HIV ve hepatit koinfeksiyonu olan hastaların değerlendirilmesi, 5 yıllık deneyim

Year 2024, Volume: 46 Issue: 4, 521 - 527, 16.07.2024

Suzan Şahin Bülent Kaya

https://doi.org/10.20515/otd.1446289

Abstract

Bu çalışmada Human Immunodeficiency Virus (HIV) infeksiyonu nedeniyle polikliniğimizde takip edilen hastalarda hepatit prevalansını görmek amaçlandı. Ocak 2018-Aralık 2022 yılları arasında Dr. Lütfi Kırdar Kartal Şehir Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji polikliniği’nde takip edilen 530 HIV pozitif hasta hepatit serolojisi açısından retrospektif olarak incelendi. Hastalara ilk başvuru sırasında hepatit A virüs (HAV) immunglobulin (Ig) G, hepatit B yüzey antijeni (HBsAg), hepatit B kor antikoru (anti-HBc), hepatit B yüzey antijenine karşı antikor (anti-HBs) ve hepatit C virus antikoru (anti HCV) bakıldı. Hepatit A infeksiyonuna karşı 412 (%77.8) hastanın bağışıklığı mevcuttu. On sekiz (%3.4) hastada HBsAg pozitifliği, 73 (%13.8) hastada anti-HBc ve anti-HBs pozitif tespit edildi, 47 (% 8.9) hastada izole anti-HBc pozitifliği mevcuttu. Aşılama sonrası 180 (%34.0) hastada anti-HBs pozitifliği gelişmişti. Hepatit B ile hiç karşılaşmayan 212 (%40.0) hasta vardı. Dört (%0.7) hastada anti HCV pozitifliği vardı. HIV pozitifliği ile takip ve tedavisine başlanan her hastanın hepatit B virüsü (HBV) ve hepatit C virüsü (HCV) açısından taranması, HIV/HBV veya HIV/HCV ko-infeksiyonu tespit edilen hastalarda sirozu ve olası karaciğer kanseri riskini önlemek için uygun tedavilerin seçilmesi, HBV ‘ye karşı bağışıklığı olmayanların aşılanması, pediatrik yaş grubu dışında geçirildiğinde fulminan seyredebilen hepatit A’ya karşı bağışıklığın tespiti, gereğinde aşılanmalarının sağlanması önemlidir.

Keywords

Human Immunodeficiency Virus (HIV), Hepatit A, Hepatit B, Hepatit C

Ethical Statement

Çalışma, S.B.Ü. Dr. Lütfi Kırdar Kartal Şehir Hastanesi Klinik Araştırmalar Etik Kurulu tarafından 14.12.2022 tarih ve 2022/514/239/9 karar numarasıyla onaylandı.

Supporting Institution

Destekleyen kurum yoktur

Evaluation of patients with HIV and hepatitis co-infection, 5 years of experience

Abstract

This study aimed to see the prevalence of hepatitis in patients followed in our outpatient clinic due to Human Immunodeficiency Virus (HIV) infection. Between January 2018 and December 2022, 530 HIV-positive patients followed in the Infectious Diseases and Clinical Microbiology outpatient clinic of Dr. Lütfi Kırdar Kartal City Hospital were retrospectively examined in terms of hepatitis serology. At the time of initial admission, patients were evaluated with hepatitis A virus (HAV) immunoglobulin (Ig) G, hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), antibody against hepatitis B surface antigen (anti-HBs) and hepatitis C virus antibody (anti HCV). Four hundred twelve (77.8%) patients were immune to hepatitis A infection. HBsAg positivity was detected in 18 (3.4%) patients, anti-HBc and anti-HBs positivity was detected in 73 (13.8%) patients, and isolated anti-HBc positivity was present in 47 (8.9%) patients. Anti-HBs positivity developed in 180 (34.0%) patients after vaccination. There were 212 (40.0%) patients who had never exposed to Hepatitis B. Four (0.7%) patients were anti-HCV positive. Screening every HIV positive patient who begins follow-up and treatment for hepatitis B virus (HBV) and hepatitis C virus (HCV), selecting appropriate treatments to prevent cirrhosis and possible liver cancer risk in patients with HIV/HBV or HIV/HCV co-infection is crucial, It is important to vaccinate those who are not immune to HBV, to determine immunity against hepatitis A, which can be fulminant when transmitted outside the pediatric age group, and to ensure that they are vaccinated when necessary.

Keywords

Human Immunodeficiency Virus (HIV), Hepatitis A, Hepatitis B, Hepatitis C

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