ACİL SERVİSE MÜRACAAT EDEN HASTALARIN HEPATİT A, B VE C SEROPREVALANSININ RETROSPEKTİF ANALİZİ

Öz

Giriş: Viral hepatitler, dünya genelinde yüksek morbidite ve mortaliteye yol açan önemli enfeksiyonlardır. Dünya Sağlık Örgütü (DSÖ), 2030 yılına kadar hepatit B (HBV) ve hepatit C’yi (HCV) elimine etmeyi hedeflemektedir. Türkiye, HBV açısından orta düzey endemisiteye, HCV açısından ise düşük prevalansa sahiptir. Acil servisler hem akut hepatit vakalarının hem de tanı almamış taşıyıcıların saptanmasında stratejik öneme sahiptir. Yöntem: Ocak 2020–Aralık 2024 arasında Balıkesir Üniversitesi Tıp Fakültesi Hastanesi Acil Servisi’nde hepatit A, B veya C’ye yönelik en az bir serolojik test yapılan 4.687 hasta retrospektif olarak incelendi. Dahil edilme kriteri, başvuru sırasında hepatit serolojisi istenmiş olmasıydı. Eksik verili veya mükerrer kayıtlar dışlandı. Demografik veriler, başvuru nedenleri ve laboratuvar sonuçları hastane kayıtlarından elde edildi. Testler ELISA yöntemiyle çalışıldı. İstatistiksel analiz SPSS 26.0 ile yapıldı, p<0,05 anlamlı kabul edildi. Bulgular: Toplam 19.100 test sonucu değerlendirildi. Anti-HAV IgG (%59,9) ve Anti-HBs (%43,9) en yüksek pozitiflik oranlarına sahipti. Aktif enfeksiyon belirteçleri (Anti-HAV IgM, Anti-HBc IgM, Anti-HCV, HBsAg) %1’in altında saptandı. En sık başvuru nedenleri kanama (%48,4), gebelikle ilişkili şikâyetler (%23,9) ve düşme (%13,8) idi. Mevsimsel olarak başvurular en çok sonbaharda gerçekleşti. Hastaların %52,1’i taburcu edildi, %47,9’u ise Kadın Doğum, Ortopedi, Genel Cerrahi ve Gastroenteroloji kliniklerine yatırıldı. Sonuç: Türkiye’de HAV ve HBV’ye karşı yüksek bağışıklık düzeyi, aşılama programlarının başarısını yansıtmaktadır. Aktif enfeksiyon oranlarının düşük olması olumlu bir tablo sunarken, tespit edilen az sayıdaki taşıyıcı, acil servis tabanlı taramaların önemini ortaya koymaktadır. Acil servislerde yaygın tarama stratejilerinin sürdürülmesi, viral hepatit eliminasyon hedeflerine ulaşmada kritik rol oynayabilir.

Anahtar Kelimeler

• viral hepatit
• seroprevelans
• acil servis
• hepatit taraması

RETROSPECTİVE ANALYSİS OF HEPATİTİS A, B, AND C SEROPREVALENCE AMONG PATİENTS PRESENTİNG TO THE EMERGENCY DEPARTMENT

Öz

Introduction: Viral hepatitis is a significant infection that causes high morbidity and mortality worldwide. The World Health Organization (WHO) aims to eliminate hepatitis B (HBV) and hepatitis C (HCV) by 2030. Turkey has moderate endemicity for HBV and low prevalence for HCV. Emergency departments play a strategic role in identifying both acute hepatitis cases and undiagnosed carriers. Method: Between January 2020 and December 2024, 4,687 patients who underwent at least one serological test for hepatitis A, B, or C at the Emergency Department of Balıkesir University Faculty of Medicine Hospital were retrospectively reviewed. The inclusion criterion was that hepatitis serology was requested at the time of presentation. Incomplete or duplicate records were excluded. Demographic data, reasons for presentation, and laboratory results were obtained from hospital records. Tests were performed using the ELISA method. Statistical analysis was performed using SPSS 26.0, with p < 0.05 considered statistically significant. Results: A total of 19,100 test results were evaluated. Anti-HAV IgG (59.9%) and Anti-HBs (43.9%) had the highest positivity rates. Active infection markers (Anti-HAV IgM, Anti-HBc IgM, Anti-HCV, HBsAg) were detected in less than 1% of cases. The most common reasons for presentation were bleeding (48.4%), pregnancy-related complaints (23.9%), and falls (13.8%). Seasonally, the highest number of presentations occurred in the fall. 52.1% of patients were discharged, while 47.9% were admitted to Obstetrics, Orthopedics, General Surgery, and Gastroenterology clinics. Conclusion: The high level of immunity against HAV and HBV in Turkey reflects the success of vaccination programs. While the low rates of active infection present a positive picture, the small number of carriers detected highlights the importance of emergency department-based screening. Continuing widespread screening strategies in emergency departments may play a critical role in achieving viral hepatitis elimination goals.

Anahtar Kelimeler

• viral hepatitis
• seroprevalence
• emergency department
• hepatitis screening

Kaynakça

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