Kronik HCV’li hemodiyaliz hastalarinda occult HBV infeksiyonu sıklığı
The prevalence of occult HBV infection in hemodialysis patients with chronic HCV infection
Özet
Giriş ve amaç: Occult HBV infeksiyonu, HBsAg’nin tespit edilemedigi HBV infeksiyonun varligi ile tanımlanir. Kronik hepatitis C, HCC ve hemodiyaliz Hastalarında, kriptojenik karaciger hastalığı olanlarda, ilaç injeksiyon kullanicilari ve HIV’lilerde, ayrica sik kan transfüzyonu yapi- lanlar ve kan donörlerinde occult HBV infeksiyonunun prevalansinin yüksek olduğu belirtilmektedir. Biz bu çalışmada, kronik HCV’li hemodiyaliz Hastalarındaki occult HBV infeksiyonun prevalansini ve klinik etkilerini araştırmayı hedefledik. Gereç ve yöntem: HBsAg’si negatif, anti-HCV’si pozitif olan 50 kronik hemodiyaliz hastası çalışmaya alındı. Bu hastalar HCV-RNA PCR sonuçlarına göre HCV-RNA pozitif ve HCV-RNA negatif olarak iki gruba ayrıldı. Her iki hasta grubunda HBVDNA duyarli PCR yöntemi ile arastirildi. Bulgular: HCV-RNA pozitif 22 hasta ve HCV-RNA negatif 28 hasta gruplarinin hiçbirinde serumda PCR yöntemi ile HBV-DNA tespit edilemedi. Hastaların ortalama yaşlari HCV-RNA pozitif grupta 47.2±17 ve HCV-RNA negatif grupta 39.6±15.6 idi. Sonuç: Bölgemizde, kronik HCV’li hemodiyaliz hastalari nda occult HBV infeksiyonu prevalansi yüksek degildir. Çalışmamızdaki bu sonucu, bölgemizdeki HBsAg pozitiflik orani (%8-10) ile HBV mutantlarinin görülme sikliginin etkilesimini dikkate alarak değerlendirmek gerekir. Ayrıca, halen standardize edilmemis HBV-DNA PCR yöntemlerinin sensitivite ve spesifitelerini de gözden geçirmenin ve buna göre ortak bir tanı yöntemi tanımlamanin gerekliliği ortaya çikmaktadır.
Abstract
Background/aim: Occult hepatitis B virus (HBV) infection is defined by the existence of HBV infection in which HbsAg cannot be determined. It is reported that the prevalence of occult HBV infection is high in chronic hepatitis C, HCC and hemodialysis patients, in patients having cryptogenic liver disease, in drug-injection users and those with HIV, as well as in those patients with blood transfusion and in blood donors. In this study, we aimed to investigate the prevalence of occult HBV infection in hemodialysis patients with chronic HCV and to establish its clinical effects. Materials and methods: A total of 50 chronic hemodialysis patients whose HbsAg was negative and anti-HCV positive were included in the study. According to the results of HCV-RNA polymerase chain reaction (PCR), these patients were divided into two groups: HCVRNA positive and HCV-RNA negative. In both groups, HBV-DNA was investigated by sensitive PCR method. Results: HBV-DNA could not be determined by PCR method in any of 22 patients in the HCV-RNA positive group and of 28 patients in the HCV-RNA negative group. The mean age of patients was 47.2±17 in the HCV-RNA positive group and 39.6±15.6 in the HCV-RNA negative group. Conclusion: The prevalence of occult HBV infection in hemodialysis patients with chronic HCV was determined not to be high in our area. This result in our study should be further evaluated by taking into account the interaction of HbsAg positivity rate (8-10%) with the prevalence of HBV mutants in the region. In addition, it is necessary to revise the sensitivity and specificity of still non-standardized HBV-DNA PCR methods and determine a common diagnosis method accordingly.
