Retrospective Analysis of Hepatitis B and Hepatitis C Viruses and HIV Infections in Patients Presenting to the General Surgery Clinic and Evaluated Preoperatively

Abstract

Aim: Hepatitis B(HBV), Hepatitis C(HCV) and HIV infections are important parenterally transmitted infections. The aim of this study is to determine the seroprevalence of HBsAg, anti-HBs, anti-HCV and anti-HIV in patients with preoperative preparation. Materials and MethodS: Anti-HBs, HBsAg, anti-HCV, anti-HIV tests with chemiluminescent enzyme immune-assay method in a total of 900 patients applied to the General Surgery Clinic and were evaluated preoperatively by Abbott Architect i1000 immunoassay analyzer (Abbott Diagnostics, Illinois, USA) operated according to the manufacturer's instructions. Anti-HBs titer above 10 IU/mL, serum optical density/”cut-off” control optical density (S/Co) ≥1 in HBsAg, anti HCV and anti-HIV tests were accepted as positive. HBV-DNA and HCV RNA tests were performed with real-time PCR method. Results: Anti-HBs test was found to be reactive in 34.11% and nonreactive in 65.89%. HBsAg positivity was 1.0% (9/900), and anti-HCV positivity was 0.33% (3/900). Anti-HIV positivity and HBsAg-anti-HCV association were not detected. Six patients with HBsAg positivity and one patient with anti-HCV positivity were found incidentally during preoperative examinations. Conclusion:As a result of these data, it can be concluded that cost-effective serological tests for HBV and HCV infections performed in the preoperative period are extremely important in the detection of asymptomatic patients. Preoperative screening is important in terms of early diagnosis of patients before complications such as cirrhosis and HCC develop, enabling treatment, as well as enabling healthcare professionals to increase infection control measures while intervening with infected patients, to be more careful in terms of percutaneous injuries, and to reduce the risk of transmission.

Keywords

• Preoperative preparation
• Hepatitis B (HBV)
• Hepatitis C (HCV)
• HIV
• Seroprevalence

Genel Cerrahi Kliniğine Başvuran ve Ameliyat Öncesi Değerlendirilen Hastalarda Hepatit B, Hepatit C Virüs ve HIV Enfeksiyonlarının Retrospektif Analizi

Abstract

Amaç: Hepatit B (HBV), Hepatit C (HCV) ve HIV enfeksiyonları parenteral yolla bulaşan önemli enfeksiyon etkenleridir. Bu çalışmanın amacı, preoperatif hazırlık yapılan hastalarda HBsAg, anti-HBs, anti-HCV ve anti-HIV seroprevalansını belirlemektir. Gereç ve Yöntem: Genel Cerrahi Kliniğine başvuran ve ameliyat öncesi değerlendirilen toplam 900 hastada anti-HBs, HBsAg, anti-HCV, anti-HIV testleri kemilüminesan enzim immun-assay (KMIA) yöntemi ile Abbott Architect i1000 (Abbott Diagnostics, Illinois, USA) cihazında üretici talimatlarına göre çalışıldı. Anti-HBs titresi 10 IU/mL üzeri olması, HBsAg, anti HCV ve anti-HIV testlerinde serum optik yoğunluk/”cut-off” kontrol optik yoğunluk (S/Co) ≥1 olması pozitif olarak kabul edildi. HBV-DNA ve HCV RNA testleri gerçek zamanlı (real-time) PCR yöntemi ile çalışıldı. Bulgular: 900 hastanın (ortalama yaş=51.8±16.5) 501’i kadın (%55.7), 399’u erkek (%44.3) hastalardan oluşmakta idi. Anti-HBs testi hastaların %34.11’inde reaktif, %65.89’unda nonreaktif olarak saptanmıştır. HBsAg pozitifliği %1.0 (9/900), anti-HCV pozitifliği %0.33 (3/900) olarak belirlenmiştir. Anti-HIV pozitifliği ve HBsAg-anti-HCV birlikteliği saptanmamıştır. HBsAg pozitifliği saptanan altı hasta ve anti-HCV pozitifliği olan bir hasta preoperatif tetkikler sırasında tesadüfen saptanmıştır. Sonuç: Bu veriler ışığında asemptomatik hastaların saptanmasında preoperatif dönemde yapılan HBV ve HCV enfeksiyonlarına yönelik maliyeti düşük serolojik testlerin son derece önemli olduğu sonucuna varılabilir. Preoperatif tarama hastaların siroz, HCC gibi komplikasyonlar gelişmeden erken dönemde tanı konması, tedaviye olanak sağlaması açısından önemli olduğu kadar, sağlık çalışanlarının da enfekte hastaya müdahale ederken enfeksiyon kontrol önlemlerini artırması ve perkütan yaralanmalar açısından daha da dikkatli olunmasına, bulaş riskinin azalmasına olanak sağlamaktadır.

Keywords

• Preoperatif hazırlık
• Hepatit B (HBV)
• Hepatit C (HCV)
• HIV
• Seroprevelans

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