Health Care–Associated Transmission of Hepatitis B and C Viruses in Hemodialysis Units英文文献.pdfVIP

Health Care– Associated Transmission of Hepatitis B and C Viruses in Hemodialysis Units Fabrizio Fabrizi, MDa,b,*, Paul Martin, MDb KEYWORDS Hepatitis B virus Hepatitis C virus Dialysis Antiviral therapy Liver disease is a significant cause of morbidity and mortality in patients receiving long-term dialysis. This article summarizes the most recent information on epidemi- ology, clinical significance, and management of infection by hepatitis B (HBV) and hepatitis C (HCV) viruses in this population. HBV Controlling the spread of HBV infection within dialysis units has been a major advance in the management of patients with chronic kidney diseases (CKD). The rate of HBV infection in dialysis units in the developed world is currently low but not negligible. A large multicenter survey conducted by the Centers for Disease Control and Prevention (CDC) reported that in 2002, the prevalence of hepatitis B surface antigen (HBsAg) positivity among hemodialysis (HD) patients was 1%, a figure that had not changed substantially during the prior decade.1 Similarly, the incidence of HBV infection in dial- ysis patients also had not changed during the prior decade, and in 2002 was 0.12%.1 This work was supported by the grant Project Glomerulonephritis in memory of Pippo Neglia. a Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Pad. Croff, Via Commenda 15, Milano 20122, Italy b Division of Hepatology, Department of Medicine, Center for Liver Diseases, Miller School of Medicine, University of Miami, 1500 NW 12th Avenue, Suite 1101-E, 31101, Miami, FL 33136, USA * Corresponding author. Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Pad. Croff, Via Commenda 15, Milano 20122, Italy. E-mail address: fabrizi@policlinico.mi.it (F. Fabrizi). Clin Liver Dis 14 (2010) 49–60 doi:10.1016/j.cld.2009.11.011 1089-3261/10/$ – see