Infección por virus de la hepatitis b y c en pacientes de hemodiálisis / Hepatitis B and Hepatitis C virus infections in patients on haemodialysis

Joachín Barrios Camba, Cristian Leyva de la Torre, NorKys J. Chávez Moreno, Yahima Cabrera Yero, Diana Rosa Márquez Márquez

Texto completo:

PDF HTML

Resumen

Por la elevada incidencia y prevalencia de las hepatitis virales en los pacientes de hemodiálisis, se realizó un estudio observacional, descriptivo, prospectivo para conocer incidencia, prevalencia de virus de la hepatitis C (VHC) y de la hepatitis B (VHB), además factores de carácter objetivos. También se evaluó el cumplimiento de las medidas de bioseguridad. Fueron estudiados pacientes con Enfermedad Renal Crónica Terminal (ERCt) en hemodiálisis del servicio Sandino. Se les aplicó una encuesta epidemiológica y realizó AgSVHB, AcVHC por técnica de ELISA de tercera generación. También se aplicó una encuesta a enfermería, además se recogieron datos durante la hemodiálisis durante 2006 y 2007. Los resultados arrojados fueron,prevalencia VHC 45 y 41,6%, años 2006 y 2007 y VHB 10 y 4,1%, respectivamente. Una incidencia VHC 5% y 12,5%, años 2006 y 2007 y VHB 0 y 4,1%, respectivamente. Predominó el sexo masculino con 15 pacientes, raza blanca con 17 y el 48,1% era mayor de 50 años. El tiempo en hemodiálisis con más pacientes fue el de menos de 5 años con 66,6%, al igual que los pacientes con vacunación completa VHB. El 40,7% de los pacientes se habían transfundido más de una vez. Se concluyó que es baja la frecuencia de casos VHB, no así VHC, que se mantiene con mayor número. Los factores como transfusiones de sangre se relacionaron con VHC y VHB. No encontramos relación entre el sexo, raza, edad, tiempo en hemodiálisis con el VHC, VHB. En general se cumplen las medidas de bioseguridad.

Palabras clave: Virus de la Hepatitis B/ Complicaciones, Hepatitis C/ Complicaciones, Diálisis Renal, Insuficiencia Renal Crónica.

ABSTRACT

An observational descriptive and prospective study was aimed at knowing the incidence and prevalence of hepatitis B and C virus as well as the objective factors. The fulfilment of biosecurity measures was evaluated. Patients suffering from Terminal Chronic Renal Disease (TCRD) were studied in the haemodialysis unit in Sandino hospital, these patients were also surveyed epidemiologically, and AgSVHB and AcVHC were used applying the third generation technique (ELISA). Nurses were also surveyed and data during haemodialysis in 2006-2007 were compiled. Results showed a prevalence rate of CVH 45 and 41.6% (2006 and 2007) and a prevalence of BVH of 0 and 4, 1 %, respectively. Masculine sex was predominating (15 patients), as well as the Caucasian race (17 patients) and 40.1% of patients was over 50 years old. Most of the patients stayed in dialysis less than 5 years (66.6%) and also those patients with a complete vaccination (HBV). 40, 7% had been transfunded more than once. It is concluded with a low frequency of HBV and a great frequency in the HCV. It was not observed any relationship among sex, race, age, time in haemodialysis with HCV and HBV. In general the biosecurity measurements are fulfilled.

Key words: Hepatitis B Virus/Complications, Hepatitis c /Complications, Renal Dialysis, Chronic Renal Failure.

Referencias

- Pérez-Graves H. Filtro dializador de hemodiálisis. En: Treviño A. Tratado de Nefrología. México: Editorial Prado; 2003, p.1331-43.

- Rolando J, Ortega Q. Hepatitis C en hemodiálisis. Rev Col Gatroeneterol. 2005; 20(1):34-50. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-99572005000100005&lng=en.

- Moreira RC, Lemos M, Longui CA, Granato C. Hepatitis C and hemodialysis: a review. Braz J Infect Dis. 2005; 9(4):269-275.

- Alter MJ, Mart EE. The epidemiology of viral hepatitis in the United States. Gastroenterology Clin North Am .1994; 23:437-455.

- Goncalves M, de Castro M, Oliveira J. Prevalence and associated factors to hepatitis C in hemodialysis patients in Brazil. Rev Saude Pública. 2004;38:187-193.

- Daugirdas JT, Blake PG, Ing TS. Handbook of dialysis. 3era ed. Philadelphia: Lippincott Williams&Wilkins; 2004,p.148-50.

- Yakaryilmaz F,Gurbuz OA, Guilter S, Mert A, Soungury Y, Karakan T, et al. Prevalence of ocult hepatitis B and hepatitis C virus infections in Turkish hemodialysis patients. Ren Fail. 2006; 28(8): 729-35.

- Sweeting MJ, De Angelis D, Neal KR, Ramsay ME, Irving WL, Wright M, et al. Estimated progression rates in three United Kindom hepatitis C cohorts differed according to method of recruitment. J Clin Epidemiol. 2006; 59(2):144-52.

- Carneiro AS, Teles AS, Diaz MA, Ferreira RC, Naghettine AV, Silva AS, et al. Decline of hepatitis C infection in hemodialysis patients in Central Barzil: a ten years of surveillance. Mem Inst Oswaldo Cruz.2005; 100(4):345-349.

- Okuda K, Yokosuka O. Natural history of chronic hepatitis C in patient on hemodialysis: case control study with 4-23 years follow-up. World Gastroenterol. 2003; 10: 2209-2212.

- Mendez N, Motola D, Chavez N. Prevalence of hepatitis C virus infection among hemodialysis patients at tertiary care hospital in Mexico City. Mexico J Clin Microbiol 2004; 42: 4321-4322.

- Rosas AM. Actualización en hepatitis C/ Update in hepatitis C. Rev Chil. Tecnol Med .2003; 23(1):1057-1063.

- Pérez Escobar María Mercedes, Herrera Cruz Nuria, Pérez Escobar Elizabeth, Cabrejas Hernández Zenaida. Factores sociales que contribuyen a la morbi-mortalidad en pacientes con Insuficiencia Renal Crónica sometidos a hemodiálisis. Un estudio necesario. Rev Hum Med [revista en la Internet]. 2008 Abr [citado ] ; 8(1): . Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-81202008000100007&lng=es.

- Taskapan H, Oymak O, Dougukan A, Utas C. Patient to patient transmission of hepatitis C virus in hemodialysis unit. Clin Nephrol .2001; 56(6):486.

- Saxena AK, Panhotra BR, Sundaram DS, Naguib M, Venkateshappa T, Uzzaman W, et al. Impacto f dedicated space, diálisis equipment, and nursing staff on the transmisión of hepatitis C virus in a hemodialysis unit of the Middle East. Am J Infect Control .2003; 31(1):26-33.

- Almawi WY, Qadi AA, Tamim H, Ameen G, Bu-Ali A, Arravid S, et al. Seroprevalence of hepatitis C virus and hepatitis B virus among dialysis patient in Bahrain and Saudi Arabia. Transplant Proc .2004; 36 (6):1824-6.

- Vladutiu DS, Cosa A, Neamtu A , State D, Braila M, Gherman M, et al. Infections with hepatitis B and c viruses in patients on maintenance dialysis in Romania and in former communist countries: yellow spots on a blank map. J viral hepat .2001; 7(4):313-9.

- Westein T, Tur-Kaspa R, Chagnac A, Kortets A, Ori Y, Zevin D, et al. Hepatitis C infection in dialysis patients in Israel. Isr Med Assoc J.2001; 3(7):551.

- Busek SU, Baba EH, Tavares F, Helcio A, Pimenta L, Salomao A, et al. Hepatitis C and B virus infection in different hemodialysis units in Belo Horizonte, Minas Gerais, Brazil. Mem Inst Oswaldo Cruz .2002; 97(6):775-778.

- Djordjevic V, Stojanovic K, Stojanovic M, Stefanovic V. Prevention of nosocomial transmission of hepatitis C infection in a hemodialysis unit. A prospective study. Int J Artif Organs .2000; 23(3):181-8.

- Karkar A, Abdelrahman M, Ghacha R, Malik TQ. Prevention of viral transmisión in HD units: the value of isolation. Sauid J Kidney Dis Transpl .2006; 17(2):183-8.

- Natov SN. Hepatitis C virus in chronic dialysis patients. Minerva Urol Nefrol .2005; 57(3):175-97.

- Capote Pereira L, Morejon Palacio E, Mora González S. Factores de riesgo para la trasmisión de la hepatitis C en hemodiálisis. Rev cubana Med .2005; 44(3):10. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232005000400006&lng=es&nrm=iso&tlng=es

- Saxena AK, Panhotra BR. The impact of nurse understaffing on the transmission of hepatitis C virus in a hospital based hemodialysis unit. Med Princ Pract .2004; 13(3):129-35.

- Medeiros M, Lima J, Lima JW, Campos H, Medeiros MM, Coelho F. Prevalência e fatores associados a hepatite C em pacientes de hemodiálise. Ver Saúde Publica .2004; 38(2)187-193.

- Otoedo AE, Mc Ligeyo SO, Okoth FA, Kayima JK. Seroprevalence of hepatitis B and C in maintenance dialysis in a public hospital in a developing country. S Afr Med J .2003; 93(5):380-4.

- Carneiro M, Oliveira L, Gomes A, Dias M, Gomes s, Yoshida C, et al. Hepatitis B and C in the hemodialysis unit of Tocantins, Brazil: serological and molecular profile. Mem Inst Oswaldo Cruz.2003; 98(5): 599-603.

- Diouf ML, Diouf B, Niang A, Ka EH, Pouye A, Seck A. Prevalence of hepatitis B nad C viruses in a chronic hemodialysis centre in Dakar. Dakar Med .2000; 45(1):1-4.

- Covic A, Iancu l, Apetrei C, Scripcaru D, Volocat C, Mititiuc I. Hepatitis virus infection in haemodialysis patients from Moldavia. Nephrol Dial Transplant .2001; 14(1):40-5.

- Alburquerque A, Coehlo M, Lopes E, Lemos M, Figueredo M. Prevalence and risk factors of hepatitis C virus infection in hemodialysis patients from one center in Recife , Brazil. Mem Inst Oswaldo Cruz.2005; 100(5):467-470.

- Lopes C, Karnopp T, Burmeister J, Campos B, Costa M, Merele R. Detectao do vírus da hepatite C pela reação em cadeia da polymerase em pacientes renais crônicos em hemodiálise e com antiVHC não reagente. GED gastroenterol. Endosc Dig. 2005; 24(1): 1-5.

- Broumand B, Shamshirsaz AA, Kamgar M, Hasheim R, Aiazi F, Bekheirnia M. Prevalence of hepatitsi C infection nad its risk factors in hemodialysis patientes in tehran: preliminary report from the effect of dialysis unit isolation on the incidence of hepatitis C in dialysis patients project. Saudi J Kidney Dis Transplant .2002; 13(4):467-72.

- Tsouchnikas I, Dounoudi E, Xamthopoulou K, Papakonstantinou S, Thomoglou V, Tsakiris D. Loss of hepatitis B immunity in hemodialysis patients acquired either naturally or after vaccination. Clin Nephrol .2007; 68(4):228-34.

- Kondili LA, Genovese D, Argentini C, Chionne P. Toscani P, Fabro R. Nosocomial transmission in simultaneous outbreaks of hepatitis C and B virus infections in a hemodialysis center. EurJ Clin Microbiol Infect Dis .2006; 25(8):527-31.

- Valtuille R, Moretto H, Left L, Rendo P, Fernadez Jl. Decline of high hepatitis C virus prevalence in a hemodialysis unit with no isolation measures duringa 6 years follow-up. Ciln Nephrol .2002; 57(5):371-5.

- Savey A, Simon F, Izopet J, Lepoutre A, Fabry J, Desenclos JC. A large nosocomial outbreak of hepatitis C virus infections at a hemodialysis center. Infect Control Hosp Epidemiol .2005; 26(10):810.

- Yanai M. Viral hepatitis in hemodialysis patients. Rinsho Byori .2002; 49(3):249-53.

- Schneeberger PM, Doorenbos CJ, Van der Vliet W, Bergervoet P, Quint W, Van doorn LJ. Nosocomial transmission of hepatitis C virus in Dutch dialysis center. Ned Tijdschr Geneeshd. 2000; 143(15):801-6.

- Delarocque _Atagneau E, Baffoy N, Thiers V, Simon N, DE Valk H, Laperche S. Outbreak of hepatitis C virus infection in a hemodialysis unit: potential transmission by the hemodialysis machine. Infect Control Hosp Epidemiol .2002; 23(6):328-34.

- Barril G, Traver JA. Decrease in the hepatitis C virus (HCV) prevalence in hemodialysis patients in Spain: effect of time, initiating HCV prevalence studies and adoption of isolation measures. Antiviral Res. 2003; 60(2):129-34.



Licencia de Creative Commons
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional.