Anti-hepatitis C virus screening before surgical procedures: Are patients sufficiently informed?

Öz

Background and Aims: The success rate of hepatitis C virus treatment is ~100% after administration of direct-acting antivirals. However, many patients remain undiagnosed. We determined the prevalence of anti-hepatitis C virus and hepatitis C virus-RNA positivity in patients who were screened for hepatitis C virus before surgical procedures and investigated the rate of awareness of their illness. Materials and Methods: Anti-hepatitis C virus screening data were requested and reviewed from all surgical clinics between 2012 and 2015, and positive patients were evaluated for hepatitis C virus-RNA positivity. Treatment data were collected from the Medula System, an integrated database of the Social Security System. Untreated anti-hepatitis C virus positive patients were contacted by phone and asked whether they were aware of their positivity. Results: A total of 19,627 patients were screened for anti-hepatitis C virus during the study period, of which 158 patients (0.8%) were positive (male: 76; female: 82; age: 58.2 ± 17.6 years). Eighty-three patients were tested for hepatitis C virus-RNA, whereas 75 patients were not. Of the 58 patients who could be contacted, 14 were aware of their anti-hepatitis C virus positivity. The remaining 44 patients were alerted to present to the gastroenterology or infectious diseases outpatient clinic. Conclusion: Among the 19,627 patients screened, 0.8% showed anti-hepatitis C virus positivity, which is similar to the prevalence of anti-hepatitis C virus positivity among the general Turkish population. Almost half of the patients were not tested for hepatitis C virus-RNA, and most of the patients had no information about their anti--hepatitis C virus positivity. These results indicate that pre-surgical anti-hepatitis C virus screening is insufficient for diagnosing new patients.

Anahtar Kelimeler

• Anti-HCV positivity
• HCV-RNA
• serology screening

Cerrahi prosedürler öncesi anti-HCV taraması: Hastalar yeterince bilgi sahibi mi?

Öz

Giriş ve Amaç: Direkt etkili anti viral ilaçların kullanılmasıyla, hepatit C virüsü enfeksiyonunun tedavisinde başarı oranı %100’e yaklaşmıştır. Bununla birlikte, birçok hasta teşhis konulmayı beklemektedir. Biz mevcut çalışmada cerrahi öncesi hepatit C virüsü taraması yapılan hastalarda anti-hepatit C virüsü ve hepatit C virüs-RNA pozitifliğinin prevalansını belirlemeyi ve hastalığından habersiz olan hastaların oranını araştırmayı amaçladık. Gereç ve Yöntem: 2012-2015 yılları arasında cerrahi kliniklerinde anti-hepatit C virüsü pozitif saptanan hastalar, hepatit C virüs-RNA pozitifliği ve tedavi geçmişi açısından araştırıldı. Hepatit C virüs-RNA pozitifliği açısından hastane kayıtları tarandı. Tedavi bilgilerine Medula Sisteminden (Sosyal Güvenlik Sisteminden entegre bir veri tabanı) ulaşıldı. Tedavisiz anti-hepatit C virüsü pozitif hastalara telefonla pozitiflikten haberdar olup olmadıkları soruldu. Bulgular: 4 yıl boyunca 19627 hasta anti-hepatit C virüsü pozitifliği açısından tarandı. 158 hastada (%0.8) anti-hepatit C virüsü pozitif bulundu (76 erkek, 82 kadın; yaş: 58.2 ± 17.6). Hepatit C virüs-RNA 83 hastada bakılmıştı, 75 hastada hepatit C virüs-RNA testi yoktu. Ulaşılabilen 58 hastanın sadece 14’ü anti-hepatit C virüsü pozitif olduğunu biliyordu. Diğer 44 hasta gastroenteroloji veya enfeksiyon hastalıkları polikliniklerine başvurmaları konusunda uyarıldı. Sonuç: Cerrahi girişim uygulanan 19627 hastanın %0.8’inde anti-hepatit C virüsü genel Türkiye nüfusuna benzer oranda pozitif bulunmuştur. Hastaların neredeyse yarısında hepatit C virüs-RNA test edilmemiş ve çoğu hasta hepatit C virüsü-RNA’nın test edilmesi ve izlenmesi gerektiği bilgisine sahip değildir. Anti- hepatit C virüsünün cerrahi öncesi taranması yeni hastaların tespiti açısından yetersiz bulunmuştur.

Anahtar Kelimeler

• Anti-HCV pozitifliği
• HCV-RNA
• serolojik tarama

Kaynakça

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