Tarkan AGASOY, Hande KIZILOCAK, Rejin KEBUDI, Gül Nihal ÖZDEMİR

Çocukluk çağı kanserlerinde tanıda ve tedavi sonrası Hepatit B, Hepatit C ve HIV seroprevelansı: 25 yılda gelişmeler

Amaç: Çocukluk çağı kanserlerinde yoğun kemoterapi sonrası kan transfüzyonu gerekliliği artmakta ve buna bağlı olarak hepatit B, hepatit C ve HIV gibi enfektif hastalıkların bulaşma olasılığı oluşmaktadır. Bu çalışmanın amacı çocukluk çağı kanserlerinde hepatit B, hepatit C ve HIV seroprevalansını incelemek ve bu sonuçları ulusal Hepatit B aşılaması başlamadan önceki ve kan bankalarında rutin hepatit C virüs (HCV) tarama programları olmadığı dönemki çalışmalarla karşılaştırmaktır. Gereç ve Yöntemler: Ocak 2010–Ocak 2012 arası kanser tedavisi gören ve çoklu kereler kan transfüzyonu alan 100 olguda (51 kız, 49 erkek) tanıda ve tedavi sonrası HBsAg, anti-HBs, anti-HCV ve anti-HIV çalışıldı. Hastalarımız 1998 ve sonrası doğumlu olup, aynı yıl başlatılan ulusal hepatit B aşı programına dahil idiler. Bulgular: HBsAg, anti-HCV ve anti-HIV seropozitifitesi tanıda ve tedavi sonu %0 saptandı. Anti-HbS seropozitivitesi tanı anında %58 iken, tedavi sonunda %42 idi. HBsAg seropozitifitesi tedavi sonunda 1986–89’da %40, 1994–95’te %10 iken son çalışmamızda %0 olarak bulunarak anlamlı fark gösterdi. Anti-HCV ise 1994–95’te saptanan %14’e oranla %0 bulundu. Tanıda Anti-HBs’si pozitif olan 17 hastanın kemoterapi sonrası Anti-HBs’leri negatifleşmesine rağmen hiçbirinde HBV enfeksiyonu gelişmedi. Çıkarımlar: Bu sonucun elde edilmesinde en önemli etkenler kan bankalarındaki donör tarama tekniklerinde gelişme, hijyen koşullarının iyileşmesi ve ulusal ücretsiz hepatit B aşı programı olarak düşünülebilir. Bu sonuç, gelişmekte olan ülkeler için yol gösterici olacaktır.

Seroprevalence of Hepatitis B, Hepatitis C, and HIV in children with cancer at diagnosis and following therapy in Turkey: progress within the last 25 years

Aim: Children with cancer receiving intensive chemotherapy require multiple transfusions and are at increased risk for blood transmittable diseases such as hepatitis B virus (HBV), hepatitis C virus (HBC), and HIV infections. The aim of this study was to investigate the seroprevalence of HBV, HCV, and HIV in children with cancer and to compare the results with findings in our previous cancer studies conducted before the national free HBV vaccination and the HCV screening program in blood banks were established. Material and Methods: Sera from 100 children (51 females, 49 males) with cancer treated between January 2010 and January 2012 who received multiple transfusions were investigated for hepatitis B surface antigen (HBsAg), anti-HBs, anti-HCV, anti-HIV at diagnosis and at the end of treatment. Patients were born after 1998 when the national free hepatitis B vaccination program began. Results: HBsAg, anti-HCV, and anti-HIV seropositivities were 0% at diagnosis and at the end of treatment. Anti-HBs seropositivity was 58% at diagnosis and 42% at the end of treatment. HBsAg seropositivity, which was 0% at the end of treatment, was lower than 10% during 1994–95, and 40% from 1986 to 1989. Anti-HCV was 0% in contrast to 14% between 1994 and 1995. Seventeen patients with anti-HBs seropositivity at diagnosis were found to be seronegative after intensive chemotherapy. Conclusion: The nil seroprevalence of anti-HBsAg, anti-HCV, and anti-HIV in this cohort of children with cancer is encouraging. This progress is due to advances in donor screening techniques in blood banks, good hygenic practices, and the national free hepatitis B vaccination program in Turkey.

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