HEPATİT C TARAMASI İÇİN SADECE ANTİ-HCV TESTİ İSTEMEK YETERLİ MİDİR?

Yıl 2024, Cilt: 87 Sayı: 3, 215 - 219, 19.07.2024

Rabia Deniz , Seda Karslı , Ömer Burak Ekinci , İlkana Kalantarova , Alp Atasoy , Mustafa Önel , Ali Ağaçfidan , Filiz Akyüz , Kadir Demir , Fatih Beşışık , Sabahattin Kaymakoğlu

https://doi.org/10.26650/IUITFD.1401786

Öz

Amaç: HCV enfeksiyonu, tedavi edilmediği sürece yüksek morbidite ve mortalite ile ilişkilidir. Bu çalışmada anti-HCV tarama etkinliği ve tedaviye erişim oranları araştırılmıştır.
Gereç ve Yöntem: Bu kesitsel çalışmada Ocak 2014 ile Haziran 2017 tarihleri arasında istenen tüm anti-HCV testleri hastane kayıtlarından tarandı. Hasta görüşmeleri yüz yüze veya telefon ortamında yapıldı.
Bulgular: İstenilen toplam anti-HCV testi sayısı 77783 olup, bunların 1373'ü pozitif çıkmıştır. Bunlardan 266'sı kadın, 222'si erkek; yaş ortalaması 52,81±16,5 yıl olan 488 hastayla görüşme yapılmıştır. Anti-HCV pozitif hastaların 69'una (%14,1) HCV-RNA ile ileri araştırma yapılmadığı saptandı. 309 hastada HCV-RNA pozitifti ve 268'i tedavi almışken (%86), 41'i (%14) tedavi edilmemişti. Tedavisiz kalmanın temel nedenleri ise bilinmeyen (%21), takip edilmeyen hasta (%28) ve hekimin endikasyon göstermemesi (%19) olarak belirlendi.
Sonuç: HCV'nin başarılı bir şekilde eradike edilmesi için anti-anti-HCV testi tek başına yeterli değildir. Hastaların anti-HCV testi sonuçları hakkında bilgilendirilmesi; pozitif ise HCV-RNA testine başvurulması önemlidir. Tedavi edilmeyen hasta sayısının yüksek olduğu göz önüne alındığında, mutlak bir kontrendikasyon olmadığı sürece HCV-RNA pozitif hastalarda tedaviye yönlendirilme teşvik edilmelidir.

Anahtar Kelimeler

Hepatit C enfeksiyonu, anti-HCV antikoru, HCV RNA, tarama

IS ONLY REQUESTING AN ANTI-HCV TEST SUFFICIENT FOR HEPATITIS C SCREENING?

Öz

Objective: Unless treated, a hepatitis C virus (HCV) infection is associated with high morbidity and mortality. The study investigates anti-HCV screening efficacy and treatment access rates for patients.
Material and Method: This cross-sectional study screened all anti-HCV tests requested between January 2014-June 2017 from hospital records. Patient interviews were conducted by telephone-based interview.
Result: The overall number of anti-HCV tests requested was 77,783, 1,373 of which were positive. Among these, the study interviewed 488 patients (266 females, 222 males; mean age=52.81±16.5 years) and analyzed their tests. Further investigation with HCV-RNA had not been done in 69 (14.1%) anti-HCV positive patients. HCV-RNA was positive in 309 patients, 268 of whom were treated (86%), while 41 were not (14%). The main reasons for remaining untreated are: unknown (21%), no patient follow up (28%), or physician didn’t indicate (19%).
Conclusion: In order to successfully eliminate HCV, the anti-HCV test alone is not enough. Informing patients about the results of the anti-HCV test and, if positive, referring them for the HCV-RNA test are important. When considering the high amount of untreated patients, linkage to care should be encouraged in HCV-RNA positive patients unless an absolute contraindication is present.

Anahtar Kelimeler

Hepatitis C virus infection, anti-HCV antibody, HCVRNA, screening

Etik Beyan

The study protocol was approved by the Institutional Research Ethics Committee (Project number 2023/1662), and all patients gave a written informed consent.

Destekleyen Kurum

none

Teşekkür

none

Kaynakça

• Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol 2014;61(1 Suppl):S58-68. [CrossRef] google scholar
• World Health Organization. Global hepatitis report 2017. Geneva SWhttps://www.who.int/publications/i/ item/9789241565455 . google scholar
• Pawlotsky JM. New hepatitis C therapies: the toolbox, strategies, and challenges. Gastroenterology 2014;146(5):1176-92. [CrossRef] google scholar
• World Health Organization. Combating hepatitis B and C to reach elimination by 2030. 28 Feb 19. http://apps.who. int/iris/bitstream/10665/206453/1/WHO_HIV_2016.04_ eng.pdf?ua=1. google scholar
• Idilman R, Razavi H, Robbins-Scott S, Akarca US, Örmeci N, Kaymakoglu S, et al. A micro-elimination approach to addressing hepatitis C in Turkey. BMC Health Serv Res 2020;20(1):249. [CrossRef] google scholar
• Radwan D, Cachay E, Falade-Nwulia O, Moore R, Westergaard R, Mathews WC, et al. HCV Screening and Treatment Uptake Among Patients in HIV Care During 2014-2015. J Acquir Immune Defic Syndr 2019;80(5):559-67. [CrossRef] google scholar
• Naz A, Mukry SN, Naseer I, Shamsi TS. Evaluation of efficacy of serological methods for detection of HCV infection in blood donors: A single centre experience. Pak J Med Sci 2018;34(5):1204-8. [CrossRef] google scholar
• Tozun N, Ozdogan O, Cakaloglu Y, Idilman R, Karasu Z, Akarca U, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect 2015;21(11):1020-6. [CrossRef] google scholar
• Bielen R, Kremer C, Koc OM, Busschots D, Hendrickx D, Vanelderen P, et al. Screening for hepatitis C at the emergency department: Should babyboomers also be screened in Belgium? Liver Int 2019;39(4):667-75. [CrossRef] google scholar
• Orkin C, Leach E, Flanagan S, Wallis E, Ruf M, Foster GR, et al. High prevalence of hepatitis C (HCV) in the emergency department (ED) of a London hospital: should we be screening for HCV in ED attendees? Epidemiol Infect 2015;143(13):2837-40. [CrossRef] google scholar
• Bert F, Rindermann A, Abdelfattah MA, Stahmeyer JT, Rossol S. High prevalence of chronic hepatitis B and C virus infection in a population of a German metropolitan area: a prospective survey including 10 215 patients of an interdisciplinary emergency unit. Eur J Gastroenterol Hepatol 2016;28(11):1246-52. [CrossRef] google scholar
• Crowley D, Van Hout MC, Murphy C, Kelly E, Lambert JS, Cullen W. Hepatitis C virus screening and treatment in Irish prisons from a governor and prison officer perspective-a qualitative exploration. Health Justice 2018;6(1):23. [CrossRef] google scholar
• Buti M, Dominguez-Hernandez R, Casado MA, Sabater E, Esteban R. Healthcare value of implementing hepatitis C screening in the adult general population in Spain. PLoS One 2018;13(11):e0208036. [CrossRef] google scholar