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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitř. Lék., 47, 2001, No. 1, p. 53-59 |
Viral Hepatitis of Patients in a Regular Haemodialysis Programme Švára F., Urbánek P., Sulková S. lInterní oddělení Strahov 1. lékařské fakulty UK a Všeobecné fakultní nemocnice, Praha, přednosta doc. MUDr. S. Sulková, CSc. I. interní klinika 1. lékařské fakulty UK a Všeobecné fakultní nemocnice, Praha, přednosta prof. MUDr. P. Klener, DrSc. |
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Summary: After cardiovascular diseases and bacterial infections víral hepatitis is the most frequent disease which complicates haemodialyzation treatment of patients with chronic renal failure.Substitution of renal function is for these patients a life saving procedure. It is, however, complicated treatment associated with various risks of acute and chronic complications. The prevalence of parenterally transmitted víral hepatitis in the population of haemodialyzed patients is by far higher than the prevalence of these diseases in the general population. There are several reasons for this condition. In addition to the character of this treatment there is also the fact that for reasons of immunodeficiency the course proper of infetious hepatitis in haemodialyzed patients is markedly more often terminated by development of the chronic state of the disease with permanent viraemia. These patients become a possible Bource of infection of the other patients and possibly also the staff of haemodialyzation centres. Vaccination against víral hepatitis B reduces the risk of transmission of the disease. However a large proportion of patients is enlisted in the haemodialyzation programme acutely without the possibility of previous vaccination. Some patients who are vaccinated during the predialyzation period do not respond by antibody formation. Víral hepatitis complicates or makes it impossible in some cases to include the patient in the transplantation programme. The prevalence of víral hepatitis in patients in the haemodialyzation programme was significantly reduced despite all mentioned facts. During the last three years a certain stagnation of this positive trend was recorded. New therapeutic possibilities (the use of interferon and new antiviral properations - analogues of nucleoside bases) offer a chance of a further decrease of the number of these serious diseases.
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