Ferit KUŞCU, Aslıhan ULU, Süheyla KÖMÜR, Filiz KİBAR, Ayşe Seza İNAL, Behice KURTARAN, Yeşim TAŞOVA, Akgün YAMAN, Hasan Salih Zeki AKSU

Kronik hepatit B hastalarının klinik özellikleri

Amaç: Kronik hepatit B tanılı hastaların klinik özellikleri ve genotipik dağılımlarının değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Kronik hepatit B tanısı ile Ocak 2011 ve Ocak 2012 tarihleri arasında Enfeksiyon Hastalıkları polikliniğine başvuran hastalar retrospektif olarak değerlendirilmiştir. Hastaların serum örneklerinde bakılan biyokimyasal testler, HBV DNA ve viral genotipleme testleri ve ayrıca karaciğer biyopsisi ile histopatolojik evreleme sonuçları gözden geçirildi. Hbe ag pozitif ve negatif olmak üzere iki gruba ayrılan hastaların özellikleri karşılaştırıldı.Bulgular: Çalışmaya dahil edilen 58 hastanın hepsinde (100%) HBV genotip D tespit edildi. Hastaların yaş ortalaması 40 (18-71) idi. Hastaların 34' ü (58.6%) erkek, 24'ü (41.4%) ise kadındı. Hbe ag pozitif hasta sayısı 13 (22%), Hbe ag negatif hasta sayısı ise 45 (78%) idi.Sonuç: HBV genotipleri, hastalığın bulaş yolunu, seyrini ve verilen tedaviye yanıt oranlarını etkileyebilecek bir parametredir. Dolayısıyla bir bölgedeki veya ülkedeki HBV genotiplerinin bilinmesi, virusun yayılım dinamiği ve uygulanacak tedavilere yanıt oranlarının nasıl olacağı hakkında önemli öngörüler sağlayacağı için önemli bir epidemiyolojik bulgudur.

Anahtar Kelimeler:

Hepatitis B, genotype

Clinical features of chronic hepatitis B patients

Purpose: We aimed to evaluate the clinical features and genotypic distribution of chronic HBV patients.Materials and Methods: The patients with chronic HBV infection were evaluated retrospectively. Biochemical tests, HBV DNA, viral genotyping in the serum samples and liver biopsy results of the patients were evaluated. The properties of the patients who were divided into two groups as Hbe ag positive and Hbe ag negative were compared.Results: HBV genotype D was found in all of the 58 patients (100%) included in the study. The mean age of the patients was found to be 40 (18-71) years. 34 (58.6%) of the patients were male and 24 (41.4%) were female. The number of Hbe ag positive patients was found to be 13 (22%) and the number of Hbe ag negative patients was found to be 45 (78%).Conclusion: HBV genotype is a parameter that may affect the mode of transmission and prognosis of the disease and the rates of treatment response. Thus, information related with the HBV genotypes in a region or country is a significant epidemiological finding because it will provide significant predictions related with the dynamics of dissemination of the virus and the rates of treatment response.

Keywords:

Hepatit B genotip, serokonversiyon,

PDF

___

1. Seeger C, Mason WS. Hepatitis B virus biology. Microbiol Mol Biol Rev. 2000;64:51-68.
2. Liaw YF, Chu CM. Hepatitis B virus infection. Lancet. 2009;373:582-92.
3. Trepo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet. 2014;384:2053-63.
4. Sunbul M. Hepatitis B virus genotypes: global distribution and clinical importance. World J Gastroenterol 2014;20:5427-34.
5. Lindh M, Andersson AS, Gusdal A. Genotypes, nt 1858 variants, and geographic origin of hepatitis B virus-largescale analysis using a new genotyping method. J Infect Dis. 1997;175:1285-1293.
6. Lok AS, McMahon BJ. AASLD Practice Guideline Update. Chronic Hepatitis B: Update 2009. Hepatology. 2009;50:661-662.
7. Fattovich G, Bortolotti F, Donato F. Natural history of chronic hepatitis B:special emphasis on disease progression and prognostic factors. J Hepatol. 2008;48:335-52.
8. Kim BK, Revill PA, Ahn SH. HBV genotypes: relevance to natural history, pathogenesis and treatment of chronic hepatitis B. Antivir Ther. 2011;16:1169-86.
9. McMahon BJ. Epidemiology and natural history of hepatitis B. Semin Liver Dis. 2005;25:3-8.
10. Atalay MA, Gokahmetoglu S, Aygen B. Genotypes of hepatitis B virus in Central Anatolia, Kayseri, Turkey. Saudi Med J. 2011;32:3630–33.
11. Leblebicioglu H, Eroglu C. Acute hepatitis B virus infection in Turkey: epidemiology and genotype distribution. Clin Microbiol Infect. 2004;10:537-41.
12. Ciftci S, Keskin F, Badur S: Clinical features of hepatitis B virus genotypes in Turkish patients. J Pak Med Assoc. 2012;62:759-63.
13. Emekdaş G, Tezcan S, Aslan G, Serin MS, Sezgin O, Uçbilek E et al.. Determination of hepatitis B virus genotypes in chronic hepatitis B patients in Mersin province, Turkey. Mikrobiyol Bul. 2012;46:432-45.
14. Kaya S, Cetin ES, Aridogan BC, Onal S, Demirci M. Distribution of hepatitis B virus (HBV) genotypes among HBV carriers in Isparta. Iran Biomed J. 2007;11:59-63.
15. Moucari R, Korevaar A, Lada O, Martinot-Peignoux M, Boyer N, Mackiewicz V et al. High rates of HBsAg seroconversion in HBeAg-positive chronic hepatitis B patients responding to interferon: a long-term follow-up study. J Hepatol. 2009;50:1084-92.
16. Wiegand J, Hasenclever D, Tillmann HL. Should treatment of hepatitis B depend on hepatitis B virus genotypes? A hypothesis generated from an explorative analysis of published evidence. Antiviral Ther. 2008;13:211-20.
17. Flink HJ, van Zonneveld M, Hansen BE, de Man RA, Schalm SW, Janssen HL, HBV 99–01 study group: Treatment with Peg-interferon alpha-2b for HBeAg-positive chronic hepatitis B: HBsAg loss is associated with HBV genotype. Am J Gastroenterol. 2006;101:297-303.
18. Zoulim F. Are novel combination therapies needed for chronic hepatitis B? Antiviral Res. 2012;96:256–9.
19. Lok AS, Lai CL, Leung N, Yao GB, Cui ZY, Schiff ER et al. Long-term safety of lamivudine treatment in patients with chronic hepatitis B. Gastroenterology. 2003;125:1714-22.
20. European Association For The Study Of The Liver. EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol. 2012;57:167-85.
21. Ozaras R, Balkan II, Yemisen M, Tabak F. Epidemiology of HBV subgenotypes D. Clin Res Hepatol Gastroenterol. 2015;39:28-37.
22. Kramvis A, Kew M, François G. Hepatitis B virus genotypes. Vaccine. 2005;23:2409-23.
23. Allain JP. Epidemiology of Hepatitis B Virus and Genotype. J Clin Virol. 2006;36:12-7.