Doğrulanmış HIV Pozitif Olgularda Hepatit Virüsler ve TORCH Grubu Mikroorganizmaların Serolojik Profillerinin İncelenmesi

Amaç: HIV virüsü, immün sistem yetmezliğine neden olarak, virüs, mantar ve protozoon kaynaklı enfeksiyonlara yakalanma riskini arttırmaktadır. Bu çalışmada; HIV pozitif hastalarda, Hepatitvirüsler Hepatit A, Hepatit B ve Hepatit C ve TORCH grubu Toxoplasma gondii, Rubella, Sitomegalovirüs CMV , Herpes Simplex Virüs HSV mikroorganizmaların serolojik profillerinin belirlenmesi amaçlanmıştır.Gereç ve Yöntem: 2017-2018 yıllarında Selçuk Üniversitesi Tıp Fakültesi Hastanesi’ne başvuran HIV şüpheli olgular n:75 retrospektif olarak incelenmiştir. Anti-HIV testi istemi olan serumlardan Architect i1000sr Abbott Diagnostics, Almanya cihazıyla "HIV1/2Ag/Ab Combo" testi çalışılmıştır. Pozitif serum örnekleri doğrulama için Türkiye Halk Sağlığı Kurumu Referans Laboratuvarı’na gönderilmiştir. Doğrulanmış pozitif serum örnekleri olan hastalar, laboratuvarımızda HIV-RNA testi ile takip edilmiştir. Bulgular: HIV pozitif hasta serumlarının 53’ünde Anti-HCV çalışılmış ve sadece birinde %1.9 pozitif saptanmıştır. Anti-HAV IgG ise 26 örneğin 16’sında %61.5 pozitif olarak saptanmıştır. Toxoplasma IgG n:49 , RubellaIgG n:35 , RubellaIgM n:21 , CMV IgG n:40 ve HSV2 IgG n:33 sırasıyla;%20.4, %97.1,%4.8,%92.5 ve%10 pozitif bulunmuştur. Sonuç: Çalışılan hasta grubunda akut enfeksiyon göstergelerinden sadece Rubella IgM %4.8 pozitif bulunmuştur, zamanla farklı enfeksiyonların da gelişebileceği düşünülmektedir. Günümüzde artan HIV sıklığı göz önüne alındığında, hastaların bu konuda daha fazla bilgilendirilmesi ve HIV pozitif hastaların serolojik profillerinin araştırılması büyük önem taşımaktadır
Anahtar Kelimeler:

HIV, hepatit, seroloji, TORCH

Investigation of the serological profiles of hepatitis viruses and torch group microorganisms in confirmed HIV positive cases

Objective: HIV virus increases the risk of infections caused by viruses, fungi and protozoa by causing immune system insufficiency.The aim of this study was to determine the frequency of hepatitis viruses Hepatitis A, Hepatitis B and Hepatitis C and TORCH group Toxoplasmagondii, Rubella, Cytomegalovirus CMV , Herpes SimplexVirus HSV microorganisms’ serologic profiles in HIV positive patients.Material and Methods: HIV suspected patients n:75 that admitted to Selcuk University Medical Faculty Hospital between 2017-2018 were examined retrospectively. "HIV-1 / 2Ag / Ab Combo" tests have been studied with the Architect i1000sr Abbott Diagnostics, Germany device from the sera that have requested anti-HIV test. Positive serum samples were sent to the Public Health Authority Reference Laboratory for verification. Patients wih confirmed positive serum sampleswerefollowedby HIV-RNA test in ourlaboratory. Results: Anti-HCV was studied in 53 of the HIV positive patient sera and was positive in only one 1.9% .Anti-HAV IgG was positive in 16 61.5% of 26 samples.Toxoplasma IgG n:49 ,RubellaIgG n:35 , RubellaIgM n:21 , CMV IgG n:40 and HSV 2 IgG n:33 were found positive; 20.4%, 97.1%, 4.8%, 92.5% and 10% respectively. Conclusion: Only Rubella IgM 4.8% was found to be positive for acute infection in the study group. It is thought that different infections may develop in time. Considering the increasing frequency of HIV, it is necessary to inform the public more about this issue and to investigate the serologic profiles in HIV positive patients

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  • Bonacini M, Louie S, Bzowej N, Wohl AR. Survival in pa- tients with HIV infection and viral hepatitis B or C: a co- hort study. AIDS 2004;18:2039–45.
  • Hernandez MD, Sherman KE. HIV/hepatitis C coinfecti- on natural history and disease progression. Curr Opin HIV AIDS 2011;6:478–82.
  • Col LS, Col SM, Prasanna S, Col MC. Seroprevalence of TORCH infections in antenatal and HIV positive patient populations. Med J Armed Forces India 2015; 71: 135-8.
  • LukhwareniA, Burnett RJ, Selabe SG, Mzileni MO, Mphah- lele MJ. Increased detection of HBV DNA in HBsAg‐po- sitive and HBsAg‐negative South African HIV/AIDS pa- tientsenrolling for highly active antiretroviral therapy at a Tertiary Hospital. J Med Virol 2009; 81: 406-12.
  • Ioannou GN, Bryson CL, Weiss NS, Miller R, Scott JD, Boy- ko EJ. The prevalence of cirrhosis and hepatocellular car- cinoma in patients with human immuno- deficiency virus infection. Hepatology 2013;57:249–57.
  • Kourtis AP, Bulterys M, Hu DJ, Jamieson DJ. HIV-HBV co- infection – a global challenge. N Engl J Med 2012;366:1749– 52.
  • Stabinski L, Reynolds SJ, Ocama P, et al. High prevalence of liver fibrosis associated with HIV infection: a study in rural Rakai, Uganda. Antivir Ther 2011;16:405–11.
  • Attia KA, Eholie S, Messou E, et al. Prevalence and virologi- cal profiles of hepatitis B infection in human immunodefi- ciency virus patients. World J Hepatol 2012;4:218–23.
  • Nikolopoulos GK, Paraskevis D, Hatzitheodorou E,et al. Impact of hepatitis B virus infection on the progression of AIDS and mortality in HIV-infected individuals: a cohort study and meta-analysis. Clin Infect Dis 2009;48:1763–71.
  • İnci A, Fincancı M,Soysal F. HIV/HBV koenfeksiyonlu ol- guların değerlendirilmesi. J Clin Anal Med 2015; 6: 439-42.
  • Tounkara A, Sarro YS, Kristensen S, et al.Seroprevalence of HIV/HBV coinfection in Malian blood donors. J Int As- soc Physicians AIDS Care (Chic) 2009;8:47–51.
  • Eke AC, Eke UA, Okafor CI, Ezebialu IU, Ogbuagu C. Pre- valence, correlates and pattern of hepatitis B surface antigen in a low resource setting. Virol J 2011;8:12.
  • Zeba MT, Karou SD, Sagna T, et al. HCV prevalence and co-infection with HIV among pregnant women in Saint Ca- mille Medical Centre, Ouagadougou. Trop Med Int Health 2011;16: 1392–6.
  • Aydın ÖA, Karaosmanoğlu HK, Korkusuz R,Nazlıcan Ö. HIV/AIDS Hastalarında Toxoplasma gondii IgG Seropre- valansı. Turkiye Parazitol Derg 2011; 35: 65-7.
  • Turbadkar D, Mathur M, Rele M. Seroprevalence of torc- hinfection in badobstetrichistory. Indian J Med Microbiol 2003; 21: 108-10.
  • Rathore S, Jamwal A, Gupta V. Herpessimplexvirustype 2: seroprevalence in antenatalwomen. Indian J Sex Transm Dis 2010; 31: 11-5.
  • Sen MR, Shukla BN, Tuhina B. Prevalence of serum antibo- dies to TORCH infection in and around Varanasi, Northern India. J Clin Diagn Res 2012; 9: 1483-5.
  • Montoya JG, Boothroyd JC, Kovacs JA. Toxoplasma gondii. Mandell GL, Bennett JE, Dolin R. eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Disea- ses. Philadelphia: Elsevier 2010; 3495-526.
  • Singla N, Jindal N, Aggarwal A. Theseroepidemiology of Rubella in Amritsar (Punjab). Indian J Med Microbiol 2004; 22: 61-6.
  • CDC 1993 Revised Classification System for human immu- no deficiency virus infection and expanded surveillance, case definition for AIDS among adolescents and adults. MMWR 1992;(RR-12):1-19.
  • Sgaier SK, Mony P, Jayakumar S, et al.Prevalence and cor- relates of Herpes Simplex Virus-2and syphilis infections in the general population in India. Sex Transm Infect 2011; 87: 94-100.
  • Kaplan JE, Benson C, Holmes KH, Brooks JT, Pau A, Masur H. Guidelines for pre- vention and treatment of opportu- nistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infecti- ous Diseases Society of America. MMWR Recomm Rep 2009;58:1–207.
  • Brook G, Main J, Nelson M, et al.British HIV Association guidelines for the management of coinfection with HIV-1 and hepatitis B or C virus 2010. HIV Med 2010;11:1–30.
  • Geretti AM, Patel M, Sarfo FS, et al.Detection of highly pre- valent hepatitis B virus coinfection among HIV-seroposi- tive persons in Ghana. J Clin Microbiol 2010;48:3223–30.
  • Matthews PC, Geretti AM, Goulder PJ, Klenerman P. Epi- demiology and impact of HIV coinfection with hepatitis B and hepatitis C viruses in Sub-Saharan Africa. J Clin Virol 2014; 61: 20-33.