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HIV ve hepatit koinfeksiyonu olan hastaların değerlendirilmesi, 5 yıllık deneyim

Yıl 2024, Cilt: 46 Sayı: 4, 521 - 527, 16.07.2024
https://doi.org/10.20515/otd.1446289

Öz

Bu çalışmada Human Immunodeficiency Virus (HIV) infeksiyonu nedeniyle polikliniğimizde takip edilen hastalarda hepatit prevalansını görmek amaçlandı. Ocak 2018-Aralık 2022 yılları arasında Dr. Lütfi Kırdar Kartal Şehir Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji polikliniği’nde takip edilen 530 HIV pozitif hasta hepatit serolojisi açısından retrospektif olarak incelendi. Hastalara ilk başvuru sırasında hepatit A virüs (HAV) immunglobulin (Ig) G, hepatit B yüzey antijeni (HBsAg), hepatit B kor antikoru (anti-HBc), hepatit B yüzey antijenine karşı antikor (anti-HBs) ve hepatit C virus antikoru (anti HCV) bakıldı. Hepatit A infeksiyonuna karşı 412 (%77.8) hastanın bağışıklığı mevcuttu. On sekiz (%3.4) hastada HBsAg pozitifliği, 73 (%13.8) hastada anti-HBc ve anti-HBs pozitif tespit edildi, 47 (% 8.9) hastada izole anti-HBc pozitifliği mevcuttu. Aşılama sonrası 180 (%34.0) hastada anti-HBs pozitifliği gelişmişti. Hepatit B ile hiç karşılaşmayan 212 (%40.0) hasta vardı. Dört (%0.7) hastada anti HCV pozitifliği vardı. HIV pozitifliği ile takip ve tedavisine başlanan her hastanın hepatit B virüsü (HBV) ve hepatit C virüsü (HCV) açısından taranması, HIV/HBV veya HIV/HCV ko-infeksiyonu tespit edilen hastalarda sirozu ve olası karaciğer kanseri riskini önlemek için uygun tedavilerin seçilmesi, HBV ‘ye karşı bağışıklığı olmayanların aşılanması, pediatrik yaş grubu dışında geçirildiğinde fulminan seyredebilen hepatit A’ya karşı bağışıklığın tespiti, gereğinde aşılanmalarının sağlanması önemlidir.

Etik Beyan

Çalışma, S.B.Ü. Dr. Lütfi Kırdar Kartal Şehir Hastanesi Klinik Araştırmalar Etik Kurulu tarafından 14.12.2022 tarih ve 2022/514/239/9 karar numarasıyla onaylandı.

Destekleyen Kurum

Destekleyen kurum yoktur

Kaynakça

  • 1. World Health organization (WHO). https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/strategic-information/hiv-data-and-statistics.: [erişim 16 Ekim 2023].
  • 2. Tekin S, Çınar G, Barkay O, Çelik İ. [HBV and HCV coinfection in patients living with HIV]. Klimik Derg. 2023;36(1):3-9.
  • 3. Sulkowski MS. Viral hepatitis and HIV coinfection. J Hepatol. 2008;48(2):353-67.
  • 4. 4-Vento S, Garofano T, Renzini C, et al. Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C. N Engl J Med. 1998;338(5):286-90.
  • 5. 5- Sun HY, Kung HC, Ho YC, et al. Seroprevalence of hepatitis A virus infection in persons with HIV infection in Taiwan: implications for hepatitis A vaccination. Int J Infect Dis. 2009;13(5):e199-e205.
  • 6. Raczyńska A, Wickramasuriya NN, Kalinowska-Nowak A, et al. Acute Hepatitis A Outbreak Among Men Who Have Sex With Men in Krakow, Poland; February 2017-February 2018. Am J Mens Health. 2019;13(6):1557988319895141.
  • 7. Saag MS, Gandhi RT, Hoy JF, et al. Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2020 Recommendations of the International Antiviral Society-USA Panel. JAMA. 2020;324(16):1651-69.
  • 8. EuropeanAIDS Clinical Society (EACS Guidelines. PART IV 114.Version 11.1. October 2022 9. Soriano V, Moreno-Torres V, Mendoza C, et al. Viral hepatitis in persons living with HIV in the post-COVID era. AIDS Rev. 2023;25(1):1-13.
  • 10. 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; 21:1020–6.
  • 11. İnci A. HIV’le infekte olgularda hepatit B ve hepatit C seroprevalansının araştırılması. Klimik Dergisi, 2018, 31.1: 34.
  • 12. Nemr WA, Nashwa RK. Development of a multiplex polymerase chain reaction assay for detection of hepatitis C virus, hepatitis B virus, and human immunodeficiency virus 1. World J Virol. 2024;13(1):88164.
  • 13. Gilson RJ, Hawkins AE, Beecham MR, et al.Interractions between HIV and hepatitis B virus inhomosexual men: effects on the natural history of infection. AIDS 1997; 11: 597-606.
  • 14. Gökengin D, Teymur Noori T, Andrea Alemany A et al. Sexually Transmitted Infections Prevention strategies for sexually transmitted infections, HIV, and viral hepatitis in Europe. The Lancet Regional Health- Europe 2023;34: 100738 Published Online 26 October 2023 https://doi.org/10. 1016/j.lanepe.2023. 100738
  • 15. Logemann S, Blinkhorn R. Acute Viral Hepatitis Due to Co-infection With Hepatitis A and Hepatitis B in an Intravenous Drug User. Cureus. 2023;15(4): e37179.
  • 16. Fujiwara K, Kojima H, Yasui S, et al. Hepatitis A viral load in relation to severity of the infection. J Med Virol. 2011;83(2):201-07.
  • 17. Bogdanić N, Begovac J, Močibob L, et al. Hepatitis A Outbreak in Men Who Have Sex with Men Using Pre-Exposure Prophylaxis and People Living with HIV in Croatia, January to October 2022. Viruses. 2022;15(1):87.
  • 18. Lin KY, Sun HY, Huang YS, et al. Durability of serologic responses to inactivated hepatitis A virus vaccination among people living with HIV following acute hepatitis A outbreak: a 5-year follow-up study. Emerg Microbes Infect. 2023;12(2):2239946.
  • 19. Tsai PH, Tsai MS, Chiang YH, et al. Effectiveness of hepatitis A vaccination among people living with HIV in Taiwan: Is one dose enough?J Microbiol Immunol Infect. 2022;55(1):18-25.
  • 20. T. C. Sağlık Bakanlığı, Türkiye Viral Hepatit Önleme ve Kontrol Programı 2018-2023.Ankara-2018. https://hsgm.saglik.gov.tr/depo/Yayinlarimiz/Programlar/Turkiye_Viral_Hepatit_Onleme_ve_Kontrol_Programi_2018-2023.
  • 21. Şenoğlu S, Yeşilbağ Z. HIV/AIDS Hastalarında Hepatit A Seroprevalansı ve İlişkili Risk Faktörleri. Klimik Dergisi, 2020, 33.2: 128-31.
  • 22. Omland LH, Weis N, Skinhøj P, et al. Impact of hepatitis B virus co-infection on response to highly active antiretroviral treatment and outcome in HIV-infected individuals: a nationwide cohort study. HIV Med. 2008;9(5):300-06.
  • 23. Türkiye Hepatit B Tanı ve Tedavi Kılavuzu – 2023. https://www.vhsd.org/tr/hepatit-b-klavuzu-2-23_a.html.
  • 24. Rockstroh JK. Influence of viral hepatitis on HIV infection. J Hepatol. 2006;44(1 Suppl):S25-S27.
  • 25. Kirk GD, Mehta SH, Astemborski J, et al. HIV, age, and the severity of hepatitis C virus-related liver disease: a cohort study. Ann Intern Med. 2013;158(9):658-66.
  • 26. Ng V, Saab S. Effects of a sustained virologic response on outcomes of patients with chronic hepatitis C. Clin Gastroenterol Hepatol. 2011;9(11):923-30.

Evaluation of patients with HIV and hepatitis co-infection, 5 years of experience

Yıl 2024, Cilt: 46 Sayı: 4, 521 - 527, 16.07.2024
https://doi.org/10.20515/otd.1446289

Öz

This study aimed to see the prevalence of hepatitis in patients followed in our outpatient clinic due to Human Immunodeficiency Virus (HIV) infection. Between January 2018 and December 2022, 530 HIV-positive patients followed in the Infectious Diseases and Clinical Microbiology outpatient clinic of Dr. Lütfi Kırdar Kartal City Hospital were retrospectively examined in terms of hepatitis serology. At the time of initial admission, patients were evaluated with hepatitis A virus (HAV) immunoglobulin (Ig) G, hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), antibody against hepatitis B surface antigen (anti-HBs) and hepatitis C virus antibody (anti HCV). Four hundred twelve (77.8%) patients were immune to hepatitis A infection. HBsAg positivity was detected in 18 (3.4%) patients, anti-HBc and anti-HBs positivity was detected in 73 (13.8%) patients, and isolated anti-HBc positivity was present in 47 (8.9%) patients. Anti-HBs positivity developed in 180 (34.0%) patients after vaccination. There were 212 (40.0%) patients who had never exposed to Hepatitis B. Four (0.7%) patients were anti-HCV positive. Screening every HIV positive patient who begins follow-up and treatment for hepatitis B virus (HBV) and hepatitis C virus (HCV), selecting appropriate treatments to prevent cirrhosis and possible liver cancer risk in patients with HIV/HBV or HIV/HCV co-infection is crucial, It is important to vaccinate those who are not immune to HBV, to determine immunity against hepatitis A, which can be fulminant when transmitted outside the pediatric age group, and to ensure that they are vaccinated when necessary.

Kaynakça

  • 1. World Health organization (WHO). https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/strategic-information/hiv-data-and-statistics.: [erişim 16 Ekim 2023].
  • 2. Tekin S, Çınar G, Barkay O, Çelik İ. [HBV and HCV coinfection in patients living with HIV]. Klimik Derg. 2023;36(1):3-9.
  • 3. Sulkowski MS. Viral hepatitis and HIV coinfection. J Hepatol. 2008;48(2):353-67.
  • 4. 4-Vento S, Garofano T, Renzini C, et al. Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C. N Engl J Med. 1998;338(5):286-90.
  • 5. 5- Sun HY, Kung HC, Ho YC, et al. Seroprevalence of hepatitis A virus infection in persons with HIV infection in Taiwan: implications for hepatitis A vaccination. Int J Infect Dis. 2009;13(5):e199-e205.
  • 6. Raczyńska A, Wickramasuriya NN, Kalinowska-Nowak A, et al. Acute Hepatitis A Outbreak Among Men Who Have Sex With Men in Krakow, Poland; February 2017-February 2018. Am J Mens Health. 2019;13(6):1557988319895141.
  • 7. Saag MS, Gandhi RT, Hoy JF, et al. Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2020 Recommendations of the International Antiviral Society-USA Panel. JAMA. 2020;324(16):1651-69.
  • 8. EuropeanAIDS Clinical Society (EACS Guidelines. PART IV 114.Version 11.1. October 2022 9. Soriano V, Moreno-Torres V, Mendoza C, et al. Viral hepatitis in persons living with HIV in the post-COVID era. AIDS Rev. 2023;25(1):1-13.
  • 10. 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; 21:1020–6.
  • 11. İnci A. HIV’le infekte olgularda hepatit B ve hepatit C seroprevalansının araştırılması. Klimik Dergisi, 2018, 31.1: 34.
  • 12. Nemr WA, Nashwa RK. Development of a multiplex polymerase chain reaction assay for detection of hepatitis C virus, hepatitis B virus, and human immunodeficiency virus 1. World J Virol. 2024;13(1):88164.
  • 13. Gilson RJ, Hawkins AE, Beecham MR, et al.Interractions between HIV and hepatitis B virus inhomosexual men: effects on the natural history of infection. AIDS 1997; 11: 597-606.
  • 14. Gökengin D, Teymur Noori T, Andrea Alemany A et al. Sexually Transmitted Infections Prevention strategies for sexually transmitted infections, HIV, and viral hepatitis in Europe. The Lancet Regional Health- Europe 2023;34: 100738 Published Online 26 October 2023 https://doi.org/10. 1016/j.lanepe.2023. 100738
  • 15. Logemann S, Blinkhorn R. Acute Viral Hepatitis Due to Co-infection With Hepatitis A and Hepatitis B in an Intravenous Drug User. Cureus. 2023;15(4): e37179.
  • 16. Fujiwara K, Kojima H, Yasui S, et al. Hepatitis A viral load in relation to severity of the infection. J Med Virol. 2011;83(2):201-07.
  • 17. Bogdanić N, Begovac J, Močibob L, et al. Hepatitis A Outbreak in Men Who Have Sex with Men Using Pre-Exposure Prophylaxis and People Living with HIV in Croatia, January to October 2022. Viruses. 2022;15(1):87.
  • 18. Lin KY, Sun HY, Huang YS, et al. Durability of serologic responses to inactivated hepatitis A virus vaccination among people living with HIV following acute hepatitis A outbreak: a 5-year follow-up study. Emerg Microbes Infect. 2023;12(2):2239946.
  • 19. Tsai PH, Tsai MS, Chiang YH, et al. Effectiveness of hepatitis A vaccination among people living with HIV in Taiwan: Is one dose enough?J Microbiol Immunol Infect. 2022;55(1):18-25.
  • 20. T. C. Sağlık Bakanlığı, Türkiye Viral Hepatit Önleme ve Kontrol Programı 2018-2023.Ankara-2018. https://hsgm.saglik.gov.tr/depo/Yayinlarimiz/Programlar/Turkiye_Viral_Hepatit_Onleme_ve_Kontrol_Programi_2018-2023.
  • 21. Şenoğlu S, Yeşilbağ Z. HIV/AIDS Hastalarında Hepatit A Seroprevalansı ve İlişkili Risk Faktörleri. Klimik Dergisi, 2020, 33.2: 128-31.
  • 22. Omland LH, Weis N, Skinhøj P, et al. Impact of hepatitis B virus co-infection on response to highly active antiretroviral treatment and outcome in HIV-infected individuals: a nationwide cohort study. HIV Med. 2008;9(5):300-06.
  • 23. Türkiye Hepatit B Tanı ve Tedavi Kılavuzu – 2023. https://www.vhsd.org/tr/hepatit-b-klavuzu-2-23_a.html.
  • 24. Rockstroh JK. Influence of viral hepatitis on HIV infection. J Hepatol. 2006;44(1 Suppl):S25-S27.
  • 25. Kirk GD, Mehta SH, Astemborski J, et al. HIV, age, and the severity of hepatitis C virus-related liver disease: a cohort study. Ann Intern Med. 2013;158(9):658-66.
  • 26. Ng V, Saab S. Effects of a sustained virologic response on outcomes of patients with chronic hepatitis C. Clin Gastroenterol Hepatol. 2011;9(11):923-30.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Bulaşıcı Hastalıklar
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Suzan Şahin 0000-0002-7124-3363

Bülent Kaya 0000-0003-3027-5868

Yayımlanma Tarihi 16 Temmuz 2024
Gönderilme Tarihi 3 Mart 2024
Kabul Tarihi 1 Temmuz 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 46 Sayı: 4

Kaynak Göster

Vancouver Şahin S, Kaya B. HIV ve hepatit koinfeksiyonu olan hastaların değerlendirilmesi, 5 yıllık deneyim. Osmangazi Tıp Dergisi. 2024;46(4):521-7.


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