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肾脏供者的丙型肝炎病毒感染

Authors
Marion Muche, MD
Brian JG Pereira, MD
Seema Baid-Agrawal, MD
Section Editors
Daniel C Brennan, MD, FACP
Adrian M Di Bisceglie, MD
Deputy Editor
Alice M Sheridan, MD
Translators
倪武, 副教授

引言

接受丙型肝炎病毒(hepatitis C virus, HCV)感染供者的肾脏移植可能使受者发生HCV感染[1,2]。HCV感染会增加肾移植受者的并发症发病率并可能增加其死亡率[3-5]。

这些观察结果促使人们制定了一些关于将HCV阳性或阴性供者的肾脏分配给HCV阳性或阴性受者的国家性和国际性政策。

本专题将围绕死亡或活体HCV感染肾脏供者进行讨论。肾移植受者、移植候选者及非移植候选者的透析患者的HCV感染将在别处讨论。 (参见“肾移植候选者和受者的丙型肝炎病毒感染”和“维持性透析患者中的丙型肝炎病毒感染”)

流行病学

全世界一般人群中，HCV感染率为2%-3%[6]。有关死亡的器官供者中感染率的最佳数据来自于一项研究，该研究纳入了美国17个器官获取机构2004-2008年评估的13,667例潜在器官供者；该研究发现，HCV感染率在一般风险的潜在供者中为3.45%，而在高风险潜在供者中为18.20%[7]。一项纳入55例潜在的活体亲缘供者的研究显示，HCV感染率为3.6%[8]。目前报道的肾移植受者的HCV感染率为1.8%-8%[9-13]。 (参见“肾移植候选者和受者的丙型肝炎病毒感染”，关于‘流行病学’一节)

经肾移植传播的HCV感染

移植HCV阳性供者的器官具有明显的HCV感染传播风险[1,14-18]。两项研究报道，移植抗HCV抗体阳性供者的器官的受者中，移植后抗HCV抗体阳性的比例为14%-100%，聚合酶链反应(polymerase chain reaction, PCR)检测HCV RNA阳性的比例为57%-96%[1,14]。

            

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Literature review current through: 2017-06 . | This topic last updated: 2016-02-24.
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