Kronik hepatit B ve kronik hepatit C'de tanı ve tedavi yaklaşımları

Kronik hepatitler (kronik hepatit B ve kronik hepatit C) morbidite ve mortaliteleri açısından önemli sağlık problemleridir. Günümüzde her iki virüsün oluşturduğu kronik infeksiyonun tanısında sorunlar yaşanmaktadır. Laboratuvar testlerinde standardizasyonun olmaması yanında tanı amaçlı uygulanan karaciğer biyopsi sonuçlarının farklı merkezlerce farklı rapor edilebilmesi sorun oluşturmaktadır. Kronik hepatitlerin tanımlanması sonrasında tedavi kararı, hangi tedavinin uygulanacağı ve tedavi sonrası izlem önem taşımaktadır. Hepatit B virusunda görülen mutasyonlar tedavi kararını etkilediği gibi, tedaviye yanıtı da değiştirmektedir. Hepatit C virusu ile ilgili önemli problemler arasında farklı genotiplerin kronikleşme potansiyelinin farklı olması ve tedaviye yanıt farklılıkları yer almaktadır. Hem kronik hepatit B'de hem de kronik hepatit C'de tedavinin köşe taşı interferonlar olup, pegile interferonların kullanıma girmesi ile sonuçlar daha iyi gibi olmaktaysa da gelecekte yeni tedavi stratejilerine gereksinim olduğu görülmektedir.

Anahtar Kelimeler:

Hepatit C, kronik, Tanı, Dozaj formları, Hepatit B e antijenleri, Hepatit B, kronik, Lamivudin

Diagnosis treatment approaches of chronic hepatitis B and chronic hepatitis C

Chronic hepatitis (chronic hepatitis B and chronic hepatitis C) are important medical problems according to their morbidity and mortality rates. Nowadays, there are diagnostic problems in these infections. There is no standardization in diagnostic laboratory tests and in reporting of liver biopsy results. There are a lot of questions about these infections and their treatment: "who must be treated, which therapy is better and how must be done their surveillance? " The mutations of hepatitis B affect the choice of treatment, and also response to therapy. In hepatitis C virus, the probability of chronicity are different between genotypes. Their response to treatment are different also. The main-stone are interferons in the treatment of chronic hepatitis B and C infections. Treatment results are better with pegylated interferons. But we need new treatment strategies for both hepatitis B and hepatitis C infections.

Keywords:

Hepatitis C, Chronic, Diagnosis, Dosage Forms, Hepatitis B e Antigens, Hepatitis B, Chronic, Lamivudine,

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