TT Virus Infection in Patients on Maintenance Hemodialysis in Eastern Taiwan

東臺灣血液透析病人輸血傳遞的病毒感染(TTV)之探討

徐邦治(Bang-Gee Hsu) ； 羅時燕(Shih-Yen Lo) ； 王豐裕(Li-Yu Wang) ； 馬心潔(Hsin-Chieh Ma) ； 王智賢(Chih-Hsien Wang) ； 廖晉興(Ching-Shing Liao) ； 胡志棠(Chi-Tang Hu) ； 林憲宏(Hans Hsien-Hong Lin)

《Acta Nephrologica》 18卷2期 (2004/05) Pp. 71-74

摘要

血液透析病人為肝炎感染的高危險族群。臺灣研究指出，血液透析病人的輸血傳遞的(TT)肝炎病毒感染較正常人普遍。但東臺灣血液透析病人的TT肝炎病毒感染的資料則缺少。本研究目的即探討東臺灣血液透析病人的TT肝炎病毒感染盛行率，並與其他地區的研究結果進行比較。研究對象為東臺灣119位血液透析病人，抽血萃取病毒DNA再以聚合連鎖反應(polymerase chain reaction)進行TT肝炎病毒DNA增幅放大。研究發現東臺灣血液透析病人TT肝炎病毒感染盛行率為18.5%，低於臺灣其它地區血液透析病人。其他如年紀、性別、平均洗腎時間、輸血史、血清AST值、血清ALT值、B型肝炎帶原率及C型肝炎感染率，在TTV(-)與TTV(+)兩組間均無統計顯著差異存在。因此，本研究顯示東臺灣血液透析病人的TT肝炎病毒感染比臺灣其他血液透析病人低，但高於北臺灣健康成人及東臺灣原住民。TT肝炎病毒感染者臨床上無任何肝炎表現，其感染途徑可能是血液透析過程中或是院內感染罹患；而非靜脈途徑的病毒傳遞亦無法完全排除，詳細之致病機轉仍需進一步的研究解答。

關鍵字

輸血傳遞的肝炎病毒 ； TTV病毒 ； 血液透析 ； 盛行率

並列摘要

Patients with chronic renal failure on maintenance hemodialysis have a higher risk of viral infection and the prevalence of transfusion-transmitted virus (TTV) infection is common in patients on hemodialysis in northern and western Taiwan. The aim of this study is to investigate the prevalence of TTV viremia on hemodialysis in eastern Taiwan. Serum samples were studied from 119 patients at a hemodialysis center in eastern Taiwan and TTV viremia were detected by polymerase chain reaction. The prevalence of TTV infection was 18.5%. None of the TTV infection patients had clinical or biochemical signs of liver disease. There were no statistically significant differences in the mean age, gender distribution, duration of hemodialysis, transfusion history, liver biochemical tests, hepatitis B antigenemia and hepatitis C infection between patients with and without TTV infection. Compared with results from other studies, the prevalence of TTV infection in our hemodialysis unit in eastern Taiwan was higher than those in healthy adults in northern Taiwan and aborigines in eastern Taiwan, but was lower than those in other hemodialysis units in Taiwan. Our results suggest that TTV infection is not associated with evident liver diseases. The TTV infection in patients on hemodialysis may be acquired during the hemodialysis procedure or by nosocomial transmission. However, a non-parenteral route of viral transmission cannot be ruled out. Further studies are needed to resolve this problem.

並列關鍵字

TT virus ； hemodialysis ； prevalence