血液病患者血清乙型、丙型肝炎和艾滋病毒标志物的系统评价

A.V. Satsuk, G.G. Solopova, A.A. Ploskireva, V.G. Akimkin
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引用次数: 0

摘要

本系统评价的目的是评估1980 - 2020年世界不同国家血液肿瘤患者血源性感染的发生率,包括主要血液肿瘤临床组患者,评估输血安全措施实施后高危组血源性感染的流行动态。对系统评价数据的分析显示,1980年至2020年期间,血液病患者的发病率很高:HCV - 8.2%, HBV(总标志物)- 14.7% (HBsAg - 10.8%), HIV - 0.4%。2009 - 2017年患者中HCV和HBV感染水平分别是2015年人群感染水平的3.9倍和1.6倍。艾滋病的流行率低1.16倍。根据个别国家的数据,HCV在血液病患者中的发病率是人群的1.3-118倍,HBV - 0.4-73.5倍。血液病患儿中HBsAg的患病率为18.3%,是成人患者(7.1%)的2.6倍。2000年前血液病患儿HBsAg患病率为14.8%,是2000年前儿童人群HBsAg患病率的3倍,2000年后为20.5%,是2000年前儿童人群HBsAg患病率的16倍。对献血者进行筛查大大降低了高危患者的发生率。引入筛查前,血液肿瘤患者HCV感染水平为35.7%,引入筛查后为5.2%,下降了7倍。筛查前HBV感染水平为41.3%,筛查后为- 5.9%,也降低了7倍。在血液病的治疗过程中或治疗结束后,HCV患者的感染率比诊断阶段或治疗开始时高7.7倍,HBV - 4.2倍。血液系统恶性肿瘤患者的HCV和HBV感染水平是实体瘤患者的1.8倍,无论是HCV还是HBV。所进行的分析强调了血源性感染的医院传播问题的紧迫性,这在高危患者中得到了积极的认识。
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Systematic review of seroprevalence of markers of hepatitis B, C and HIV among oncohematological patients
The purpose of systematic review was to assess the incidence of blood-borne infections in oncohematological patients in the period from 1980 to 2020 in different countries of the world, including in main oncohematological clinical groups of patients, assessment of the dynamics of the prevalence of blood-borne infections in the high-risk group after implementation of blood transfusion safety measures. An analysis of the data of the systematic review showed a high incidence of patients with oncohematological diseases in the period from 1980 to 2020: HCV – 8.2%, HBV (total markers) – 14.7% (HBsAg – 10.8%), HIV – 0.4 %. Middle levels of HCV and HBV infection in patients in the period from 2009 to 2017 exceeded the infection levels of the population in 2015 by 3.9 and 1.6 times, respectively. The prevalence of HIV was 1.16 times lower. According to the data of individual countries, the incidence of HCV among oncohematological patients is 1.3-118 times higher than the population, HBV – 0.4-73.5 times. The prevalence of HBsAg among children with oncohematological diseases was 18.3% and exceeded the same level among adult patients (7.1%) by 2.6 times. The prevalence of HBsAg among children with oncohematological diseases before 2000 was 14.8% and exceeded the prevalence of HBsAg among the child population before 2000 by 3 times, after 2000 – 20.5% and exceeded that among the child population by 16 times. The introduction of screening of blood donors has significantly reduced the incidence of patients at risk. Prior to the introduction of screening, the level of HCV infection among oncohematological patients was 35.7%, after the introduction of screening it was 5.2%, which is 7 times less. The level of HBV infection in the pre-screening period was 41.3%, after the introduction of screening – 5.9%, which is also 7 times less. During the course of treatment of oncohematological diseases or after its completion, the infection of patients with HCV is 7.7 times higher, HBV – 4.2 times higher, compared with infection at the stage of diagnosis or start of treatment. The level of HCV and HBV infection in patients with hematological malignancies exceeded that in patients with solid tumors by 1.8 times, both in the case of HCV and HBV. The conducted analysis emphasizes the urgency of the problem of nosocomial transmission of blood-borne infections, which is actively realized among patients at risk.
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