Aksaray ilindeki HBsAg/HCV prevalansı, HCV’li hastaların demografik verileri ve yeni tedavilere ulaşım oranları

Amaç: Tüm dünyada yaklaşık olarak 210 milyona yakın kişinin kronik HCV ile enfekte olduğu tahmin edilmektedir. Günümüzde doğrudan etkili antiviral ajanların kullanılmasıyla HCV’de tedavi başarısı %95’in üzerinde kalıcı viral yanıt oranlarına ulaşılmıştır. Ülkemizde de bu ilaçlar son iki yıldır kullanılmaktadır. Tedaviye ulaşan hasta sayılarında istenen sonuçlara ulaşılamamıştır. Bu çalışmada Aksaray İlindeki HBsAg ve HCV prevalansını araştırdık. Ayrıca HCV ile enfekte olan hastaların demografik özellikleri, hastalıkla ilgili farkındalıklarını ve tedaviye ulaşım oranlarını ortaya çıkarmayı amaçladık.Gereç ve Yöntem: Bu çalışmada Ocak 2016 ile Ekim 2018 tarihleri arasında Aksaray Eğitim ve Araştırma Hastanesi Gastroenteroloji, Enfeksiyon hastalıkları polikliniği ve endoskopi ünitesine başvuran 11716 hasta geriye doğru tarandı. HCV pozitif hastalar iletişim numaralarından arandı.Bulgular: 11716 hastanın 244’ünde (%2,08) HBsAg ve 71’inde (%0,6) anti-HCV pozitifliği saptandı. Ulaşılabilen elli üç HCV’li hasta çalışmaya alındı. 16 hastaya ulaşılamadı. Bu hastalardan 9’unun dış merkezde yeni tedavi rejimleri ile tedavi aldıkları saptandı. Dokuz hastaya bu çalışma sırasında ulaşılarak tedaviye ulaşmaları sağlandı. Bu hastaların tamamının tedaviyi tolere edebildiği ve kalıcı viral yanıt sağlandığı tespit edildi.Sonuç: HCV’li hastalarda doğrudan etkili antiviral ajanlar etkili ve güvenilir ilaçlardır. Hastaların ilaçlara ulaşımını sağlamak için ek çabalara ve bilgilendirmelere ihtiyaç duyulmaktadır.

Anahtar Kelimeler:

hepatit C virüsü, direk etkili antiviral ilaçlar, kalıcı viral yanıt

The prevalence of HBsAg / HCV in Aksaray province, demographic data of patients with HCV and the rates of access to new treatments

Aim: Approximately 210 million peoples worldwide are estimated to be infected with chronic HCV. Nowadays, with the use of direct-acting antiviral agents, sustained viral response rates of more than 95% have been achieved in HCV. In our country, these drugs have been used for the last two years. The desired results could not be reached in the number of patients reaching treatment. In this study, we investigated the prevalence of HBsAg and HCV in Aksaray. In addition, we aimed to reveal the demographic characteristics of patients infected with HCV, their awareness about the disease and the rates of access to treatment.Material and methods: In this study, 11716 patients admitted to Aksaray Training and Research Hospital Gastroenterology, Infectious Diseases Outpatient Clinic and Endoscopy Unit between January 2016 and October 2018 were retrospectively screened. HCV positive patients were called from their contact numbers.Results: HBsAg was detected in 244 (2.08%) and anti-HCV positivity in 71 (0.6%) of 11716 patients. Fifty-three patients with HCV were included in the study. 16 patients could not be reached. Nine of these patients were treated with new treatment regimens at the external center. Nine patients were reached during this study and were provided access to treatment. All of these patients were able to tolerate treatment and a permanent viral response was found.Conclusion: Direct effective antiviral agents are effective and safe drugs in patients with HCV. Additional efforts and means of communication are needed to enable patients to access drugs.

Keywords:

hepatitis C virus, direct effective antiviral agents, permanent viral response,

PDF

___

European Association of the Study of the Liver. 2011 European Association of the Study of the Liver hepatitis C virus clinical practice guidelines. Liver Int. 2012; 32(Suppl 1): 2-8.
World Health Organization. Hepatitis C fact sheet. Available from URL: http://www.who.int/mediacentre/factsheets/fs164/en. Updated April 2014. Accessed February 18, 2015
Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: new estimates of age- specific antibody to HCV seroprevalence. Hepatology 2013; 57: 1333-1342. PMID: 23172780. (doi: 10.1002/hep.26141).
Hauri AM, Armstrong GL, Hutin YJ. The global burden of disease attributable to contaminated injections given in health care settings. Int J STD AIDS 2004; 15: 7-16. PMID: 14769164. (doi: 10.1258/0 95646204322637182).
Bruggmann P, Berg T, Øvrehus AL, Moreno C, Brandão Mello CE, Roudot-Thoraval F, ve ark. Historical epidemiology of hepatitis C virus (HCV) in selected countries. J Viral Hepat. 2014; 21(Suppl 1): 5-33.
van de Laar M, Veldhuijzen I, Hahn S. Hepatitis B and C in the EU neighbourhood: prevalence, burden of disease and screening policies. Stockholm: ECDC 2010; 56.
American Association for the Study of Liver Diseases, Infectious Diseases Society of America. HCV guidance: recommendations for testing, manag- ing, and treating hepatitis C. Available from URL: http://www.hcvguidelines.org/. Accessed 3 Jul 2017.
Division of Viral Hepatitis, Center for Disease Control and Prevention (CDC). U. S. 2014 surveillance data for viral hepatitis 2016. Available from URL: https://www.cdc.gov/hepatitis/statistics/2014surveillance/index.htm#tabs-1170600-11.
Centers for Disease Control and Prevention (CDC). Hepatitis C kills more Americans than any other infectious disease. 2016. Available from URL: https://www.cdc.gov/media/releases/2016/p0504-hepc-mortality.html. Accessed 20 July 2017.
Hepatitis Awareness Month and Testing Day–May 2017. MMWR Morb Mortal Wkly Rep. 2017; 66: 465.
Tozun N, Ozdogan O, Cakaloglu Y, Idilman R, Karasu Z, Akarca U, Kaymakoglu S, Ergonul O. Seroprevalence of hepatitis B and Cvirus infections and risk factors in Turkey: a fieldwork TURHEPstudy. Clinical microbiology and infection: the official publicationof the European Society of Clinical Microbiology and InfectiousDiseases 2015; 21: 1020-1026.
Çeldir M, Kara I, Coşkuner S, Keskin B, Küçüker M, Orer H, Ergönül O. Hepatitis C prevalence in Turkey: estimation through meta-analysis: Ilayda Arjen Kara. European Journal of Public Health 2014; 24: cku163-032.
Demirpençe Ö, Tezcan SI, Değirmen E, Mert D, Gümüş A, Çelen MK. Seroprevalence of HAV, HBV, HCV and HIV in People Admitted to Batman State Hospital. Viral Hepat J. 2012; 18: 6-10.
Gültepe B, Dülger AC, Aytemiz E. Epidemiology of the hepatitis C infection in Van’s region. Eastern Journal of Medicine. 2013; 18: 123-126.
Mıstık R. Türkiye’de viral hepatit epidemiyolojisi yayınların irdelenmesi. İçinde: Tabak F, Tekeli E (eds). Viral Hepatit 2007. 1. Baskı. İstanbul: Viral Hepatitle Savaşım Derneği, 2007. p. 10-50.