| Objective: To systematically evaluate the risk factors for hemodialysis patients with hepatitis C virus infection in China,and provide the reference for clinical prevention and treatment of HCV infection in HD patients.Methods: Articles related with hepatitis C virus infection among hemodialysis patients in China were retrieved from PubMed,Embase,The Cochrane library,Web of Science,CBM,CNKI,Wanfang databasea and VIP database,the time span between construction of database and December 2017.According to the in clusion and exclusion criteria,In accordance with the inclusion exclusion criteria,the literature was screened for comparison of HCV infection and non-infection HCV in HD patients,and the literature quality was evaluated and the data were extracted.All data were conducted Meta-analysis with RevMan5.3 software provided by The Cochrane Collaboration.Results: A total of 29 cross-sectional studies(CSS)and case-control studies(CCS)involving 6695 HD patients,in which 1542 were HCV infection patients,a total of 14 risk factors were involved.10 factors were statistically significant between HD patients with or without HCV infection: Medical factors were as follows: average hemodialysis time(CSS)MD=25.24,95%CI[18.74,31.75],P < 0.00001,average hemodialysis time(CCS)MD=44.89,95%CI[3.72,86.07],P=0.03.Average hemodialysis time(CSS)SMD=1.02,95%CI[0.64,1.41],P<0.00001,average hemodialysis frequency(CSS)SMD=12.25,95%CI[10.90,13.60],P<0.00001,average hemodialysis frequency(CCS)SMD=0.448,95%CI[0.23,0.74],P=0.0002.Dialyzer reuse OR=10.60,95%CI[7.44,15.09],P<0.00001;Blood transfusion history(CSS)OR=5.28,95%CI[3.17,8.80],P < 0.00001,Blood transfusion history(CCS)OR=4.14,95%CI[2.38,7.18],P<0.00001;Blood transfusion volume(CSS)SMD=0.70,95%CI[0.47,0.94],P<0.00001,Blood transfusion volume(CCS)SMD=0.97,95%CI[0.12,1.82],P=0.03;The average transfusion tims(CSS)MD=7.77,95%CI[4.55,10.99],P<0.00001,The average transfusion tims(CCS)MD=24.57,95%CI[5.07,44.07],P=0.01.History of kidney transplantation(CSS)OR=5.94,95%CI[4.03,8.76],P<0.00001,history of kidney transplantation(CCS)OR=5.85,95%CI[2.28,15.02],P=0.0002.Surgical trauma history(CSS)OR=3.69,95%CI[1.02,13.36],P=0.05,Surgical trauma history(CCS)OR=2.41,95%CI[1.42,4.09],P=0.001.History of other types of hepatitis virus infection(CSS)OR=2.33,95%CI[1.42,3.83],P=0.0009.Abnormal history of liver enzymes(CSS)OR=4.31,95%CI[2.09,8.86],P<0.0001.2 factors were no statistically significant between HD patients with or without HCV infection: mean age(CSS)MD=0.47,95%CI[-1.28,2.22],P=0.60,mean age(CCS)MD=0.74,95%CI[-1.10,2.58],P=0.43.Peritoneal dialysis OR=1.91,95%CI[0.61,5.98],P=0.27.2 factors were inconsistent statistical results between HD patients with or without HCV infection in two types of literature: Gender(CSS)OR=1.18,95%CI[1.02,1.36],P=0.02,gender(CCS)OR=1.20,95%CI[0.76,1.91],P=0.43.Albumin(CSS)MD=-7.22,95%CI[-22.62,8.17],P=0.36,albumin(CCS)MD=-8.76,95%CI[-9.48,-8.04],P<0.00001.Conclusion: Gender,age and peritoneal dialysis have no definite effect on HCV infection in HD patients.Hemodialysis time,the strength of dialysis,dialyser reuse,history of blood transfusion,blood transfusion volume,blood transfusion times,history of renal transplantation,trauma,surgery,combined with other types of hepatitis virus infection for HCV infection in HD patients can be considered as early warning indicators.Hepatic enzyme abnormality and HCV infection of HD patients were the mutual influencing factors,and suggested as the monitoring indicator. |
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