MERSİN İLİNDE 202 HIV/AIDS OLGUSUNUN EPİDEMIYOLOJİK VE KLİNİK ÖZELLİKLERİNİN DEĞERLENDİRİLMESİ

Öz

Türkiye'de ilk HIV/AIDS olgusu 1985 yılında bildirilmiş ve bu tarihten itibaren olgu sayısı yıllar içinde giderek artmıştır. Bu çalışma ile ilimizdeki HIV/AIDS olgularının epidemiyolojik ve klinik özelliklerinin değerlendirilmesi amaçlanmıştır. Mersin ilinde Ocak 1993-Aralık 2015 tarihleri arasında tanı konan 202 HIV/AIDS olgusuna ait veriler hasta dosyalarından elde edilmiştir. Çalışmaya 158'i (%78.2) erkek olmak üzere toplam 202 HIV/AIDS olgusu alınmıştır. Olguların 136 (%67.3)'sı 24-44 yaş aralığındadır. Olguların 198’i (%98.0) Türk vatandaşı olup 115 (%40.1)'i sosyal güvenceye sahiptir. Mesleklerine göre değerlendirildiğinde en yüksek grup 66 olgu (%32.6) ile işçilerde görülmektedir. En yüksek risk faktörünü 16 (%7.9) olgu ile cinsel ilişki oluşturmaktadır. HIV/AIDS insidansı 2000 yılından yüz binde 2.0 iken, 2015 yılında bu oranın yüz binde 10.9’a çıktığı tespit edilmiştir. Olgular ilk başvurduklarında ortalama CD4+T lenfosit hücre sayısı 39'unda (%19.3) >500'den büyük olduğu saptanmıştır. AIDS aşamasında fırsatçı enfeksiyonların eşlik etmektedir. Viral yük oranları 49'unda (%24.3) <10000 küçüktür. 59 (%29.2) olgu anti-retroviral tedavi almaktadır. Çalışma süresince olguların 11'i (%5.4) hayatını kaybetmiştir. Bölgemizde HIV/AIDS insidansı yıllar itibariye artmaktadır. Çalışmamızda, olgulara ait risk faktörlerine çok büyük oranda ulaşılamamıştır. Tespit edilen olguların risk faktörlerinin belirlenmesi, bu hastalıkla mücadele için planlanacak sağlık hizmetlerine yön verecektir.

Anahtar Kelimeler

• HIV
• AIDS
• epidemiyoloji
• klinik takip

EVALUATION OF EPIDEMIOLOGICAL AND CLINICAL FEATURES OF 202 HIV/AIDS CASES DIAGNOSED IN MERSIN

Öz

The number of cases has steadily increased over the years since 1985 in Turkey. The aim of this study was to evaluate the epidemiological and clinical characteristics of HIV/AIDS cases in our province. Data on 202 HIV/AIDS cases diagnosed between January 1993 and December 2015 in Mersin were obtained from patient files. A total of 202 HIV/AIDS cases, 158 (78.2%) males, were included in the study. 136 (67.3%) of the cases were in the 24-44 age range. 198 (98.0%) of the cases were Turkish citizens and 115 cases (40.1%) had social security 66 cases (32.6%) are the most common workers. The highest risk factor was risky sexual intercourse with 16 (7.9%) cases. While the incidence of HIV/AIDS was 2.0 per hundred thousand in 2000, it was found that this rate increased to 10.9 per hundred thousand in 2015. Opportunistic infections were detected during the AIDS phase. When the patients applied for the first time, the mean number of CD4+ T lymphocyte cells was greater than> 500 in 39 (19.3%). Viral load rates are in the range of <10000 in 49 (24.3%). 59 (29.2%) cases received anti-retroviral therapy. During the study 11 (5.4%) of the cases died. In our region, the incidence of HIV/AIDS has been increasing over the years. Risk factors of cases have not been reached to a large extent. Risk factors are  determined in the shortest time and education and health services should be planned to combat this disease.

Anahtar Kelimeler

• HIV
• AIDS
• epidemiology
• clinical follow

Kaynakça

1. 1. Tümer A, Ünal S. HIV/AIDS epidemiology and protection.Aile ve Toplum Dergisi. 2001;4:1.
2. 2. Dökmetaş İ, Hamidi AA. HIV-Epidemiology. Türkiye Klinikleri Infectious Diseases 2016;9(1):6-11.
3. 3. WHO. [Cited 2019 June 19] Avaliable from: http://. www.who.int/hiv/progressreports/update2014/en/.
4. 4. WHO. HIV/AIDS surveillace in Europe 2017. [Cited 2019 June 19] WHO ISBN 978-92-8905-284-9.
5. 5. WHO. Bulaşıcı Olmayan Hastalıkların Önlenmesine ve Kontrolüne İlişkin Küresel Eylem Planı 2013-2020 [cited 2018 Semptember 1] Available from: ile:///C:/Users/hsl/Desktop/ Bulaşıcı%20Hastalıklar%20Daire%20Başkanlığı%20Istatiksel%20Verileri.html.
6. 6. Centers for Disease Control and Prevention. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMMR 1992; 41(17):1174-203.
7. 7. Babayiğit MA, Bakır B. HIV infection and AIDS: Epidemiology and prevention. TSK Koruyucu Hekimlik Bülteni 2004;(3):11.
8. 8. Taşcı E, Saruhan A. Effects of gender on HIV/AIDS.Uluslararası İnsan Bilimleri Dergisi 2007;(4):1.

9. 9. Shetty A, Maldonado YA. Epidemiology and prevention of HIV infection in children and adolescents. In: Long SS, Pickering LK, Prober CG, eds. Principles and Practice of Pediatric Infectious Diseases, 3rd ed. Philadelphia: Churchill Livingstone. 2008:641-52. Available from: https://doi.org/10.1016/B978-0-7020-3468-8.50115-2
10. 10. TC Ministry of Health HIV / AIDS Data Sheets 01 October1985-30 June 2013 [cited 2014 July 15] Ankara, Turkey Public Health Agency of Infectious Diseases Department of Venereal Diseases Unit Available from: http://hatam.hacettepe.edu.tr./data_june_2013.pdf.
11. 11. T. C. Ministry of Health HIV / AIDS Data Sheets 01 October1985-30 June 2013 [cited 2018 April 13] Ankara, Turkey Public Health Agency of Department of Infectious Diseases. Available from: http://www.thsk.gov.tr/. data 31 _December2016.pdf.
12. 12. WHO. World Health Statistics 2018 Monitoring Healt For The SDGs Sustaınable Development Goalds. [Cited 2018 July 10] ISBN 978-92-4-156558-5. Available from: http://apps.who. int/iris/bitstream/handle/10665/272596/9789241565585-eng.pdf?ua=1.
13. 13. Akdeniz M, Yaman H. Defining HIV/AIDS in primary care . ISSN 1016-5134. Sendrom May-June2008.67.
14. 14. Çelikbaş A, Ergönül Ö, Baykaram N, Eren Ş, Esener H, Eroğlu M, et al. Epidemiologic and clinical characteristics of HIV/AIDS patients in Turkey, where the prevalence is the lowest in the region. Journal of the International Association of Physicians in AIDS Care 2008;7(1):42-5.
15. 15. Kim JM, Cho GJ, Hong SK, Chang KH, Chung JS, Choi YW, et al. Epidemiology and clinical features of HIV infection/AIDS in Korea, Yonsei. Medical Journal 2003;3:363-70.
16. 16. Taşdelen-Fışkın N, Tanyel E, Sarıkaya-Genç H, Tülek N. Evaluation of HIV/AIDS cases. Klimik Dergisi 2009;22(1):18-20.
17. 17. Alp E, Bozkurt İ, Doğanay M. Epidemiological and clinical characteristics of HIV/AIDS patients followed in the Cappadocia region: 18 years of experience. Mikrobiyoloji Bulteni 2011;45(1):125-36.
18. 18. Kaya S, Yılmaz G, Erensoy Ş, Arslan M, Köksal İ. Retrospective analysis of 36 HIV/AIDS cases .Klimik Dergisi 2011;24(1):11-6.
19. 19. Akın H, Bölük G, Akalın H, Oğuz-Ayarcı A, Kazak E, Aslan E, et al. HIV/AIDS: 78 retrospective analysis .Klimik Dergisi 2012;25(3):111-6. 20. Karaosmanoğlu HK, Aydın ÖA, Nazlıcan Ö. Profile of HIV/AIDS Patients in a Tertiary Hospital in Istanbul, Turkey. HIV Clinical Trials 2015;12:104-8. Available from:https://doi.org/10.1310/hct 1202-104
20. 21. Kıyılıoğlu L, Dönmez A. Sexual behaviors that increase the risk of HIV/AIDS. Current Approaches in Psychiatry 2017;9(2):147-62.
21. 22. Güneş N, Elbir TZ, Yazıcı S, Üçışık AC, Doğru A, Ergen P, et al. The epidemiological and clinical characteristics of HIV/AIDS patients admitted to our center. Flora Dergisi 2012;17(2):57-61.
22. 23. Punar M, Uzel S, Cemil EH, Çağatay AA, Özsüt H, Eraksoy H, Dilmener M. HIV infection: analysis of 44 cases. Klimik Dergisi 2000;13(3):94-7.
23. 24. Yaşar KK, Kehriba AH, Kaşıkçı H, Cebeci N, Pehlivanoğlu F, Şengöz G, Karaosmanoğlu HK. Analysis of HIV RNA results of HIV/AIDS patients. DOI:10.4274/Haseki.1251
24. 25. Bayazıt Y. Infectious diseases notification system in Turkey. Turkish Bulletin of Hygiene and Experimental Biology 2005;62(1):73-6.
25. 26. Taylor A, Little K, Zhang X. Estimated perinatal antiretroviral exposures, cases prevented, and infected infants in the era of antiretroviral prophylaxis in the US. Conference on Retroviruses and Opportunistic infections (CROI) 2012. Boston, MA.
26. 27. Yardımcı AC, Fincancı M. The relationship between opportunistic diseases and viral load and CD+4 T cell numbers in HIV-infected patients. Klimik Dergisi 2015;28(1):28-34.
27. 28. Girardi E, Sabin CA, Monforte AA. Late diagnosis of HIV ınfection: epidemiological features, consequences, and strategies to encourage earlier testing. Journal of Acquired Immune Deficiency Syndromes 2007;46(1):3-8.
28. 29. Gülümser Ç, Erbaydar T. HIV/AIDS epidemic in Turkey and use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. Turkish Journal of Obstetrics and Gynecology 2015;12:192-8.
29. 30. Özgüneş N, Elbir TZ, Yazıcı S, Üçışık AC, Doğru A, Ergen P, et al. The epidemiological and clinical characteristics of HIV/AIDS patients admitted to our center. Flora Dergisi 2012;17(2):57-61.