Nagehan Didem SARI, Rıza Umar GÜRSU

Onkoloji hastalarında kemoterapi öncesi HBsAg, antiHBs ve izole antiHBc IgG pozitiflik oranları

Amaç: Onkoloji hastalarında uygulanan kemoterapi HBV reaktivasyonuna neden olabilmektedir. Bu çalışmada amacımız hastanemiz Onkoloji Polikliniği’nde takip edilen ve kemoterapi alması planlanan hastalarda kemoterapi öncesinde HBV enfeksiyonu açısından yapılan tarama sonuçlarını değerlendirmektir. Gereç ve yöntem: Bu çalışmada Ocak 2014-Aralık 2018 tarihleri arasında, Sağlık Bilimleri Üniversitesi İstanbul Eğitim ve Araştırma Hastanesi Medikal Onkoloji Polikliniği’ne başvuran ve kemoterapi alması planlanan, HBV serolojileri taranmış, 544 hasta değerlendirmeye alındı. Hastaların yaş, onkolojik tanıları, HBV enfeksiyonu açısından HBsAg, antiHBs ve antiHc IgG sonuçları geriye dönük olarak tarandı. Bulgular: Hastaların tamamından HBsAg istenmiş olduğu belirlenmiş olup, 16’sında (16/544) %2,94 HBsAg pozitifliği görüldü. AntiHBs istenen hasta sayısının 158 olduğu ve bu hastalardan 51’nin pozitif %32,27 (51/158) olduğu, izole antiHBc IgG pozitiflik oranının ise 4/50 (%8) olduğu belirlendi. HBsAg pozitif 16 hastanın malignite dağılımlarına bakıldığında en sık akciğer ve gastrointestinal kanser olduğu görüldü. Sonuç: Kemoterapi planlanan hastalarda HBV reaktivasyonu ve bunun sonucu olarak gelişen karaciğer yetmezliği, başlanan tedaviye ara verme gibi istenmeyen bir tabloya yol açabilir. Bu durum göz önüne alınarak hastaların HBV enfeksiyonu açısından taranması ve immunsüpresif tedavi uygulayan hekimlerin bu konuda farkındalığının arttırılması gerekmektedir.

The positivity ratios of HBsAg, anti-HBs and isolated anti-HBc IgG before chemotherapy

Purpose: Chemotherapy may cause HBV reactivation in oncology patients. This study was aimed to evaluate screening results for HBV infection before chemotherapy in patients who are being followed-up and planned to receive chemotherapy in the oncology clinic. Materials and methods: This study included 544 patients who are admitted to the Health Sciences University Istanbul Training and Research Hospital Medical Oncology Outpatient Clinic between January 2014 and December 2018, planned to receive chemotherapy. Age, diagnoses, HBsAg, anti-HBs and anti-HBc IgG results were screened retrospectively for HBV infection. Result: When a total of 544 patients who were planned to receive chemotherapy were analyzed with regard to cancer type, lung and gastrointestinal cancers were found to be most common. It was determined that HBsAg was screened in all. HBsAg positivity ratio of our patients was 2,94 % (16/544), anti-HBs positivity was found as 32,27% (51/158), the rate of isolated anti-HBc IgG was 4/50 (8%). Conclusion: Results of this study considering the risk factors such as reactivation, hepatic failure, interruption of treatment in patients who are scheduled for chemotherapy, we think that the patients should be screened for HBV infection and the awareness of physicians who apply immunosuppressive treatment study should be increased.

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