Hepatit B tanısında hbsag kantitatif değerlerinin, HBV dna değeri ve diğer serolojik / biyokimyasal belirteçler ile ilişkilerinin değerlendirilmesi.
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Sivas Cumhuriyet Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hepatit B virüsü enfeksiyonları dünyada ve ülkemizde çok önemli bir toplum sağlığı problemi oluşturmaktadır. Dünyada yaklaşık 2 milyar kişinin hepatit B virüsü (HBV) ile karşılaşmış olduğu, 400 milyon kişinin ise kronik hepatit B (KHB) hastası olduğu bilinmektedir. Türkiye'de karaciğer hastalıklarının en başta gelen nedeni HBV enfeksiyonudur. HBV ye bağlı olarak gelişen akut hepatit, kronik hepatit, karaciğer sirozu ve hepatosellüler karsinoma (HCC) gibi tablolar medikal-cerrahi tedavileri ve ciddi komplikasyonları ile tıbbın birçok alanını ilgilendiren, hatta ülkenin sağlık sorunları arasında önemli yer tutan bir hastalık grubunu oluşturur. KHB enfeksiyonunun tanı ve izlenmesinde serum HBV DNA düzeyi virus replikasyonunun en yaygın göstergesi olup, serolojik belirteçler ve alanin aminotransferaz (ALT) düzeyinin ölçümü ile birlikte yaygın olarak kullanılmaktadır. Son yıllarda ise, HBsAg' nin serum konsantrasyonları ile HBV DNA ve ALT düzeylerinin ilişkili olduğu gösterilmiştir. Bu çalışmada, Hepatit B tanısında HBsAg kantitatif değerleri ile HBV DNA, alanin aminotransferaz (ALT), aminotransferaz (AST), Alfa - Feto Protein (AFP), HBcTotal / anti HBcIgG (Hepatit B virüs çekirdek G antikoru), anti HBcIgM (Hepatit B virüs çekirdek M antikoru), HBeAg (Hepatit B virüs e antijeni), anti HBe (Hepatit B virüs e antikoru) ve anti HBs (Hepatit B virüs yüzey antikoru) değerleri laboratuvar kayıtlarından geriye dönük olarak incelenmiştir. Toplam 3788 hastadan HBsAg ve HBV DNA testleri çalışılmıştır. Bu hastaların 1536'sı kadın (% 40,6), 2252'si erkektir (% 59,4). Çalışmamızdaki 3788 hastada en küçük yaş 0 en büyük yaş 94 tür. Yaş ortalaması 49,43 tür. Kadınlarda yaş ortalaması 49,65 erkeklerde ise 49,30 olarak hesaplanmıştır. HBsAg ve HBV DNA çalışılan 3788 hastanın 2074'ünde HBcTotal (anti HBcIgG) testi, 2080'inde anti HBcIgM testi çalışılmıştır. Çalışmamızdaki 3788 hastanın 2519'unda HBeAg testi, 2471'inde anti HBe testi, 3452'sinde AST testi, 3466'sında ALT testi, 1269 tanesinde ise AFP testi çalışılmıştır. Bu çalışmada, Hepatit B tanısında HBsAg serum konsantrasyon değerlerinin HBV DNA, ALT, AST, AFP, anti HBc IgG, anti HBc IgM, HBeAg, anti HBe, anti HBs ile karşılaştırılarak aralarındaki ilişkinin değerlendirilmesi amaçlanmıştır. Çalışmamızda HBsAg titreleri arttıkça HBV DNA pozitiflik oranlarının arttığı görülmüştür. HBsAg titresi <1 IU/ml' de HBcTotal (anti HBcIgG) pozitifliği % 68,6 iken, titreler arttıkça bu oranın %100' lere kadar ulaştığı tespit edilmiştir. HBsAg titreleri ve anti HBcIgM değerleri incelendiğinde HBsAg titrelerinde % 0 ile % 7 arasında anti HBcIgM pozitiflikleri bulunmuştur. Çalışmamızda HBsAg titreleri arttıkça anti HBe pozitifliklerinin de arttığı görülmüştür. Belirli bir noktaya kadar artan HBsAg titreleri ile HBeAg pozitifliği artarken, belirli bir titreden sonra HBeAg pozitifliklerinin düştüğü görülmüştür. HBsAg titreleri arttıkça Anti HBe pozitifliklerinin de arttığı görülmüştür. HBsAg titresi 1'den 1000 IU/ml' ye kadar olan titrelerde AST yüksek değerleri daha fazla görülürken, bu titreden sonra AST yüksekliklerinde azalmalar tespit edilmiştir. HBsAg'nin tüm titrelerinde normal ALT değerinin yüksek ALT değerlerinden daha fazla oranda bulunmuştur. HBsAg titreleri ile AFP değerleri arasında önemli bir ilişki görülmemiştir. HBV DNA sonuçları ile HBeAg sonuçları karşılaştırıldığında iki değer arasındaki ilişki önemli bulunmuştur. Sonuç olarak HBsAg serum titreleri ile HBV DNA arasında ve HBeAg ile HBV DNA arasında pozitif ilişki bulunmuştur. Ancak HBV varyantları ve mutasyonları (HBsAg mutasyonları, HBeAg mutasyonları v.b.) dikkate alındığında HBV enfeksiyonunun doğru bir şekilde tanımlanmasında ve tedavinin izlenmesinde HBV DNA düzeylerinin oldukça önemli olduğunu düşünmekteyiz.
Hepatitis B virus infections constitute a very important public health problem in the world and in our country. It is known that approximately 2 billion people in the world have encountered hepatitis B virus (HBV) and 400 million people have chronic hepatitis B (CHB). The leading cause of liver diseases in Turkey is HBV infection. Conditions such as acute hepatitis, chronic hepatitis, liver cirrhosis and hepatocellular carcinoma (HCC) that develop due to HBV constitute a group of diseases that concern many fields of medicine and even hold an important place among the health problems of the country, with their medical-surgical treatments and serious complications. Serum HBV DNA level is the most common indicator of virus replication in the diagnosis and monitoring of CHB infection and is widely used together with serological markers and measurement of alanine aminotransferase (ALT) level. In recent years, it has been shown that serum concentrations of HBsAg are related to HBV DNA and ALT levels. In this study, HBsAg quantitative values and HBV DNA, alanine aminotransferase (ALT), aminotransferase (AST), Alpha - Feto Protein (AFP), anti HBcIgG (Hepatitis B virus core G antibody), anti HBcIgM (Hepatitis B) were used in the diagnosis of Hepatitis B. virus core M antibody), HBeAg (Hepatitis B virus e antigen), anti HBe (Hepatitis B virus e antibody) and anti HBs (Hepatitis B virus surface antibody) values were retrospectively examined from laboratory records. HBsAg and HBV DNA tests were studied on a total of 3788 patients. 1536 of these patients are women (40.6%) and 2252 are men (59.4%). Among the 3788 patients in our study, the youngest age is 0 and the oldest is 94. The average age is 49.43. The average age was calculated as 49.65 for women and 49.30 for men. Of the 3788 patients in whom HBsAg and HBV DNA were studied, the HBcTotal (anti HBcIgG) test was performed in 2074 and the anti HBcIgM test was performed in 2080. Of the 3788 patients in our study, HBeAg test was performed in 2519, anti-HBe test in 2471, AST test in 3452, ALT test in 3466, and AFP test in 1269. This study aimed to compare HBsAg serum concentration values with HBV DNA, ALT, AST, AFP, anti HBc IgG (HBcTotal), anti HBc IgM, HBeAg, anti HBe, anti HBs and evaluate the relationship between them in the diagnosis of Hepatitis B. In our study, it was observed that HBV DNA positivity rates increased as HBsAg titers increased. While HBcTotal (anti HBcIgG) positivity is 68.6% at HBsAg titer <1 IU/ml, it has been determined that this rate reaches up to 100% as titers increase. When HBsAg titers and anti HBcIgM values were examined, anti HBcIgM positivity was found between 0% and 7% in HBsAg titers. In our study, it was observed that as HBsAg titers increased, anti-HBe positivity also increased. While HBeAg positivity increases with increasing HBsAg titers up to a certain point, it has been observed that HBeAg positivity decreases after a certain titer. It has been observed that as HBsAg titers increase, Anti HBe positivity also increases. While elevated AST values were more common in HBsAg titers ranging from 1 to 1000 IU/ml, decreases in AST elevations were detected after this titer. In all titers of HBsAg, normal ALT values were found to be higher than high ALT values. No significant relationship was observed between HBsAg titers and AFP values. When HBV DNA results were compared with HBeAg results, the relationship between the two values was found to be significant. As a result, a positive relationship was found between HBsAg serum titers and HBV DNA and between HBeAg and HBV DNA. However, considering HBV variants and mutations (HBsAg mutations, HBeAg mutations, etc.), we think that HBV DNA levels are very important in correctly identifying HBV infection and monitoring treatment.
Hepatitis B virus infections constitute a very important public health problem in the world and in our country. It is known that approximately 2 billion people in the world have encountered hepatitis B virus (HBV) and 400 million people have chronic hepatitis B (CHB). The leading cause of liver diseases in Turkey is HBV infection. Conditions such as acute hepatitis, chronic hepatitis, liver cirrhosis and hepatocellular carcinoma (HCC) that develop due to HBV constitute a group of diseases that concern many fields of medicine and even hold an important place among the health problems of the country, with their medical-surgical treatments and serious complications. Serum HBV DNA level is the most common indicator of virus replication in the diagnosis and monitoring of CHB infection and is widely used together with serological markers and measurement of alanine aminotransferase (ALT) level. In recent years, it has been shown that serum concentrations of HBsAg are related to HBV DNA and ALT levels. In this study, HBsAg quantitative values and HBV DNA, alanine aminotransferase (ALT), aminotransferase (AST), Alpha - Feto Protein (AFP), anti HBcIgG (Hepatitis B virus core G antibody), anti HBcIgM (Hepatitis B) were used in the diagnosis of Hepatitis B. virus core M antibody), HBeAg (Hepatitis B virus e antigen), anti HBe (Hepatitis B virus e antibody) and anti HBs (Hepatitis B virus surface antibody) values were retrospectively examined from laboratory records. HBsAg and HBV DNA tests were studied on a total of 3788 patients. 1536 of these patients are women (40.6%) and 2252 are men (59.4%). Among the 3788 patients in our study, the youngest age is 0 and the oldest is 94. The average age is 49.43. The average age was calculated as 49.65 for women and 49.30 for men. Of the 3788 patients in whom HBsAg and HBV DNA were studied, the HBcTotal (anti HBcIgG) test was performed in 2074 and the anti HBcIgM test was performed in 2080. Of the 3788 patients in our study, HBeAg test was performed in 2519, anti-HBe test in 2471, AST test in 3452, ALT test in 3466, and AFP test in 1269. This study aimed to compare HBsAg serum concentration values with HBV DNA, ALT, AST, AFP, anti HBc IgG (HBcTotal), anti HBc IgM, HBeAg, anti HBe, anti HBs and evaluate the relationship between them in the diagnosis of Hepatitis B. In our study, it was observed that HBV DNA positivity rates increased as HBsAg titers increased. While HBcTotal (anti HBcIgG) positivity is 68.6% at HBsAg titer <1 IU/ml, it has been determined that this rate reaches up to 100% as titers increase. When HBsAg titers and anti HBcIgM values were examined, anti HBcIgM positivity was found between 0% and 7% in HBsAg titers. In our study, it was observed that as HBsAg titers increased, anti-HBe positivity also increased. While HBeAg positivity increases with increasing HBsAg titers up to a certain point, it has been observed that HBeAg positivity decreases after a certain titer. It has been observed that as HBsAg titers increase, Anti HBe positivity also increases. While elevated AST values were more common in HBsAg titers ranging from 1 to 1000 IU/ml, decreases in AST elevations were detected after this titer. In all titers of HBsAg, normal ALT values were found to be higher than high ALT values. No significant relationship was observed between HBsAg titers and AFP values. When HBV DNA results were compared with HBeAg results, the relationship between the two values was found to be significant. As a result, a positive relationship was found between HBsAg serum titers and HBV DNA and between HBeAg and HBV DNA. However, considering HBV variants and mutations (HBsAg mutations, HBeAg mutations, etc.), we think that HBV DNA levels are very important in correctly identifying HBV infection and monitoring treatment.
Açıklama
Sağlık Bilimleri Enstitüsü, Tıbbi Mikrobiyoloji Ana Bilim Dalı, Tıbbi Mikrobiyoloji Bilim Dalı
Anahtar Kelimeler
Mikrobiyoloji, Microbiology
