18-25 Yaş Grubu arasındaki Viral Hepatit A, B, C Seroprevalansının İki Merkezli Karşılaştırılması

Year 2024, Volume: 19 Issue: 1, 89 - 94, 28.03.2024

Evrim Gülderen Kuşcu , Işıl Deniz Alıravcı , Özlem Kirişci , Servan Vurucu

https://doi.org/10.17517/ksutfd.1303208

Abstract

Amaç: Viral hepatit, dünya çapında milyonlarca insanı etkileyen, akut-kronik enfeksiyon, karaciğer kanseri ve siroz nedeniyle binlerce ölüme neden olan viral bir enfeksiyona bağlı karaciğer iltihabıdır. Bu çalışma, Türkiye'nin doğu ve batı bölgelerinde bulunan iki üniversite hastanesi arasında 18-25 yaş grubunda, ayaktan polikliniğe başvuran hastalarda ve sağlık çalışanlarında viral hepatit A, B, C belirteçlerinin seroprevalans verilerini karşılaştırmayı amaçlamaktadır.
Gereç ve yöntemler: Sütçü İmam Üniversitesi Tıp Fakültesi ve Onsekiz Mart Üniversitesi Tıp Fakültesi Hastanesine 01.01.2022-01.07.2022 tarihleri arasında ayaktan polikiniğe başvuran yaşları 18 ile 25 arasında değişen toplam 562 hastanın ve sağlık çalışanının verileri retrospektif olarak incelendi. HAV, HBV, HCV’ye ve HIV'e karşı gelişen serolojik belirteçlerin varlığı ELİSA yöntemi ile test edildi.
Bulgular: Anti-HAV IgG pozitifliği Çanakkale ve Kahramanmaraş için sırasıyla %25,5 ve %40,3 idi. Kahramanmaraş'ta anti-HAV seropozitiflik oranı Çanakkale'ye göre istatistiksel olarak anlamlı derecede yüksekti (P<0.001). Anti-HBs pozitifliği oranları Çanakkale ve Kahramanmaraş'ta sırasıyla %74,5 ve %75,4 olarak benzer bulundu (P=0.458). HBsAg pozitifliği Çanakkale'de %1,5 iken Kahramanmaraş'ta %0,8 olarak tespit edildi, iki şehir arasında anlamlı farklılık yoktu (P=0.810). Çanakkale'de bir (%0,5), Kahramanmaraş'ta dört (%1,1) hastada anti HCV pozitif bulundu. Kahramanmaraş’ta anti-HCV pozitifliği, Çanakkale’de anti-HIV pozitifliği daha yüksekti (P=0.03, P=0.000). 562 hastanın 171’i sağlık çalışanıydı. Sağlık çalışanlarında anti-HBs pozitifliğinin (%80,7) ve sağlık çalışanı olmayanlarda anti-HAV IgG pozitifliğinin (%38,4) daha yüksek olduğu tespit edildi (P=0.042, P=0.013). Anti-HCV ve anti-HIV pozitifliği açısından sağlık çalışanı olan ve olmayan arasında anlamlı fark yoktu.
Sonuç: Anti-HAV seropozitiflik oranlarının 18-25 yaş grubunda düşük olması bu bireyleri akut HAV enfeksiyonu açısından riskli hale getirmektedir. Özellikle Çanakkale'de anti-HAV pozitifliğinin düşük olması bu bölgede aşılamanın desteklenmesi için önem kazanmaktadır. Sağlık çalışanlarının hepatit hastalığına maruz kalma riskleri nedeniyle sağlık çalışanlarına da aşı ile önlenebilir hastalıklara karşı tarama yapmanın ve önlem almanın gerekli olduğu düşünülmüştür.

Keywords

Viral hepatit, Epidemiyoloji, Seroprevalans, 18-25 yaş

Two-Center Comparison of Viral Hepatitis A, B, C Seroprevalence among the 18-25 Age Group

Abstract

Objective: Viral hepatitis is inflammation of the liver due to a viral infection that affects millions of people worldwide, causing thousands of deaths due to acute-chronic infection, liver cancer and cirrhosis. This study is aimed to compare datas of the seroprevalence of markers for viral hepatitis A, B, C among 18-25 age group outpatient clinic patients and healthcare workers between the two University Hospitals from east and west zone of Turkey.
Material and Methods: The data of a total of 562 patients and healthcare workers, aged between 18 and 25, who applied to the outpatient clinic at Sütçü İmam University Faculty of Medicine and Onsekiz Mart University Faculty of Medicine Hospital between 01.01.2022 and 01.07.2022, were retrospectively examined. The presence of serological markers against HAV, HBV, HCV and HIV was tested with the ELISA method.

Results: Anti-HAV IgG positivity was 25.5% and 40.3% for Çanakkale and Kahramanmaraş, respectively. Anti-HAV seropositivity rate in Kahramanmaraş was statistically significantly higher than in Çanakkale (P<0.001). Anti-HBs positivity was found to be 74.5% and 75.4% for Çanakkale and Kahramanmaraş, which were similar to each other bulundu (P=0.458). HBsAg positivity was detected as 1.5% in Çanakkale and 0.8% in Kahramanmaraş. There was no significant difference between the two cities (P = 0.810). Anti-HCV was found to be positive in one (0.5%) patient in Çanakkale and in four (1.1%) patients in Kahramanmaraş. Anti-HCV positivity was higher in Kahramanmaraş and anti-HIV positivity was higher in Çanakkale (P=.03, P<0.001). It was detected that anti-HBs positivity (80.7%) was higher in HCWs and anti-HAV IgG positivity was higher in non-HCWs (38.4%) (P=.042, P=0.013). There was no significant difference between the 2 groups in terms of anti-HCV and anti-HIV positivity.
Conclusion: Due to the low anti-HAV seropositivity rates in the 18-25 age group, this makes this group more risky in terms of HAV infection. Especially due to the anti-HAV positivity in Çanakkale is low compared to Kahramanmaraş, it is recommended to support vaccination in this region. Since health care workers are at risk of having and transmitting hepatitis, it was found to be appropriate getting prevention measures by screening against vaccine-preventable diseases.

Keywords

Viral hepatitis, Epidemiology, Seroprevalance, 18-25 years

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