Dergiler / Viral Hepatitis Journal / 2015 / Cilt: 21 - Sayı: 3
The Distribution Clinical and Demographic Features of HBsAg Positive Patients in Şanlıurfa Region
- Sayfa
- 89–93
- DOI
- —
Özet
Amaç: Şanlıurfa yöresinde hepatit B yüzey antijeni (HBsAg) pozitif hastaların klinik dağılımı ve demografik özelliklerinin araştırılması amaçlanmıştır.Gereç ve Yöntemler: Aralık 2011-Nisan 2012 tarihleri arasında gastroenteroloji polikliniğine başvuran HBsAg seropozitif hastalar; inaktif taşıyıcı, kronik hepatit B (KHB), hepatit B virüs (HBV) sirozu, kronik delta hepatiti ve sirozu olarak sınıflandırıldı. Bu hastaların demografik, klinik özellikleri ve aldıkları antiviral tedaviler incelendi.Bulgular: HBsAg pozitif saptanan 296 hastanın yaş ortalaması 38,8±13,7 yaş , 152'si (%51) erkek, yaş ortalaması 38,5±14,4 yaş , 144'ü (%49) kadın, yaş ortalaması 39,1±13 yaş idi. İnaktif HBV taşıyıcı teşhisi konulan 205 (%69) hastanın yaş ortalaması 37,7±12,9 yaş ve 91'i (%44,4) erkek idi. Kronik hepatit saptanan 44 (%16) hastanın yaş ortalaması 36,7±13,4 yaş ve 27'si (%60) erkek idi. HBV siroz saptanan 30 hastanın (%10) yaş ortalaması 49±15 yaş ve 24'ü (%83) erkek idi. Hastaların 17'sinde (%5) anti-hepatit D virüs (anti-HDV) pozitif saptanmış olup yaş ortalaması 37,8±12,8 yaş , 11'i (%65) erkek ve 4 tanesi sirotik evrede idi. İki hasta (%0,6) hepatit HBV/HCV koenfeksiyonu idi. Hastalardan 7 tanesinde gebelik vardı, 3 tanesine yüksek viral yük nedeniyle 3. trimesterde tenofovir verilmişti. İki hastada (%0,6) hepatosellüler karsinom (HSK) saptandı. HBV veya delta hepatitine bağlı kronik hepatit veya siroz evresinde olan 73 (%26) hastadan 71 tanesi (interferon tedavisi almış, tedaviyi tamamlamış hastalar dahil) antiviral tedavi almış veya almakta olup en sık tenofovir kullanmakta idi. Hastalardan 2 tanesine (%0,6) HBV'ye bağlı karaciğer sirozu nedeniyle karaciğer nakli yapıldı.Sonuç: Şanlıurfa yöresinde HBsAg (+) hastaların dörtte üçü inaktif HBV taşıyıcısı, dörtte biri kronik hepatit veya sirotik dönemdedir. İnaktif taşıyıcı ve kronik hepatit hastalar sıklıkla 3. dekadda, sirotik hastalar dördüncü dekattadır. Kronik delta hepatit sıklığı %5, HSK sıklığı %0,6, HBV/HCV koenfeksiyon sıklığı %0,6'dır. KHB veya siroz olan hastaların tamamına yakını antiviral tedavi almış/almakta olup en sık tenofovir kullanmaktadır.
Abstract
Objective: The objective of this study was to investigate the distribution of the clinic and demographic characteristics of hepatitis b surface antigen (HBsAg) positive patients in Şanlıurfa region.Materials and Methods: HBsAg seropositive patients admitted to the gastroenterology outpatient clinics were classified as inactive carriers, chronic hepatitis B (CHB), hepatitis B virus (HBV) cirrhosis, chronic hepatitis delta and cirrhosis. Demographic and clinical features of the patients and antiviral treatment they received were analyzed.Results: HBsAg seropositivity was detected in 296 patients , 152 patients (51%) were male and 144 (49%) were female . Two hundred five patients (69%) were detected to be inactive HBV carriers and 91 (44.4%) of them were male. CHB was detected in 44(16%) patients and 27 (60%) were male. Cirrhosis was detected in 30 (10%) patients and 24 (83%) were male. Seventeen patients (5%) were antihepatitis D virus (anti-HDV) positive, 11 (65%) were male, 5 of them were in the cirrhotic stage. Two patients (0.6%) had HBV/HCV coinfection, two patients (0.6%) had hepatocellular carcinoma (HCC). Seven patients were pregnant, three patients were given tenofovir in the 3rd trimester, due to high viral load. Seventy one of 73 (26%) patients who were identified to have cirrhosis or chronic hepatitis due to HBV or HDV, 71 of (those who received or completed interferon treatment) received antiviral therapy, most commonly tenofovir. Liver transplantation was performed in two patients (0.6%) due to HBV related liver cirrhosis.Conclusion: Three-quarters HBsAg seropositive patients in Şanlıurfa region were inactive HBV carriers and one quarter were at the stage of chronic hepatitis or cirrhosis. Inactive carriers and chronic hepatitis patients are often in the 3rd decade and cirrhotic patients were in the 4th decade of life. Chronic HDV was observed in 5% of patients, HBV related HCC 0.6%, HBV/HCV co-infection was found in 0.6% of patients. Almost all patients with chronic hepatitis or cirrhosis were found to be received or/receiving antiviral treatment and the most commonly used medication was tenofovir.