TÜRKİYE'NİN DOĞUSUNDA BİR AMATEM KLİNİĞİNDE ALKOL VE MADDE KULLANAN HASTALARDA, HBsAg, Anti-HBs, Anti-HCV ve Anti-HIV Seroprevalansı: ALTI YILLIK RETROSPEKTİF DEĞERLENDİRME

Year 2022, , 959 - 965, 30.11.2022

Pinar Öner , Seda Yılmaz , Nülüfer Kılıç , Filiz Özsoy

https://doi.org/10.16899/jcm.1189072

Abstract

Amaç
Madde kullanımı ve eşlik eden enfeksiyonlar önemli bir morbidite ve mortalite nedenidir. Ancak, ülkemizde madde kullananlarda bulaşıcı hastalıklar ile ilgili epidemiyolojik çalışmalar kısıtlıdır. Bu çalışmada, Türkiye'de bir AMATEM kliniğinde 2016-2021 yılları arasında yasa dışı madde kullanım sıklığının ve HBsAg, anti-HBs, anti-HCV ve anti-HIV parametrelerinin incelenmesi amaçlanmıştır.
Gereç ve yöntem
6881 alkol ve madde kullanım bağımlısında (AMKB), HBsAg, anti-HBs, anti-HCV ve anti-HIV testleri ELISA tekniği ile çalışılmıştır. İdrar örnekleri, AMKB’lerden alkol, esrar ve kokain metabolitleri açısından analiz edilmiştir. Sonuçlar retrospektif olarak değerlendirilmiştir.
Bulgular
6881 AMKB’nin tümü erkektir ve ortalama yaşları 32.18±9.66 yıldır. Çalışmaya dahil edilen 6881 AMKB’nın 4107’si(%59.7) opioid, 1479’u (%21.5) mix ilaç, 897’si (%13) alkol, diğerleri ise farklı yollarla madde kullanan bağımlılardan oluşmaktadır. Alkol kullananların yaş ortalamaları 45.33±13.03 ve opioid kullanıcılarının ise 29.90±7.13 idi. 2016 yılında opioid bağımlılığı %71,2 iken, 2021 yılında %28,7’ye düşmüştür. Bununla birlikte alkol bağımlılığı 2016 yılında %13,6 iken, 2021 yılında %21,4’e ve mix ilaç kullanımı ise 2016 yılında %8,7 iken 2021 yılında %36,8’e yükselmiştir. Opioid kullanıcıları arasında HBsAg pozitifliği (%56.7), esrar (%2.6) ve mix ilaç kullanıcılarından (%22.3) yüksek olarak tespit edilmiştir. Opioid kullanıcılarının anti-HCV pozitifliği (%69.4), alkol (%9.4), esrar (%2) ve mix ilaç kullanıcılarından (%16.2) yüksek ve istatistiksel olarak anlamlı bulunmuştur (p=0.0001). Opioid kullanıcılarının anti-HBs pozitifliği (%63.1), alkol (%9.9), esrar (%3) ve mix ilaç kullanıcılarından (%21) yüksek ve istatistiksel olarak anlamlı bulunmuştur (p=0.0001). Anti-HIV tüm AMKB hastalarda negatif olarak tespit edilmiştir. HbsAg, anti-HCV, anti-Hbs pozitifliği en yüksek oranlarda 26-30 yaş aralığında belirlenmiştir.
Sonuç
Bu veriler, bölgemizde özellikle 26-30 yaş grubunda yüksek damar içi madde kullanım yaygınlığını ve bu hasta grubunda, yüksek HBV, HCV oranlarını işaret etmektedir.

Keywords

Alkol, madde kullanımı, Hepatit B, Hepatit C, HIV.

SEROPREVALENCE OF HBsAg, Anti-HBs, Anti-HCV, and Anti-HIV IN PATIENTS WITH ALCOHOL AND SUBSTANCE ABUSE IN AN AMATEM CLINIC IN EASTERN TURKIYE: A SIX-YEAR RETROSPECTIVE EVALUATION

Abstract

Aim
Substance abuse and concomitant infections are important causes of morbidity and mortality. Yet, the number of epidemiological studies regarding infectious diseases in people with substance abuse are limited in our country. In this study, the aim was to investigate the frequency of illegal alcohol and substance use in an Alcohol and Drug Research, Treatment and Training Centres (AMATEM) clinic in Turkey as well as the HBsAg, anti-HBs, anti-HCV, and anti-HIV parameters between the years of 2016-2021.
Material and Method
HBsAg, anti-HBs, anti-HCV, and anti-HIV tests were conducted using the ELISA technique in 6881 alcohol and substance use disorder (ASUD). Urine samples from ASUD’s were analyzed for alcohol, cannabis, and cocaine metabolites. The results were evaluated retrospectively.
Results
All of the 6881 ASUD’s were male with a mean age of 32.18±9.66 years. Of the 6881 ASUD’s included in the study, 4107 (59.7%) were opioid addicts; 1479 (21.5%) were mixed drug addicts; 897 (13%) were alcohol addicts; and the rest were addicts with other types of substance use. The mean age of the alcohol users was 45.33±13.03 and the mean age of opioid users was 29.90±7.13. The percentage of opioid addiction in 2016 was 71.2% which dropped to 28.7% in 2021. Meanwhile, the percentage of alcohol addiction was 13.6% in 2016 and increased to 21.4% in 2021; and the percentage of mixed drug use was 8.7% in 2016 and increased to 36.8% in 2021. HBsAg-positivity in opioid users (56.7%) was higher compared to cannabis users (2.6%) and mixed drug users (22.3%). Anti-HCV positivity of opioid users (69.4%) was found to be higher compared to alcohol (9.4%), cannabis (2%), and mixed drug (16.2%) users, and this finding was statistically significant (p=0.0001). Anti-HBs positivity of opioid users (63.1%) was found to be higher compared to alcohol (9.9%), cannabis (3%), and mixed drug (21%) users, and this finding was statistically significant (p=0.0001). Anti-HIV was determined negative in all ASUD’s. The highest rates of HBsAg, anti-HCV and anti-HBs positivity were found in the 26-30 years of age.
Conclusion
These findings indicate a high prevalence of intravenous substance abuse in the 26-30 years age group in our region as well as the high HBV and HCV rates in this patient group.

Keywords

substance abuse, Hepatitis B, Hepatitis C, HIV., Alcohol

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