Arzu ALTUNÇEKİÇ YILDIRIM, Celali KURT, Ali Seydi ALPAY, Ahmet DOĞAN

Kronik Hepatit C Enfeksiyonlu Hastalarda Genotip Dağılımı ve Risk Faktörleri

Amaç: Hepatit C virusu (HCV) enfeksiyonu tüm dünyada yaygın, önemli bir halk sağlığı sorunudur. HCV genotipinin belirlenmesi epidemiyolojik olarak ve tedavi yaklaşımının belirlenmesinde önemlidir. Bu çalışmada, Türkiye’nin kuzeyinde yer alan merkezimizde takip ettiğimiz hastalarda genotip dağılımının ve ilişkili risk faktörlerinin değerlendirilmesi amaçlanmıştır. Yöntem: Çalışmamızda 2016-2019 yılları arasında Enfeksiyon Hastalıkları Polikliniğinde Kronik hepatit C tanısı almış ve doğrudan etkili antiviral tedavi uygulanmış 175 hasta retrospektif olarak değerlendirildi. Genotip dağılımı belirlenerek hastaların bulaş ve farklı genotipler açısından risk faktörleri analiz edildi. Bulgular: Genotip 1b hakim genotip olarak saptandı (%95). % 5 hastada 1b dışı genotipler (genotip 1a, 3 ve mixt) mevcuttu. Genotip 1b, 50 yaş üstü hastalarda sık iken diğer genotiplere sahip hastalar daha gençti. Risk faktörü olarak en sık cerrahi girişim öyküsü tespit edildi. Genç yaş, transplantasyon ve damar içi uyuşturucu kullanımı 1b dışı genotip ile enfeksiyon gelişimi için risk faktörü olarak saptanırken, ev içi HCV teması genotip 1b için anlamlı bulundu. Sonuç: Çalışmamızda hakim genotip, genotip1 b olarak saptanmıştır. Risk faktörleri arasında en sık tespit edilenler cerrahi müdahaleler ve dental girişim öyküsüdür. Geleneksel risk faktörlerindeki değişim 1b dışı genotiplerin artmasına yol açabilir. HCV ile küresel mücadelede bu değişimin doğru analiz edilmesinin önemli olduğunu düşünüyoruz.

Anahtar Kelimeler:

Hepatit C, genotip, risk faktörleri, epidemiyoloji

Genotype distribution and risk factors in patients with chronic hepatitis C infection

Objective: Hepatitis C virus (HCV) is a common infection around the world and an important public health problem. Determination of HCV genotype is important epidemiologically and for treatment approaches. In this study, the aim was to assess the genotype distribution and associated risk factors for patients monitored at our center in northern Turkey. Methods: A cross-sectional study was carried out of patients with confirmed HCV infection. Our study retrospectively assessed 175 patients with chronic hepatitis C diagnosis in the Infectious Diseases clinic from 2016-2019 and with antiviral treatment administered. The samples were tested by type specific genotyping assay. The relationship between demographic characteristics and potential risk factors and genotype was investigated. Results: Genotype 1b was identified as the dominant genotype (95%). In 5% of patients, non-1b genotypes were present (genotype 1a, 3 and mixed). Genotype 1b was more common in patients over 50 years of age, while the patients with other genotypes were younger. The most frequent risk factor was identified as surgical intervention history. While young age, transplantation and intravenous drug use were identified as risk factors for development of infection with non-1b genotypes, household HCV contact was significant for genotype 1b. Conclusion: In our study, the dominant genotype was identified as genotype 1b. Among the risk factors in our study, the most frequently identified are surgical interventions and dental treatment. The variation in traditional risk factors will cause an increase in non-1b genotypes. We think it is important to correctly analyze these variations in the global struggle with HCV.

Keywords:

Hepatitis C genotype, risk factors, epidemiology, non- 1b genotypes,

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