Güngör T. TÜMAY, Tülin ERKAN, Figen ÇULLU, Hilda ÇERÇİÖZKAN, Evrim KIRAY, Tufan KUTLU

Kronik karaciğer hastalarında hepatit A aşısı yapılmalı mı?

Gelişmekte olan ülkelerde daha çok çocukluk çağında geçirilen hepatit A enfeksiyonu kronik karaciğer hastalarında fülminan seyredebilmektedir. Risk altındaki bu hastaların aşılanması önerilmektedir. Retrospektif olarak yapılan bu çalışmada kronik karaciğer hastalarındaki anti HAV IgG (+)'liği irdelenmiştir.Bu amaçla araştırılan 171 hastanın 5 8'inde (%34) anti HAV IgG (+), 113'ünde (%66) anti HAV IgG (-) idi. Yedi olgu (%4) ise izlem süreleri içinde hastalığı akut enfeksiyon şeklinde geçirmişti. Anti HAV IgG (+) ve (-) olan olguların yaş ortalaması sırasıyla 9,9±4,6 ve 8,7± 4,3 yaş idi. Her ne kadar ülkemizde anti-HAV prevalansı yaşa ve yöreye göre değişmekte ise de (3-10 yaşta %54,5), hijyen koşullarının düzelmesi ile bu oranın giderek azaldığı görülmektedir. Enfeksiyon riskinin ileri yaşlara kayması kronik karaciğer hastalarındaki riski daha da arttıracağından, bu hastaların aşılanması uygundur.

Is hepatitis A vaccination necessary for patients with chronic liver disease?

Background and design.- Hepatitis A virus (HAV) infection which commonly is seen in childhood in developing countries and may be responsible for fulminant hepatic failure. In this study, antibody to HAV in the patients with chronic liver disease was studied retrospectively. Vaccination of these patients who are under risk is recommended. Results.- Fifty-eight of 171 patients had had anti HAV IgG (+) and 113 of 171 had anti HAV IgG(-). Acute HAV infection was occurred in 7 patients during follow-up. The mean age of the anti HAV IgG (+) and (-) groups was 9.9± 4.6 and 8.7± 4.3 years respectively. Conclusion.- Although in our country, the prevalence of exposure to HAV changes with age and regions (54.5% at 3-10 years), there is a decrease in the ratio with improvement of hygienic conditions. Because the possibility of HAV infection in patients with chronic liver disease during adolescent or elderly is more dangerous, passive immunization of these patients is recommended.

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