Hbeag negatif kronik hepatit B hastalarında hastalığın ciddiyeti ve antiviral tedaviye yanıtının belirlenmesinde tümör nekrosis faktör alfa promotor polimorfizmlerinin rolü
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Dosyalar
Tarih
2007
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
HBeAg negatif KHB enfeksiyonunun ciddiyetine ve interferon alfa + lamivudin kombinasyon tedavisine verilen yanıtın ön görülmesinde TNFalfa promotor polimorfizmlerinin rolünün belirlenmesi Hastalar: Klinik Bakteriyoloji ve Ebfeksiyon Hastalıkları kliniğinde 2002-2007 yılları arasında HBeAg negatif Kronik heptatit B tanısıyla takip edilen 43 hasta çalışmaya alındı. Karaciğer biyopsileri hastanemizde yapıldı. Hastalara 1 yıl süreyle haftada 3 kez interferon alfa2b 10MU ve lamivudin 100mg/gün tedavisi verildi. Hastalar aylık olarak polikliniğimzde takip edildi. Bulgular: Nekroinflamatuar ve fibrozis skorları yüksek olan hastalar ile nekroinflamasyon düzeyi düşük olan kişiler arasında TNF alfa promotor polimorfizmleri açısından farklılık saptanmadı. Tedaviyle birlikte, 3 ay içerisinde, hastaların AST/ALT düzeylerinde istatistiksel anlamlı azalma saptandı (p_0,000). Hastaların %16.2'sinde tedavi yanıtı elde edilemedi. Kalıcı virolojik ve biyokimyasal yanıt hastaların %67.4'ünde tespit edildi. Kalıcı yanıt veren hastalar ve kalıcı yanıt vermeyen hastalar TNFalfa promotor polimorfizmleri açısından kıyaslandığında iki grup arasında fark saptanmadı. Sonuç ve tartışma: TNF alfa promotor -238 ve -308 bölgesindeki tek baz polimorfizmleri Türk popülasyonunda KHB enfeksiyonunun ciddiyetine ve hastalığın antiviral tedaviye yanıtına etki etmemektedir.
To investigate whether TNF alfa promoter polymorphisms affets disease severity and response to interferon alpha plus lamivudine combination therapy in HBeAg negative chronic hepatitis B patients. Patients and methods: 43 patients diagnosed to have HBeAg negative chronic hepatitis B between years 2002-2007 at Dept. of Clin. Bacteriology and Infectious Diseases were enrolled in this study. All patients underwent liver biopsy examination before the onset of treatment. Patients received interferon alpha2b 10MU tiw and lamivudine 100mg QD combination therapy for a year. Routine follow-ups were carried-out at out patient clinics of our department. TNF alpha promotor polymorphisms at positions -238 and -308 were studied by PCR-RFLP. Results: Patients diagnosed to have severe hepatitis as a result of higher necroinflamatory and fibrosis scores and higher AST/ALT levels were compared with patients WHO had milder disease. No statistically significant difference was found between patients with severe disease and milder disease in terms of TNFalpha promoter -238 and -308 polymorphisms.24 week after commencement of antiviral treatment AST and ALT levels were decreased significantly with respect to initial values. 16.2% of patients did not respond to treatment whereas sustained response was achieved in 67% of patients. Once again, no statistically significant difference was found between sustained responders and nonresponders in terms of TNF alfa promoter -238 and -308 polymorphisms. Discussion: TNF alpha promoter polymorphisms at position -38 and -308 do not contribute to disease severity and response to antiviral treatment in Turkish chronic hepatitis B patients.
To investigate whether TNF alfa promoter polymorphisms affets disease severity and response to interferon alpha plus lamivudine combination therapy in HBeAg negative chronic hepatitis B patients. Patients and methods: 43 patients diagnosed to have HBeAg negative chronic hepatitis B between years 2002-2007 at Dept. of Clin. Bacteriology and Infectious Diseases were enrolled in this study. All patients underwent liver biopsy examination before the onset of treatment. Patients received interferon alpha2b 10MU tiw and lamivudine 100mg QD combination therapy for a year. Routine follow-ups were carried-out at out patient clinics of our department. TNF alpha promotor polymorphisms at positions -238 and -308 were studied by PCR-RFLP. Results: Patients diagnosed to have severe hepatitis as a result of higher necroinflamatory and fibrosis scores and higher AST/ALT levels were compared with patients WHO had milder disease. No statistically significant difference was found between patients with severe disease and milder disease in terms of TNFalpha promoter -238 and -308 polymorphisms.24 week after commencement of antiviral treatment AST and ALT levels were decreased significantly with respect to initial values. 16.2% of patients did not respond to treatment whereas sustained response was achieved in 67% of patients. Once again, no statistically significant difference was found between sustained responders and nonresponders in terms of TNF alfa promoter -238 and -308 polymorphisms. Discussion: TNF alpha promoter polymorphisms at position -38 and -308 do not contribute to disease severity and response to antiviral treatment in Turkish chronic hepatitis B patients.
Açıklama
Anahtar Kelimeler
Viral hepatit, Viral hepatitis, kronik hepatit, chronic hepatitis
Kaynak
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Künye
İnkaya, A. Ç. (2007). Hbeag negatif kronik hepatit B hastalarında hastalığın ciddiyeti ve antiviral tedaviye yanıtının belirlenmesinde tümör nekrosis faktör alfa promotor polimorfizmlerinin rolü. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Enfeksiyon Hastalıkları Anabilim Dalı, Konya.
