Hastanemize Başvuran Hastalardaki HIV Seropozitifliği: Altı Yıllık Değerlendirme

Amaç: İnsan bağışıklık yetmezliği virüsü (human immundeficiency virüs, HIV) ile infekte bireylerin tespit edilmesi yaşam kalitesi açısından oldukça önemlidir. Ancak yalancı pozitifliklerin olabileceği ve testlerin mutlaka doğrulanması gerçeği unutulmamalıdır. Bu çalışmada hastanemizdeki altı yıllık süre zarfında HIV seropozitifliğinin saptanması ve ülke epidemiyolojik verilerine katkı sağlanması amaçlanmıştır. Gereç ve Yöntemler: Ocak 2014 ve Aralık 2019 tarihleri arasında seroloji laboratuvarına gelen örnekler geriye dönük olarak incelenmiştir. Toplamda 180,413 örnekte makro-ELISA yöntemi ile (Architect i2000sr, Abbott, USA) anti-HIV antikoru taranmıştır. Reaktif gelen sonuçların hasta örnekleri doğrulanmak üzere Ulusal HIV-AIDS Doğrulama ve Viral Hepatitler Referans Laboratuvarı’na gönderilmiştir. Bulgular: Makro-ELISA yöntemi ile kan serum örnekleri çalışılan 180,413 hastadan 178 (%0,1)’inin anti-HIV sonucu reaktif olarak değerlendirilmiştir. 102 hastanın doğrulama testi negatif iken 76'sı pozitifti. Doğrulama testi sonucu pozitif olan hastalar tüm tetkik edilen hastaların %0,04’ünü oluşturmuştur. Doğrulama testi sonucu pozitif olan hastaların 67 (%88,2)’si erkek iken 9 (%11,8)’u ise kadındır. Yaş dağılımı incelendiğinde ise 26-35 yaş ve 36-45 yaş aralıkları eşit oranda olup en fazla (n=20, %26,3) yeni vaka tespit edilen yaş aralıkları olmuştur. Sonuç: Yapılan geriye dönük bu değerlendirmemiz sonucunda, HIV seropozitifliği, cinsiyet ve yaş dağılımlarının ülkemiz verileri ve ülkemizde yapılan diğer çalışmaların verileri ile uyumlu bulunmuştur. Tarama testlerindeki yalancı pozitifliğin oldukça yüksek olması, doğrulama testlerinin ne denli önemli olduğunu bir kez daha hatırlatmıştır.

Anahtar Kelimeler:

Anti-HIV, ELISA, HIV doğrulama

HIV Seropositivity in Patients Admitted to Our Hospital: Six Year Evaluation

Aim: Detecting human immunodeficiency virus (HIV)-infected individuals is very important in terms of quality of patients’ lives. However, it should be kept in mind that there may be false positives and tests must be confirmed. In this study, it was aimed to determine HIV seropositivity in our hospital for a period of six years and to contribute to the epidemiological data of the country. Material and Methods: The samples that came to serology laboratory between January 2014 and December 2019 were analyzed retrospectively. Anti-HIV antibodies were screened in a total of 180,413 samples by the macro-ELISA method (Architect i2000sr, Abbott, USA). Patient samples were sent to the National HIV/AIDS Confirmation and Viral Hepatitis Reference Laboratory for verification of reagents results. Results: Anti-HIV results of 178 (0.1%) of 180,413 patients whose blood serum samples were studied with the macro-ELISA method were evaluated as reactive. Confirmation test of 102 patients were negative while 76 were positive. Patients with positive confirmation result account for 0.04% of all patients. While 67 (88.2%) of the patients with positive confirmation were male and 9 (11.8%) were female. The ages of 26-35 and 36-45 years were equal with the highest number of new cases detected (n=20, 26.3%). Conclusion: As a result of our retrospective evaluation, HIV seropositivity, gender and age distributions in our hospital were found to be compatible with the data of our country and other studies conducted in our country. The high false positivity rate of screening tests, again indicates the importance of confirmation tests.

Keywords:

Anti-HIV, ELISA, HIV verification,

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unaids.org [Internet]. UNAIDS. UNAIDS data 2019. [Cited: 2020 Dec 12]. Available from: https://www.unaids.org/en/resources/documents/2019/2019-UNAIDS-data
hsgm.saglik.gov.tr [Internet]. Republic of Turkey Ministry of Health. Turkey HIV/AIDS control program 2019-2024. [Cited: 2020 Dec 12]. Available from: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/HIV-ADS/Tani-Tedavi_Rehberi/HIV_AIDS_Kontrol_Programi.pdf
hsgm.saglik.gov.tr [Internet]. Republic of Turkey Ministry of Health. HIV/AIDS diagnostic guide. [Cited: 2020 Dec 12]. Available from: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/HIV-ADS/Tani_Klavuzu/HIV-AIDS_Tani_Klavuzu.pdf
hsgm.saglik.gov.tr [Internet]. Republic of Turkey Ministry of Health. HIV/AIDS diagnosis and treatment guide 2019. [Cited: 2020 Dec 12]. Available from: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/HIV-ADS/Tani-Tedavi_Rehberi/HIV_AIDS_Tani_Tedavi_Rehberi_Yeni.pdf
Özkaya Şahin G, Başaran Çalık N, Ünal S. HIV transmission routes and speeds. Türk HIV/AIDS Derg. 2005;8(1):5-12.
Toptan H, Aslan FG, Karakeçe E, Aydemir Ö, Demiray T, Köroğlu M, et al. Evaluation of patients with anti-HIV ½ reactivity with confirmation test results. J Biotechnol and Strategic Health Res. 2019;3(1):27-32.
Aslan FG, Altındiş M. Current diagnostic algorithm of HIV and emerging prevention methods. Türk Mikrobiyol Cem Derg. 2017;47(2):47-60.
Şamlıoğlu P, Karaca Derici Y, Yılmaz Hanci S, Doğan G, Bayram A, Agus N, et al. Evaluation of two-year HIV positivity in a tertiary hospital. Turk Hij Den Biyol Derg. 2019;76(4):391-4.
Doğaner İB, Tabak FA, Us T. The incidence rate of confirmed real HIV pozitivity in Eskisehir region. T Tıp Öğr Arş D. 2019;1(3):73-7.
Güreser AS, Özçelik S, Boyacıoğlu Zİ, Özünel L, Yıldız Ü, Taylan Özkan A. Seropositivity rates of HBsAg, anti-HCV, HIV and VDRL in blood donors in Çorum Turkey. Turk Hij Den Biyol Derg. 2015;72(2):123-30.
Şanlı K, Sarı ND, Hatipoğlu N. Evaluation of 10-year screening test result in blood donors consulted to our blood center. JOPP Derg. 2013;5(3):136-41.
Bulut N, Yenişehirli G, Bulut Y. Seroprevalence of Hepatitis B, Hepatitis C, HIV and Syphilis in blood donors in Tokat. Viral Hepat J. 2012;18(1):11-4.
Gül M, Çıragil P, Aral M, Doğramacı N. The evaluation of HBV, HCV, HIV and syphilis screening test results in voluntary and nonvoluntary blood donors. Türk Mikrobiyol Cem Derg. 2006;36(1):35-9.
Gürkan Y, Toyran A, Aksoy A, Coşkun FA, Sezer A. Seroprevalance of Hepatitis and HIV in patients and blood donors and evaluation of HCV-RNA levels in Anti-HCV positive samples in Ankara Numune Training and Research Hospital. Viral Hepat J. 2013;19(3):131-5.
Parlak M, Özlük S, Demir C, Rağbetli C. Seroprevalence of HBsAg, Anti-HCV, Anti-HIV and syphilis in blood donors. KÜ Tıp Fak Derg. 2015;17(3):1-6.
Çelebi D, Çelebi Ö, Altoparlak Ü, Kök AN. Evaluation of HBsAg, Anti-HCV, Anti-HIV½ and syphilis seroprevalence of the blood donors and the comparison of the macro-ELISA optical density values with confirmatory tests. Türk Mikrobiyol Cem Derg. 2012;42(4):137-41.
Uzun B, Güngör S, Er H, Pektaş B, Demirci M. Seropositivity rates of HBsAg, Anti-HCV, Anti-HIV in outpatients in İzmir Atatürk Traning and Research Hospital. Viral Hepat J. 2013;19(3):123-5.
Özdem B, Çelikbilek N, Açikgöz ZC. Anti-HIV and confirmation test results of our hospital for seven years (2004-2010). Mikrobiyol Bul. 2011;45(3):577-9.
Yüksel P, Ziver T, Izmirli S, Aslan M, Sarıbaş S, Güngördü Z, et al. Confirmatory test results in anti-HIV-positive patients: Evaluation of five-year data. Klimik Derg. 2010;23(2):51-4.
İnci A, Okay M, Güven D. HBsAg, anti-HBs, anti-HCV and anti-HIV seroprevalence of the patients apply to Artvin State Hospital. Viral Hepat J. 2013;19(1):41-4.
Şafak B. HBsAg, anti-HCV and anti-HIV seroprevalence of the patients in Balıkesir Atatürk State Hospital. Viral Hepat J. 2013;19(2):43-5.
Aynali A, Cicioğlu Arıdoğan B, Nurlu Temel E, Çarsancaklı SA, Sesli Çetin E. HBs Ag, Anti-HCV, Anti-HIV seropositivity rates in samples working in a university hospital laboratory. Genel Tıp Derg. 2016;26(4):106-8.
Çetinkol Y. HBsAg, Anti-HCV and Anti-HIV seroprevalence of the patients apply to Kars Public Hospital. Viral Hepat J. 2012;18(2):76-80.
Dinç HÖ., Özbey D, Sirekbakan S, Gareayaghi N, Kocazeybek BS. Seroepidemiologic evaluation of HIV scanning and verification datas during the period of 2015-2018. ANKEM Derg. 2019;33(3):89-94.
hsgm.saglik.gov.tr [Internet]. Republic of Turkey Ministry of Health. HIV/AIDS Statistics. [Cited: 2020 Dec 12]. Available from: https://hsgm.saglik.gov.tr/tr/bulasici-hastaliklar/hiv-aids/hiv-aids-liste/hiv-aids-istatislik.html
who.int [Internet]. World Health Organization. HIV data and statistics. [Cited: 2020 Dec 12]. Available from: https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/strategic-information/hiv-data-and-statistics.
Beka H, Yılmaz M, Köksal MO, Meşe S, Eraksoy H, Somer A, et al. Evaluation of validation test result in anti HIV reactive patients. ANKEM Derg. 2018;32(2):72-7.