treated in the unit in 2001 and not infected with HCV, 22 (36.1%) became case-patients with onset from May 2001 to January 2002 for an incidence density rate of 70 per 100 patient-years. Phylogenic analysis identified four distinct HCV groups and an index case-patient for each with a similar virus among patients already known to be infected. No multidose medication vials or material was shared between patients. Connection to a dialysis machine by a nurse who had connected an HCV-infected patient "just before" or "one patient before" increased the risk of HCV infection, whereas using the same dialysis machine after a patient infected with HCV did not. Understaffing, lack of training, and breaches in infection control were documented. Direct observation of practices revealed frequent flooding of blood into the double filter on the arterial pressure tubing set. CONCLUSIONS: During this outbreak, HCV transmission was mainly patient to patient via healthcare workers' hands. However, transmission via dialysis machines because of possible contamination of internal components could not be excluded.  相似文献   

7.
There is little information on the prevalence of hepatitis C virus (HCV) infection in China. The prevalence of HCV infection was determined in 998 subjects (398 with liver disease and 600 without) in the city of Nanjing in southern China. Subjects were tested for anti-HCV antibodies by a second generation assay. We also determined serological HCV genotypes and HCV RNA sequences. Among the 600 subjects without liver disease, 3 (0.5%) were seroreactive for anti-HCV. All were less than 12 years of age and had a history of transfusion. Of the 398 liver disease patients, 20 (5.0%) were seroreactive for anti-HCV. Of 16 patients in whom serological HCV genotype was determined, 10 (62.5%) were infected with HCV type 1, 5 (31.3%) with type 2 and 1 (6.3%) undetermined. HCV genomes sequenced from 2 patients belonged to genotype 2 and were closely related to strains in Beijing and Japan by molecular evolutionary analysis. These results suggest that HCV infection is rare and not a major cause of liver disease in southern China.  相似文献   

8.
This work was carried out to study the prevalence of hepatitis C virus (HCV) infection, its associated risk factors and possible routes of transmission in hemodialysis patients and renal transplant recipients. Ninety five patients and 15 normal controls were included in this study. Patients were classified into 3 groups: Group I (64 hemodialysis patients), Group II (16 renal transplant recipients) and Group III (15 patients with chronic renal insufficiency on conservative treatments). Each individual was subjected to full clinical examination, estimation of serum alanine aminotransferase (ALT), testing for antibodies to hepatitis C virus (anti-HCV), screening for hepatitis B surface antigen (HBsAg), antibodies to hepatitis B surface antigen (anti-HBs) and core antigen (anti-HBc) by modified ELISA technique. Anti-HCV was found in 87.5% of hemodialysis patients, 81.25% of renal transplant patients, 53.3% of the conservative group and in 13.3% of the control group. There was a significant correlation between the presence of anti-HCV and the duration on dialysis in groups I and II (p < 0.05), while no significant correlation was detected between HCV positive cases and the number of units of transfused blood in groups I and II (p > 0.05). Serum ALT was elevated in patients with HCV infection, but there was no significant correlation between the presence of anti-HCV and elevated ALT level among the examined groups of patients (p > 0.05). The prevalence of HCV infection was not correlated with the duration of renal transplantation and the type of immunosuppressive therapy (p > 0.05). Coinfection with HBV and HCV could occur, as previous infection with HBV was demonstrated. Anti-HBc was found in 51.8%, 66.7%, 37.5% of anti-HCV positive patients in groups I, II, II respectively. Anti-HBs was detected in 24.1% and 15.4% of anti-HCV positive in groups I and II. HBsAg was found only in 4.7% of anti-HCV positive hemodialysis.  相似文献   

9.
OBJECTIVE: To identify the routes of transmission in a nosocomial outbreak of hepatitis C virus (HCV) infection. DESIGN: Epidemiological investigation, including screening for HCV of hospitalized patients, and a retrospective cohort study, review of hygiene and medical practices, and molecular comparison of HCV isolates. SETTING: A specialized care unit for cystic fibrosis (CF) and diabetic patients at an acute-care facility in the south of France. RESULTS: Of the 57 CF patients (age in 1995: 2-28 years), 38 (66.7%) were tested and 22 (57.9%) were anti-HCV positive. Eight (50%) of 16 patients with anti-HCV antibody tested by polymerase chain reaction were viremic. No patients had received blood products or had any history of intravenous drug use. All 18 (100%) patients with CF who had ever undergone self-monitoring of capillary blood glucose in the unit were anti-HCV positive, compared to 4 (20%) of 20 who had not (relative risk, 5.0; 95% confidence interval, 2.1-12.0). Seventy (39.5%) of the patients with diabetes were screened for anti-HCV; 12 (18.8%) tested positive, with 3 (25%) positive for HCV-RNA. Patients with diabetes had routine capillary blood glucose monitoring while hospitalized and shared with CF patients the same spring-triggered devices for capillary blood glucose monitoring. The disposable platform of the devices was not changed between patient use. All HCV isolates belonged to the type 1, subtype b, and phylogenetic analysis showed a close homology by sequencing of NS5b and E2/HVR regions. CONCLUSION: As reported earlier for the hepatitis B virus, shared spring-triggered devices for capillary blood glucose monitoring by finger puncture may transmit HCV. Strict application of Standard Precautions procedures is warranted in any healthcare setting.  相似文献   

10.
BACKGROUND/AIMS: The aim of this study was to determine the frequency of hepatitis E virus (HEV) infection among unpaid blood donors and haemodialysis patients in Egypt and to find out any possible relationship between HEV and HCV. METHODS: Serum samples collected from 95 unpaid blood donors and 96 haemodialysis patients were screened for HEV and HCV antibodies by enzyme immunoassay techniques. RESULTS: The prevalence of anti-HEV IgG was 45.2% (43/95) in blood donors and 39.6% (38/96) in haemodialysis patients. Anti-HEV IgG was found in 69.2% (18/26) and 28.6% (20/70) in haemodialysis patients positive and negative for HCV, respectively. CONCLUSION: This study emphasizes that HEV is endemic in Egypt and tends to accumulate in certain groups showing evidence of hepatitis C virus infection as in haemodialysis patients suggesting either shared parenteral risk or increased sensitivity to HEV coinfection; that is to say a possibility of combined route of transmission for HEV.  相似文献   

11.
A Pár 《Orvosi hetilap》1991,132(18):955-959
Serum samples from 1185 individuals (blood donors, health care workers, patients on haemodialysis or from other high risk groups or with non-A, non-B [NANB] hepatitis and other liver diseases) were examined for antibody to a recombinant antigen of hepatitis c virus (anti-HCV). A new ABBOTT HCV EIA system was used and a parallel study with ORTHO HCV ELISA was also done for 380 samples to compare the two anti-HCV tests. A confirmatory neutralizing ABBOTT ELISA probe was also performed in 45 cases. Anti-HCV seropositivity was found in 1.60% of accepted healthy blood donors, while among subjects excluded from donation for elevated aminotransferase the rate was 8.95%. In patients on haemodialysis 47.15% anti-HCV prevalence was found, in other high risk group subjects 32.5%. Patients with acute post-transfusion (PT) NANB hepatitis showed 40% prevalence, this rate in chronic PT-NANB was 77.8%. The two ELISA tests revealed 95% agreement in the parallel determinations. Serial dilution studies of anti-HCV positive sera showed that ABBOTT test was of superior sensitivity. The results of the confirmatory test suggest that reactive (positive) samples of low optical density near to the cut-off value require a confirmation with the neutralization test. In conclusion HCV infection in Hungary seems to be a common aetiologic factor in PT-NANB hepatitis and the screening of blood donors for anti-HCV may be useful. However, because of financial difficulties, cost/benefit calculations are recommended before the introduction of this preventive measure.  相似文献   

12.
不同人群HCV感染状况及传播途径的研究   总被引:5,自引:0,他引:5  
应用第二代抗HCV ELISA试剂对我国中南地区部分人群 HCV感染状况进行了血清学调查,同时对HCV感染的传播途径进行了研究。结果表明:1.HCV感染率在不同人群中检出不一,凡与血液接触频繁的人群感染率较高,如恶性肿瘤患者(9.9%),献血(浆)员(12.25%),血液病患者(24.3%),血液透析者(37.2%),药瘾者(60.5%)。无明显血液接触史者则较低,如性错乱者(4.9%),医务人员(0.33%)及健康孕妇(0.24%)。2.经血传播是我国HCV传播的主要途径。除频繁接触血液者HCV感染率高以外,血液制品中丙球制剂抗 HCV检出率为 100%,HCV RNA阳性率为 31. 9%,其余制剂中虽然抗 HCV检出率极低,但 HCV RNA阳性率仍达 7. 94%。提示应用被污染的血液制品也存在传播 HCV的潜在危险。 3.性接触和日常生活密切接触有可能传播HCV,但机率较低。 4. HCV的家庭内聚集性感染的危险性远低于HBV。 5.职业性暴露感染 HCV的危险性亦较低。 上述研究结果为阐明我国 HCV感染流行规律及制订HCV感染防治措施提供了客观依据。  相似文献   

13.
A 75-year-old female with no known risk factors for hepatitis C virus (HCV) infection was hospitalized and a diagnosis of HCV seroconversion was established (HCV immunoblot and a positive quantitative viral load). An epidemiological investigation revealed that, during a previous hospitalization resulting in a diagnosis of diabetes, she had shared a Glucotrend capillary blood glucose meter (CBGM; Roche Diagnostics, France) with a known HCV-positive diabetic patient. Poor hygiene practices were observed when using this device. Since the Glucotrend CBGM had been purchased, the suspected source patient had been hospitalized eight times and another 19 diabetic patients with known anti-HCV antibodies also regularly attended the same hospital. Consequently, 35 diabetic patients who had been hospitalized at the same time as the suspected source patient and 1305 patients who had used the Glucotrend CBGM were invited to undergo serum anti-hepatitis B virus, anti-HCV and anti-human immunodeficiency virus testing. Among the 35 diabetic patients, none of the 24 subjects tested were positive. Among the 1305 other patients, 995 were tested and 19 (2%) were anti-HCV positive. Although this prevalence is higher than that reported in the general French population, this excess risk cannot be attributed to use of the CBGM. Furthermore, molecular analysis showed that the two HCV strains isolated did not belong to the same phylogenetic cluster. However, as a result of this incident, measures were taken to minimize the transmission of bloodborne viruses in the hospital concerned. Other French hospitals were informed by a national alert message from the French Agency for the Safety of Health Products.  相似文献   

14.
目的研究住院患者丙型肝炎、艾滋病以及梅毒指标感染状况,探讨其与医院感染的关联价值。方法选自2008-2010年住院患者38 952份血清标本,采用酶联免疫吸附试验(ELISA)检测丙型肝炎抗体(HCVAb)、人类免疫缺陷病毒抗体(HIVAb)、梅毒螺旋体抗体(TPAb)。结果 HCV感染402例,感染率1.03%,TP感染298例,感染率0.77%,HIVAb经天津市疾控中心确认16例,感染率0.04%。结论患者入院后病毒筛查阳性感染HCV、HIV、TP不容忽视,尤其艾滋病以及梅毒感染呈逐年上升趋势,其3种疾病阳性指标的检出对医院感染控制具有重要意义。  相似文献   

15.
OBJECTIVES: To evaluate the risk of probable iatrogenic hepatitis C virus (HCV) infection following transfusion of donor blood that has not been screened for HCV. STUDY DESIGN: Prospective study. METHODS: Screening for human immunodeficiency virus and hepatitis B virus is routine in the University of Benin Teaching Hospital. HCV screening was performed on transfused bags of donor blood selected at random. The detection of anti-HCV was based on the principle of double antigen sandwich immunoassay, in which purified recombinant antigens are employed sufficiently to identify anti-HCV. The outcomes of interest included the proportion of HCV-positive units of transfused donor blood, the source of blood and the total number of units of blood processed in the hospital blood bank. RESULTS: A total of 4532 units of donor blood were procured in the blood bank. Of these, 4132 units were certified as fit for transfusion following the hospital protocols. The sources of the transfused blood samples were commercial blood donors [89.2% (n = 3687)] and targeted donation [10.8% (n = 445)]. One hundred and ninety-two transfused blood samples were randomly screened for HCV, and 3% (n = 6) were found to be positive (95% confidence intervals 0.007-0.06). The likely risk of iatrogenic transfusion-related HCV infection was estimated to be 129 cases/year at the present rate of utilization of donor blood at the University of Benin Teaching Hospital. CONCLUSION: There is a risk of iatrogenic transfusion-transmitted HCV in the study hospital. Hospitals in Nigeria should screen for HCV prior to allogeneic transfusion, which may help in avoiding transfusion-related HCV and its probable long-term effects.  相似文献   

16.
First identified in the late 1980s as the main causative agent of non-A, non-B hepatitis, hepatitis C virus (HCV) infection is now the most common chronic bloodborne infection in the United States. It is likely that the number of deaths attributable to HCV-related chronic liver disease will increase substantially during the next 2 decades, and the potential economic and clinical burden related to HCV is staggering. Accordingly, it is essential to identify risk factors for transmission of HCV and implement appropriate precautions to decrease the prevalence of this emerging infection. The relative importance of the two most common types of exposures associated with transmission of HCV, ie, blood transfusion and injection drug use, has evolved over time. Strict blood-donor selection and the use of reliable serological tests have led to a significant reduction in transfusion-associated risk. Injection drug use is currently the single most important risk factor for HCV infection in the United States. Transmission of HCV poses a serious threat to healthcare workers and patients if infection control techniques or disinfection procedures are inadequate. Potential exposures include contact of the eyes, mucous membranes, broken skin, or needlestick injury. Hospitalized patients may serve as a reservoir for transmission, and the prevalence of anti-HCV seropositivity among such patients can be as high as 20%. The infected healthcare worker is a potential source of transmission. A recent molecular phylogenetic analysis demonstrated that a cardiac surgeon likely transmitted HCV to five of his patients during open heart surgery. In summary, nosocomial transmission has been unequivocally confirmed and underscores the need for strict infection control practices.  相似文献   

17.
应用第二代抗HCV试剂对我国不同地区肝病患者血清抗HCV进行了检测,同时调查了HBV和 HAV感染状况。 2016例肝病患者血清中抗 HCV检出率为 12. 25%,HBVm 检出率为 74. 55%,抗 HAV-IgM检出率为29.31%。各型肝病患者抗HCV检出情况分别是:急性肝炎62/752(8.24%);慢迁肝48/541(8.87%);慢活肝93/523(17.78%),慢性重症肝炎5/32(15.63%);肝硬化34/143(23.78%);肝癌5/25(20. 00%)。对不同年龄组肝病患者抗 HCV检出率的比较表明,抗 HCV检出率随患者年龄增加而增高。受血史及其他经血液暴露史与 HCV感染密切相关,但仍有近半数肝病患者 HCV感染途径不明。各型肝病患者中仅47/2016(2.13%)为单纯HCV感染,其他HCV感染者则为重叠感染。不同地区肝病患者血清抗HCV检出率间差异较大(2.15%~30.95%),北方地区较高,对其影响因素进行了探讨。  相似文献   

18.
We describe the transmission of hepatitis C virus (HCV) to two patients from a thoracic surgeon who was unaware of his hepatitis C infection. By partial sequencing of the non-structural 5B gene and phylogenetic analysis, the viruses from both patients were found to be closely related to genotype 1a strain from the surgeon. Two further hepatitis C cases were found in relation to the thoracic clinic. Their HCV sequences were related to each other but were of genotype 2b and the source of infection was never revealed. To elucidate the magnitude of the problem, we conducted a prospective study for a period of 17 months in which patients who were about to undergo thoracic surgery were asked to participate. Blood samples were drawn prior to surgery and at least four months later. The postoperative samples were then screened for anti-HCV and, if positive, the initial sample was also analysed. The only two patients (0.4%) identified were confirmed anti-HCV positive before surgery, and none out of 456 evaluable cases seroconverted to anti-HCV during the observation period. Despite the retrospectively identified cases, nosocomial hepatitis C is rare in our thoracic unit. The study points out the risk of transmission of hepatitis C from infected personnel and reiterates the need for universal precautions.  相似文献   

19.
目的 了解河南省2012-2014年新报告HIV感染者中HCV抗体的流行情况。方法 通过艾滋病综合防治数据信息管理系统对河南省2012年7月1日至2014年6月30日新报告的HIV感染者进行信息整理、HIV-1 BED新发感染检测和HCV抗体检测。结果 4 267例新报告HIV感染者中HCV抗体阳性率为13.19%(563/4 267),感染途径为注射吸毒者的HCV抗体阳性率最高(77.27%),采血浆/输血、异性性传播、同性性传播和母婴传播人群的HCV抗体阳性率分别为15.06%、15.81%、3.74%和8.96%。开封(32.04%)、驻马店(25.00%)、商丘(25.00%)、周口(18.86%)和南阳(14.67%)为HCV抗体阳性率最高的前五个省辖市。BED阳性者(HIV新近感染者)中HCV抗体阳性率为7.50%(86/1 146)。多因素logistic回归分析发现:BED阴性、年龄>40岁、农民、HIV感染途径为注射吸毒以及报告地区为开封市、南阳市、商丘市、驻马店市和周口市为HCV感染的危险因素。结论 2012-2014年河南省新报告HIV感染者中HCV抗体流行率有降低的趋势,但是部分地区和重点人群仍存在较高的HCV抗体流行率。  相似文献   

20.
北京市4 055名健康儿童丙型肝炎血清流行病学调查   总被引:3,自引:0,他引:3  
目的 了解北京市城区儿童中丙型肝炎的发病情况。方法 对北京市4个城区4055名健康儿童用ELISA法进行丙型肝炎病毒抗体(抗-HCV)检测。结果 抗-HCV阳性14人,同时伴丙型肝炎病毒核糖核酸阳性4人,HCV感染率为0.35%。各城区、各年龄组、男女性儿童间HCV感染率比较差异无显性。但有输血、注射人血球蛋白等史与无上述历史组对比,HCV感染率差异有极显性。14例抗-HCV阳性儿童的父母检  相似文献   

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