Kronik hepatit b tedavisinde HBsAg ve M30 antijen titre takibinin klinik yararı

Amaç: Antiviral tedavi öncesi ve sonrası serum HBsAg ve cccDNA düzeyleri ve bu değerlerdeki düşüş oranları arasında pozitif ilişki olduğu bilinmektedir. Serolojik HbsAg seviyesi de cccDNA ile ilişkilendirilmiştir ve serolojik HbsAg, enfekte olmuş hücreleri teşhis etmek için cccDNA'nın yerini alan bir biyobelirteç olarak kabul edilmiştir. M30 antijeni, apoptoz sırasında kaspaz proteinleri tarafından parçalanan CK 18 seviyelerini tespit etmek için kullanılır. Ayrıca KHB hastalığında, apopitoz belirteci olan M30 antijen düzeyleri ile karaciğer hasarı arasında ilişki olduğu gösterilmiştir. Bu çalışmada KHB enfeksiyonu’nun şiddeti ve nucleoz (t)ide analoğu (NA) tedavisine klinik yanıtının değerlendirilmesinde HbsAg ve M30 antijen titre takibinin yararını saptamayı amaçladık. Gereç ve yöntem: Çalışmaya KHB enfeksiyonuna yönelik oral antiviral tedavi verilen 60 hasta dahil edildi. Tüm hastalarda tedavi başlangıcında saptanan AST, ALT, HBVDNA, HAİ, fibrozis ile HbsAg ve M30 antijen düzeyleri arasındaki korelasyon değerlendirildi. Tedavi başlangıcı ve tedavinin 6. ayında saptanan AST, ALT, HBVDNA, HbsAg ve M30 antijen düzeyleri karşılaştırıldı. Tedavi ile bu değerlerde saptanan düşüş oranları değerlendirildi. Ayrıca hastalar aldıkları tedaviye göre Lamivudin ve Tenofovir alanlar olarak iki gruba ayrıldı. İki grup tedavi ile AST, ALT, HBVDNA, HbsAg ve M30 antijen düzeylerindeki düşüş oranları açısından karşılaştırıldı. HbsAg ve M30 antijen seviyelerinin tedavi sonrası azalma oranı açısından iki grup da karşılaştırıldı. Bulgular: Tedavi başlangıcında saptanan AST, ALT, HBVDNA düzeyleri ile HbsAg ve M30 antijen arasında pozitif korelasyon saptandı (p0,05), HAİ, Fibrozis dereceleri ile M30 antijen düzeyleri arasında pozitif korelasyon saptandı (p

Clinical utility of HBsAg and M30 antigen titer follow-up in chronic hepatitis B treatment

Purpose: Positive correlation has been detected between pretreatment and posttreatment serologic levels and amount of decrease of HbsAg and cccDNA. Serologic HbsAg level has also been correlated with cccDNA, and serologic HbsAg has been accepted to be a biomarker replacing cccDNA to diagnose infected cells. M30 antigen is used to detect CK 18 levels that are disintegrated by caspase proteins during apoptosis. As an indicator of apoptosis, M30 levels show liver injury in chronic Hepatitis B infection. In this study, we aimed to evaluate clinical efficacy of measurement of HbsAg and M30 titrated antigen levels for response to treatment of chronic Hepatitis B infection during follow-up. Materials and methods: Sixty patients receiving oral antiviral therapy for chronic Hepatitis B infection were included in the study. Correlation in between before treatment antigen levels of AST, ALT, HBVDNA, HAI, fibrosiswith HbsAg and M30 were evaluated in all patients. Before treatment and at sixth of month of treatment antigen level results of AST, ALT, HBVDNA, HbsAg and M30 were compared. Detected decrement levels following treatment were evaluated. In addition, patients were grouped in two according to medicine received by the patients as Lavumidin and Tenofovir. Two groups were compared concerning age, sex, pretreatment antigen levels of AST, ALT, HBVDNA, HAI, Fibrosis, HbsAg and M30. Two groups were also compared concerning posttreatment decrement ratio of antigen levels of HbsAg and M30. Results: Positive correlation was detected between levels of AST, ALT, HBVDNA and HbsAg and M30 antigens at pretreatment period measurements (p0.05), positive correlation was detected between HAI, degree of Fibrosis and m30 antigen levels (p

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Kaynak Göster

  • ISSN: 1309-9833
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2008

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