Siirt İlinde Yüksek Hepatit Delta Antikoru Sıklığı

Öz

Amaç: Eş zamanlı hepatit delta virüs (HDV) enfeksiyonu varlığı kronik hepatit B (KHB) ilişkili karaciğer hastalığının seyrini olumsuz yönde etkilemektedir. Bu çalışmada Siirt ilinde hepatit B virusu (HBV) ile kronik olarak enfekte olan hepatit gelişmiş ve gelişmemiş olgularda delta antikoru (anti-HDV) sıklığının belirlenmesi ve HDV koenfeksiyonu varlığının klinik etkilerinin irdelenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif kesitsel çalışmaya Şubat 2017-Şubat 2018 tarihleri arasında Siirt Devlet Hastanesi Enfeksiyon Hastalıkları polikliniğine başvuran Anti-HDV testi bakılmış 288’i HBV ile kronik olarak enfekte, 174’ü KHB gelişmiş toplam 462 olgu dahil edildi. HBV deoksiribonükleik asit (DNA), hepatit B “e” antijeni (HBeAg), alanin aminotransferaz (ALT), HDV ribonükleik asit (RNA) sonuçları ile siroz ve hepatosellüler karsinom (HCC) durumu ile ilgili verilere retrospektif olarak ulaşılmıştır. Çalışmaya alınan hastalar Anti-HDV pozitif (n=128) ve negatif (n=334) olmak üzere iki gruba ayrıldı. KHB, siroz ve HCC sıklığı gruplar arasında karşılaştırılmıştır. Bulgular: Toplam 462 olgunun 205’i (%44,4) kadın, 257’si erkek (%55,6) olup, medyan yaşı 37 (çeyrekler arası aralık (IQR) 26 ila 49) idi. Anti-HDV pozitifliği saptanan toplam 128 (%27,8) olgunun 32’sinde HDV RNA çalışılabilmiş ve 9’unda pozitif olarak saptanmıştır. Çalışmamızda nonsirotik ve sirotik olgulardaki anti-HDV sıklığının sırasıyla %26,2 ve %68,8 olduğu görülmüştür. Anti-HDV pozitif olgularda KHB, siroz ve HCC sıklığının Anti-HDV negatif olgulara göre anlamlı oranda yüksek olduğu görülmüştür (p=0,003, p=0,001, p=0,021). Sonuç: Bu çalışmada elde edilen verilere dayanarak, Siirt ilinde HBV ile enfekte olgularda Anti-HDV sıklığının Türkiye ortalamasının (%5,2) çok üzerinde olduğu ve Anti-HDV pozitif olguların KHB, siroz ve HCC gelişimi açısından Anti-HDV negatif olgulara oranla daha yakın izlem gerektirdiği söylenebilir.

Anahtar Kelimeler

• Hepatit delta virüs
• hepatosellüler karsinom
• kronik hepatit B
• siroz

High Prevalence of Hepatitis Delta Antibody in Siirt Province

Öz

Aim: The presence of concomitant hepatitis delta virus (HDV) infection negatively affects the course of chronic hepatitis B (CHB) related liver disease. In this study, it was aimed to determine the frequency of delta antibody (anti-HDV) and to investigate the clinical effects of hepatitis delta virus (HDV) coinfection in patients with CHB and who are chronically infected with hepatitis B virus (HBV) in Siirt. Material and Methods: In this retrospective cross-sectional study, a total of 462 cases, 288 of whom were chronically infected with HBV and 174 with CHB, who were admitted to the Siirt State Hospital Infectious Diseases outpatient clinic between February 2017 and February 2018, were included. Data on HBV deoxyribonucleic acid (DNA), hepatitis “e” antigen (HBeAg), alanine aminotransferase (ALT), HDV ribonucleic acid (RNA) results and cirrhosis and hepatocellular carcinoma (HCC) status were accessed retrospectively. The patients included in the study were divided into two groups as anti-HDV positive (n=128) and negative (n=334). The frequency of CHB, cirrhosis and HCC were compared between the groups. Results: Of the 462 cases in total, 205 (44.4%) were female and 257 (55.6%) were male and the median age was 37 (interquartile range (IQR): 26 to 49). Anti-HDV was positive in 128 (27.8%) of these cases, only 32 cases were examined for HDV RNA and 9 were positive. In our study, the frequency of anti-HDV in non-cirrhotic and cirrhotic cases was found to be 26.2% and 68.8%, respectively. It was observed that the frequency of CHB, cirrhosis and HCC were significantly higher in anti-HDV positive cases compared to anti-HDV negative cases (p=0.003, p=0.001, p=0.021). Conclusion: Based on the data obtained from the present study, we consider that, in Siirt province, the prevalence of anti-HDV in the patients infected with HBV is much higher than average for Turkey. Additionally, it can be said that anti-HDV positive cases require closer monitoring compared to anti-HDV negative cases in terms of CHB, cirrhosis and HCC development.

Anahtar Kelimeler

• Hepatitis delta virus
• chronic hepatitis B
• cirrhosis
• hepatocellular carcinoma

Kaynakça

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