TİP 1 DİYABETES MELLİTUS TANILI ÇOCUKLARDA HEPATİT A VE B SEROPREVALANSI

Year 2021, , 57 - 63, 05.01.2021

Muammer Büyükinan , Muhammed Yaşar Kılınç

https://doi.org/10.18229/kocatepetip.592207

Abstract

AMAÇ: Tip1 diyabetes mellitus (T1DM) immün sistem üzerine etkileriyle aşılara karşı immünolojik yanıtı etkileyebilen otoimmun bir hastalıktır. Bu çalışmada T1DM’li hastalarda hepatit A (HA) ve hepatit B (HB) seroprevelansının araştırılması amaçlanmıştır.
GEREÇ VE YÖNTEM: Ocak 2014-Ocak 2017 tarihleri arasında Konya Eğitim ve Araştırma Hastanesi Çocuk Endokrinoloji bölümünde izlenen 1-18 yaş aralığında 144 T1DM tanılı hasta ve 58 kontrol olgu alındı. Retrospektif olarak hasta kayıtlarından yaş, diyabet tanı zamanı, HBsAg, anti-HBs ve anti-HAV IgG, HbA1c sonuçları kaydedildi.
BULGULAR: T1DM grubunda kontrol grubuna göre median anti-HBs düzeyi (14,8 mIU/ml [interquartile range (IQR): 4,2- 100] ve 37,7 mIU/ml [IQR: 7,16- 122,7], p=0,026), median anti-HAV IgG düzeyi (11 mIU/ml [IQR: 9,88- 21,7] ve 19,8 mIU/ml [IQR: 15,2- 80], p <0,001), hepatiti B virüs (HBV) seropozitif hasta oranı (%59 ve %73,7, p=0,048) ve hepatiti A virüs (HAV) seropozitif hasta oranı (%27,5 ve %44,2, p=0,027) düşük saptandı. Anti-HBs, anti-HAV IgG düzeyleri ile yaş, diyabet süresi ve HbA1c arasında korelasyon saptanmadı.
SONUÇ: Çalışmamızda gösterilen düşük anti-HBs, anti-HAV IgG titreleri, HAV ve HBV seropozitif hasta oranları T1DM’li hastalarda HAV ve HBV aşılarına karşı immünolojik yanıtın yetersiz olduğunu düşündürmektedir.T1DM’li hastaların HBV maruziyeti için çeşitli risk faktörlerine sahip olması, HA enfeksiyonunda ilerleyen yaşla birlikte artan komplikasyon riski, enfeksiyona bağlı glisemik kontrolde bozulma ihtimalleri ve T1DM’li hastalarda düşük HAV ve HBV seropozitiflik oranları göz önüne alındığında ilk tanıda T1DM’li hastalarda HAV ve HBV serolojileri çalışılmalı, seronegatif hastalar aşılanmalı ve aşı yanıtları kontrol edilmelidir

Keywords

Tip 1 diabetes mellitus, anti-HBs, anti-HAV IgG, aşı

HEPATITIS A AND B SEROPREVALENCES IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

Abstract

OBJECTIVE: Type 1 diabetes mellitus (T1DM) is an autoimmune disease that can affect immunologic response to vaccines by its effects on the immune system. We aimed to investigate hepatitis A (HA) and hepatitis B (HB) seroprevalences in patients with T1DM.
MATERIAL AND METHODS: We included 144 patients with T1DM and 58 patients in control group between the ages of 1 and 18 who have been followed up in the Pediatric Endocrinology Clinic of Konya Training and Research Hospital between January 2014 and January 2017. We have recorded the age of the patient, diabetes diagnosis time, HBsAg, anti-HBs, anti-HAV IgG and HbA1c results from records of the patients retrospectively.
RESULTS: The median anti-HBs levels (14,8 mIU/ml [interquartile range (IQR): 4,2- 100] and 37,7 mIU/ml [IQR: 7,16- 122,7], p=0,026), median anti-HAV IgG levels (11 mIU/ml [IQR: 9,88- 21,7] and 19,8 mIU/ml [IQR: 15,2- 80], p <0,001), hepatitis B virus (HBV) seropositive patient rate (%59 and %73,7, p=0,048) and hepatitis A virus (HAV) seropositive patient rate (%27,5 and %44,2, p=0,027) were low in patients with T1DM comparing to patients in control group. We have found no correlation between anti-HBs, anti-HAV IgG levels and age, duration of diabetes and HbA1C levels.
CONCLUSIONS: The findings of low anti-HBs, anti-HAV IgG levels, HAV and HBV seropositive patient rates in patients with T1DM demonstrated that immunologic responses to HAV and HBV vaccines were insufficient. Given the facts that patients with T1DM have various risk factors for HBV exposure, HA infection in advanced ages result in increased complication risk, poor glycemic control with infections and low HAV and HBV seropositivity rates in T1DM patients, we need to test T1DM patients for HAV and HBV serology, vaccinate the seronegative patients and monitor the vaccine response.

Keywords

Tip 1 diabetes mellitus, anti-HBs,, anti-HAV

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