Prevalence of HIV Infection among Hemodialysis Patients

D. Yadegarynia, Sara Rahmati Roodsari, Zahra Arab-Mazar
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Abstract

Human immunodeficiency virus (HIV) belongs to human retrovirus family and transmitted by blood transfusion and blood products. 36.9 million People were living with HIV infection worldwide in 2014 approximately 1 , during which 2 million (1.9–2.2 million) new infections with HIV had occurred. End-stage renal disease (ESRD) patients treated by hemodialysis (HD) are more susceptible for infection by human immunodeficiency virus infection. Renal failure can be an associated condition or could be a direct consequence of HIV infection 2 , 3 . Advanced HIV disease which is indicates by a low CD4 cell count is development of renal diseases subsequently 4 , however many other causes now may cause renal failure in patients with HIV, including drug-induced toxicity, hypertensive nephroangiosclerosis, and diabetes 5 . HIV infection and hemodialysis have same consequences such as cardiovascular diseases, immunosuppression, anemia, weight loss, and osteodystrophy 6 , 7 . Compared with rate of infection with other viral infection such as hepatitis B virus (HBV) or hepatitis C virus (HCV), the risk of HIV infection among hemodialysis patients is lower as the contact with contaminated sources. Although intensive HIV research has been done for 20 years, we have a little knowledge about mortality risk factor in ESRD on HIV-infected patients. Hemodialysis patients who have HIV-infected are assumed to a high risk for death 4 . The finding the current study demonstrated the prevalence of HIV in hemodialysis patients which was conducted in 5 hemodialysis centers in Tehran province, Iran, in the 2016. All the enrolled participants were informed about study and written informed consent was obtained. Statistical analysis was performed by SPSS version 16 (SPSS Inc, Chicago, IL, USA).  Among 360 patients, 213 (59.17%) of patients were men and 147 (40. 83%) were females; the mean age of patients was 53.43. HIV Ab was negative in all cases. This result has been confirmed in other studies as well 8 . The highest frequency for duration of dialysis is 1-5 years. Nowadays viral transmission via hemodialysis routes is controlled and limited since more effective screening of blood donor. Screening and early diagnosis of kidney disease will improve outcomes in patients with HIV infection. Considering all of these evidences, further studies are recommended strongly to evaluate the real prevalence of HIV in these patients.
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血液透析患者HIV感染的流行情况
人类免疫缺陷病毒(HIV)属于人类逆转录病毒家族,通过输血和血液制品传播。2014年,全世界约有3690万人感染艾滋病毒,其中200万(190 - 220万)新发艾滋病毒感染。终末期肾病(ESRD)患者接受血液透析(HD)治疗更容易感染人类免疫缺陷病毒感染。肾功能衰竭可能是HIV感染的一个相关条件或直接后果2,3。CD4细胞计数低表明的晚期HIV疾病是随后肾脏疾病的发展,然而现在许多其他原因可能导致HIV患者肾功能衰竭,包括药物性毒性、高血压肾血管硬化和糖尿病。艾滋病毒感染和血液透析具有相同的后果,如心血管疾病、免疫抑制、贫血、体重减轻和骨营养不良6,7。与乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)等其他病毒感染率相比,血液透析患者因接触污染源而感染HIV的风险较低。尽管对艾滋病毒的深入研究已经进行了20年,但我们对艾滋病毒感染的终末期肾病患者的死亡风险因素知之甚少。感染艾滋病毒的血液透析患者被认为有很高的死亡风险。目前的研究结果表明,2016年在伊朗德黑兰省的5个血液透析中心进行的血液透析患者中艾滋病毒的流行情况。所有入组的参与者都被告知研究内容并获得书面知情同意书。统计学分析采用SPSS version 16 (SPSS Inc ., Chicago, IL, USA)。360例患者中,男性213例(59.17%),147例(40例)。83%)为女性;患者平均年龄53.43岁。所有病例的HIV抗体均为阴性。这一结果在其他研究中也得到了证实。透析时间最长的频率为1 ~ 5年。如今,由于对献血者进行了更有效的筛查,通过血液透析途径的病毒传播得到了控制和限制。肾脏疾病的筛查和早期诊断将改善HIV感染患者的预后。考虑到所有这些证据,强烈建议进一步研究以评估这些患者中艾滋病毒的真实流行情况。
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