Kronik karaciğer hastalıklarının etyolojisinde hepatit B, C ve delta virüslerinin rolü

Abstract

Cumhuriyet Üniversitesi Tıp Fakültesi Hastanesi'ne Ağustos 1993 - Temmuz 1994- tarihleri arasında başvuran kronik karaciğer hastalığı ( KKH ) düşünülen hastaların serumlarında ELİSA yöntemi ile Hepatit B virus ( HBV ), Hepatit C virus ( HCV ) ve Hepatit Delta virus ( HDV ) 'üne ait "marker"lann sıklığı araştırıldı. Kırk hastanın 20 ( %50 )'sinde HBs Ag, 13 ( %32.5 )'ünde Anti - HCV, 3 ( %7.5 J'ünde HBs Ag + Anti -HCV, 2 ( %5 )'sinde HBs Ag + Anti - HDV pozitif, olarak saptandı, 2 ( %5 ) hastada ise serolojik göstergeler negatif idi. Yapılan tetkikler sonucu 17 ( %42.5 ) hastaya kronik aktif hepatit ( KAH ), 8 hastaya ( %20.0 ) kronik persistant hepatit ( KPH ), 14 hastaya ( %35.0 ) siroz, 1 hastaya ( %2.5 ) siroz + hepatosellüler karsinom tanısı konuldu. HBs Ag, Anti - HCV, HBs Ag + Anti - HDV, HBs Ag + Anti - HCV pozitifliği KAH'li hastalarda %41.2, %35.3, %5.9,%5.9, KPH'li hastalarda %50.0, %37.5, % 12.5, %0, sirozlu hastalarda %64.3, %28.6, %0, %7.1 idi. Siroz + hepatosellüler karsinomlu hastada ise HBs Ag ve Anti - HCV pozitif idi. Sonuç olarak KKH'da HCV'ünün, HBV gibi etyolojide önemli bir rol oynadığını düşünüyoruz.

We investigated the prevalance of markers of hepatitis B virus ( HBV ), hepatitis C virus ( HCV ) and hepatitis delta virus ( HDV ) by using ELISA method in the sera of patients thought to be chronic liver disease (CLD), applying to hospital of Faculty of Medicine of Cumhuriyet University between the dates of August 1 993 and July 1994. Of the 40 patients, in 20 ( 50.0% ) of them HBs Ag, 13 ( 32.5% ) Anti - HCV, ( 7.5% ) HBs Ag + Anti - HCV, 2 ( 5.0% ) HBs Ag + Anti - HDV were determined to be positive. In 2 ( 5.0% ) cases serological markers were all negative. After the examinations, chronic active hepatitis (CAH) was diagnosed in 17 ( 42.5% ) patients, chronic persistant hepatitis ( CPH ) in 8 ( 20.0% ) patients, cirrhosis in 14 ( 35.0% ) patients and 1 patient was diagnosed as cirrhosis and hepatocelluler carsinoma together. Positivity of HBs Ag, Anti - HCV, HBs Ag + Anti -HDV, HBs Ag + Anti - HCV in patients with CAH were as; 41.2%, 35.3%, 5.9%, 5.9%, in patients with CPH, 50.0%, 37.5%, 12.5%, 0%, in patients with cirrhosis; 64.3%, 28.6%, 0%, 7.1%. In the patient with cirrhosis + hepatocelluler carcinoma, both HBs Ag and Anti - HCV were positive. As a result we think that HCV plays an important role in the etiology of CLD as HBV.