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

Year 2022, Volume: 12 Issue: 2, 373 - 376, 15.03.2022

Ali Duran

https://doi.org/10.16899/jcm.1061392

Cited By: 1

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

References

• 1. Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol 2014;61:45-57.
• 2. Tozun N, Ozdogan O, Cakaloglu Y, Idilman R, Karasu Z, Akarca U, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a field-work TURHEP study. Clin Microbiol Infect 2015;21:1020-6.
• 3. Lingala S, Ghany MG. Natural history of hepatitis C. Gastroenterology Clinics of North America 2015; 44: 717–34.
• 4. Razavi-Shearer D, Gamkrelidze I, Nguyen MH, Chen DS, Van Damme P, Abbas Z, Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study. Lancet Gastroenterol Hepatol 2018;3(6):383–403.
• 5. Madihi S, Syed H, Lazar F, Zyad A, Benani A. A Systematic Review of the Current Hepatitis B Viral Infection and Hepatocellular Carcinoma Situation in Mediterranean Countries. Biomed Res Int. 2020 Jun 10;2020:7027169.
• 6. Yapali S, Tozun N. Epidemiology and viral risk factors for hepatocellular carcinoma in the Eastern Mediterranean countries. Hepatoma Res 2018;4:24
• 7. Petruzziello A. Epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) related hepatocellular carcinoma. Open Virol J 2018;12:26-32.
• 8. WHO. Global health sector strategy on viral hepatitis 2016–2021. Geneva: World Health Organization, 2016.
• 9. Spearman CW, Dusheiko GM, Hellard M, Sonderup M. Hepatitis C. Lancet. 2019;394(10207):1451-1466.
• 10. Beltrami EM, Williams IT, Shapiro CN, Chamberland ME. Risk and management of blood-borne infections in health care workers. Clinical Microbiology Reviews. 2000;13(3):385-407.
• 11. Pehlivanoğlu F, Kart Yaşar K, Şengöz G. Ameliyat olmak üzere başvuran hastalarda hepatit B ve hepatit C seroprevalansı. Viral Hepatit Dergisi. 2011; 17(1): 27-31.
• 12. Onerci Celebi O, Araz Server E, Hamit B, Yiğit Ö. The seroprevalence of hepatitis B, hepatitis C, and human immunodeficiency virus in patients undergoing septoplasty. Braz J Otorhinolaryngol. 2018; 84(1): 34-9.
• 13. Erbay K, Hızel K, Özdil T. Importance of anti-HCV screening before invasive procedures. Klimik Derg. 2019; 32(3): 229-32.
• 14. Karaayak Uzun B, Er H, Güngör S, Pektaş B, Demirci M. Seropositivity of HBsAg, anti-HCV and anti-HIV in preoperative patients. J Clin Exp Invest. 2013;4(4):449-452.
• 15. Sayhan, H. Preoperative Seroprevalence of HbsAg, Anti-HCV, and Anti-HIV in Patients Apply to Anesthesia Clinic. Van Medical Journal. 2015; 22(2):80-83.
• 16. Akpınar O, Akpınar H. Preoperative seroprevalence of HBsAg, Anti-HCV, Anti-HIV in patient with dental surgery under general anesthesia. Sdü Sağlık Bilimleri Enstitüsü Dergisi 2018;9(2): 37-41.
• 17. Weinbaum CM, Williams I, Mast EE, et al. Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. MMWR Recommendations and reports: Morbidity and mortality weekly report Recommendations and reports. 2008;57(Rr-8):1-20.
• 18. Hepatitis C guidance: AASLD-IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus. Hepatology (Baltimore, Md). 2015;62(3):932-54.
• 19. Board S. Risks to health care workers in developing countries. N Engl j Med. 2001;345(7).
• 20. Azap A, Ergönül Ö, Memikoğlu KO, et al. Occupational exposure to blood and body fluids among health care workers in Ankara, Turkey. American Journal of Infection Control. 2005;33(1):48-52.
• 21. Dresing K, Pouwels C, Bonsack S,et al. HCV, HBV and HIV infections: risk for surgeon and staff. Results and consequences of routine screening in emergency patients. Chirurg. 2003;74(11):1026-33.
• 22. Buti M, Domínguez-Hernández R, Casado MÁ, Sabater E, Esteban R. Healthcare value of implementing hepatitis C screening in the adult general population in Spain. PloS one. 2018;13(11):e0208036.
• 23. Ledesma F, Buti M, Domínguez-Hernández R, Casado MÁ, Esteban R. Is the universal population Hepatitis C virus screening a cost-effective strategy? A systematic review of the economic evidence. Revista Española de Quimioterapia. 2020;33(4):240.
• 24. Weber P, Eberle J, Bogner JR, Schrimpf F, Jansson V, Huber-Wagner S. Is there a benefit to a routine preoperative screening of infectivity for HIV, hepatitis B and C virus before elective orthopaedic operations? Infection. 2013;41(2):479-83.