2020年南部某醫院血液透析室病人C型肝炎抗體陽轉處理流程經驗分享

Experience of Seroconversion of Hepatitis C Virus Antibody Among Hemodialysis Patients, 2020

長期接受血液透析的末期腎臟病人，相較於一般族群，有較高的C型肝炎發生率及盛行率。為及早偵測到疑似個案，「醫療機構血液透析感染管制措施指引」已建議，透析病人每6至12個月檢查C型肝炎抗體。2020年，南部某醫院血液透析室共3名病人在同次定期檢查中，C型肝炎抗體均於1年內陽轉，屬疑似急性C型肝炎群聚事件。衛生單位接獲通報，即會同院方展開調查。該院隨即邀集跨科部專家，針對案例進行研判與制訂後續處理計畫，同時制訂C型肝炎抗體陽轉處理流程。惟之後3名病人的C型肝炎核酸檢驗均為陰性。本次經驗可提供血液透析場域照護人員處理類似事件之參考。

End-stage renal disease patients who receive long-term hemodialysis have a higher incidence and prevalence of hepatitis C virus infection than the general population. It has been recommended that hemodialysis patients should check for hepatitis C virus antibodies (HCV-Ab) every 6 to 12 months to detect suspected cases. This article described an incident in 2020 with three long-term hemodialysis patients in Southern Taiwan who were found to have HCV-Ab seroconversion within one year, leading to a presumed hospital outbreak. Health authorities and the hospital investigated the scale of this outbreak and transmission route, and implemented infection control measures. The hospital immediately convened an interdisciplinary team to assess the infection status of the patients and determine the follow-up measures. A strategy of managing hemodialysis patients with HCV-Ab seroconversion was also established. In the end, hepatitis C virus nucleic acid tests of the three patients were all negative. This experience can provide a reference for the personnel in hemodialysis units to manage similar events.