免疫球蛋白G对肝移植候选者的甲型肝炎病毒免疫：来自伊朗的血清调查

IF 0.3 4区医学 Q4 GASTROENTEROLOGY & HEPATOLOGY

Hepatitis Monthly Pub Date : 2021-04-03 DOI:10.5812/HEPATMON.113001

Kamran B. Lankarani, B. Honarvar, Mohammad Hassan Zahedroozegar, A. Dehghan, M. R. Rouhezamin, Mojdeh Khorrami, Saeid Amiri zadeh fard, Vahid Seifi, B. Geramizadeh, H. Salahi, S. Nikeghbalian, A. Shamsaeefar, S. A. Malek-Hosseini

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引用次数: 0

摘要

背景：感染甲型肝炎病毒（HAV）在终末期肝病患者中更致命。目的：本研究旨在确定肝移植（LT）候选者中甲型肝炎慢性免疫的血清流行率，以确定是否需要接种甲型肝炎疫苗。方法：这项横断面研究是对转诊到伊朗设拉子LT中心的成年LT候选人进行的。为了填写数据收集表，对患者进行了访谈。这些表格包括人口统计信息、医学背景、慢性肝病病因、终末期肝病（MELD）评分模型、实验室检查结果和腹部超声报告。此外，从每个患者获得3-cc血液样本，并使用标准Diapro试剂盒通过酶联免疫吸附测定（ELISA）检测抗HAV IgG。使用SPSS版本20进行单变量和多变量数据分析。P值小于0.05被认为是回归分析中的显著截止值。结果：本研究共招募了291名患者，平均年龄为47.73±12.9岁，其中197名（67.7%）患者为男性，237名（81.4%）患者已婚，229名（78.7%）患者受教育程度低于12岁，250名（85.9%）患者生活在城市地区，（221）75.9%的患者在其生活区有卫生用水。269例（92.4%，95%可信区间：89.4-95.4%）患者检测到抗HAV IgG。多变量分析显示，对甲型肝炎传播途径的了解程度较低（OR:11.9，95%CI:1.39-10.8，P=0.024）、不吸烟（OR:9.5，95%CI:1.6-55.5，P=0.014）和年龄较大（OR:1.12，95%CI:1-1.24，P=0.03）依次是甲型肝炎免疫的主要预测因素。结论：大多数LT候选者是HAV IgG阳性，但由于LT候选者的数量不断增加，以及非免疫病例中HAV的高死亡率，LT候选者应该检查HAV IgG，尤其是免疫较弱的年轻或水烟患者。此外，如果可能的话，所有非免疫患者都应该接种甲型肝炎疫苗。

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Immunoglobulin G Immunity to Hepatitis A Virus in Liver Transplant Candidates: A Serosurvey from Iran

Background: Becoming infected with hepatitis A virus (HAV) is deadlier in patients with end-stage liver disease. Objectives: This study aimed to determine the seroprevalence of chronic immunity to HAV in liver transplant (LT) candidates to determine whether HAV vaccination is necessary for them or not. Methods: This cross-sectional study was conducted on adult LT candidates who were referred to the LT center of Shiraz, Iran. The patients were interviewed for filling the data collection forms. These forms consisted of demographic information, medical backgrounds, etiology of chronic liver disease, a model for end-stage liver disease (MELD) score, laboratory findings, and abdominal sonography report. Furthermore, a 3-cc blood sample was obtained from each patient, and anti-HAV IgG was detected by Enzyme-linked Immunosorbent assay (ELISA) using standard Diapro kits. Univariable and multivariable data analyses were performed using SPSS version 20. A P-value of less than 0.05 was considered the significant cutoff in regression analysis. Results: A total of 291 patients with a mean age of 47.73 ± 12.9 years were recruited in this study of whom, 197 (67.7%) patients were males, 237 (81.4%) were married, 229 (78.7%) were educated lower than 12 years, 250 (85.9%) were living in urban areas, and (221) 75.9% had access to sanitary water in their living area. anti-HAV IgG was detected in 269 (92.4%, 95% CI: 89.4 - 95.4%) patients. Multivariable analysis showed that lower knowledge of hepatitis A transmission routes (OR: 11.9, 95% CI: 1.39 - 101.8, P = 0.024), no waterpipe smoking (OR: 9.5, 95% CI: 1.6 - 55.5, P = 0.014), and older age (OR: 1.12, 95% CI: 1 - 1.24, P = 0.03) were the main predictors of HAV immunity, in sequence. Conclusions: Most LT candidates are HAV IgG positive, but due to the growing number of LT candidates and high mortality of HAV in non-immune cases, LT candidates should be checked for HAV IgG, especially younger or waterpipe smoking patients who are less immune. Also, all non-immune patients should be vaccinated against HAV, if possible.

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来源期刊

Hepatitis Monthly 医学-胃肠肝病学

CiteScore

1.50

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： Hepatitis Monthly is a clinical journal which is informative to all practitioners like gastroenterologists, hepatologists and infectious disease specialists and internists. This authoritative clinical journal was founded by Professor Seyed-Moayed Alavian in 2002. The Journal context is devoted to the particular compilation of the latest worldwide and interdisciplinary approach and findings including original manuscripts, meta-analyses and reviews, health economic papers, debates and consensus statements of the clinical relevance of hepatological field especially liver diseases. In addition, consensus evidential reports not only highlight the new observations, original research, and results accompanied by innovative treatments and all the other relevant topics but also include highlighting disease mechanisms or important clinical observations and letters on articles published in the journal.