Aysun ÖZEL YEŞİLYURT, Arzu AYRALER, Selim TURFAN, Ahmet cumhur DÜLGER, Muhammed AYVAZ

Hepatit Delta Virüs ile Enfekte Hastalarda Hepatit E Seroprevalansı

Amaç: Bu çalışmanın amacı özellikle HDV ile enfekte hastalarda HEV enfeksiyonunun epidemiyolojik, biyokimyasal ve virolojik özelliklerini açığa çıkarmaktır. Ayrıca HDV enfeksiyonunun HEV seroprevalansı üzerine etkisini, her iki hastalığında endemik olduğu Van ilinde araştırdık.Materyal ve Metod:2015 Mayıs ve 2018 Mayıs ayları arasında 3.basamak hastanemize başvuran 198 vakaretrospektif olarak incelendi. Epidemiyolojik veriler, biyokimyasal, serolojik ve virolojik testlerin sonuçları kaydedildi.Bulgular: Araştırmamızda kronik HDV enfeksiyonlu hastalarda kronik HBV enfeksiyonlulara göre hem anti-HEV IgG hem de anti-HEV IgM düzeyleri daha yüksekti(sırasıyla %77’ye karşı %44, p=0,001 ve %23’e karşı %6, p=0,003). Ayrıca Kronik HDV enfeksiyonlu hastalarda kronik HBV enfeksiyonlulara göre daha yüksek AST (49±34’e karşı 26±12 U/L, p=0,005) ve ALT (45±27’ye karşı 28±15, p=0,001) seviyeleri ile daha düşük trombosit (159000±91000’e karşı 223000±69000/mm3, p<0,001) ve serum albumin (3,8±0,8’e karşı 4,2±0,3 mg/dl, p<0,001) seviyeleri gözlemlendi. Sonuç: Aynı çevresel koşullardan ötürü HDV enfeksiyonunun bulunuşu HEV enfeksiyonu yayılımı için major bir risk faktörüdür. Biz bozulmuş karaciğer durumuna bağlı olarak hastalığın yayılımında HDV enfeksiyonlu hastaların hatrı sayılır bir rolü olduğu sonucunu çıkarıyoruz. Ek olarak delta hepatiti özellikle 45 yaş üstü hastalarda önemli bir halk sağlığı problemi olarak devam etmektedir. Hastalığın tedavi başarısına yön vermesi için daha geniş ölçekli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Hepatit B virüs, Hepatit D virüs, Hepatit Delta virüs, Hepatit E virüs, Seroprevalans

Hepatitis E Virus Seroprevalence in Patients with Hepatitis Delta Virus Infection

Objective: The current study was conducted in order to reveal the epidemiologic, biochemical and virologic properties of the HEV cases particularly in patients with HDV infection. We also analysed the impact of HDV infection on HEV seroprevalence in Van region of eastern part of Turkey where the both diseases are still endemic. Material and Methods: 198 individuals that admitted to a tertiary hospital in the period of between May 2015 and May 2018 were retrospectively examined. Epidemiologic data, results of the biochemical, serologic and virologic tests were recorded. Results:Our analysis proved higher seroprevalence both of Anti HEV Ig G and anti HEV Ig M in most patients hospitalised with chronic HDV infection than in patients with chronic HBV infection (77% versus 44%; p=0.001 and 23% versus 6%; p=0.003, respectively). We also noticed that there were higher levels of AST (49±34 versus 26±12 U/L; p=0.005) and ALT (45±27 versus 28±15 U/L; p=0.001) and lower levels of platelet (159.000±91.000 versus 223.000±69.000 /mm3; p<0.001) and serum albumin (3.8±0.8 versus 4.2±0.3 mg/dl.; p<0.001) in chronic HDV patients than in chronic hepatitis B patients. Conclusion: Presence of HDV infection is a major risk factor for spreading HEV infection because of same environmental conditions. We conclude that patients with HDV infection have a considerable role in the transmission of the disease due to impaired liver condition. Additionally, delta hepatitis remains a serious health concern particularly in patients older than 45 years. Larger case series are needed to accurately guide in the success of the disease treatment.

Keywords:

Hepatitis B virus, Hepatitis D virus, Hepatitis Delta virus, Hepatitis E virus, Seroprevalence,

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