Anti-hcv bakılan olgularda hcv-rna sonuçlarının değerlendirilmesi
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Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada anti-HCV pozitif olan hastalarda HCV-RNA istenme oranı ve pozitifliğinin belirlenmesi, anti-HCV pozitifliği saptandıktan sonra HCV-RNA bakılmayan hastaların güncel HCV-RNA düzeylerinin incelenmesi amaçlanmıştır.
Yöntem: Bu prospektif kohort çalışmasına, 1 Ocak 2011–31 Aralık 2020 tarihleri arasında Necmettin Erbakan Üniversitesi (NEÜ) Meram Tıp Fakültesi Hastanesi’nde anti-HCV bakılan hastalar dahil edilmiştir. Bu olgular arasından HCV RNA bakılmayanlar tekrar kontrole çağrılmış, gerekli tetkik ve tedavileri yapılmıştır.
Bulgular: Kayıtlarına ulaşılan 161.282 kişinin %6,3’ünün (n = 10.115) test sonucu pozitifti. En sık anti-HCV tetkiki isteyen bölümler %8,9 hepatoloji ve %7,8 kadın hastalıkları ve doğum idi. Anti-HCV pozitifliği saptanan olguların %53,3’ü erkekti ve yaş ortalaması 55,12 ± 16,83 yıldı. Yapılan tetkiklerin %60,7’si tarama amaçlıyken, %39,3’ü preoperatif tetkiklerdi. Anti-HCV pozitifliği saptanan olguların %74,0’ının (n = 7485) HCV RNA pozitif olduğu, %3,4’üne (n = 342) ise HCV RNA bakılmadığı görüldü. Pozitif anti-HCV saptadıktan sonra en sık HCV RNA tetkiki isteyen bölümler %40,1 enfeksiyon hastalıkları ve %33,4 hepatoloji iken, en sık HCV RNA istemeyen bölümler %9,9 genel cerrahi ve %8,8 göz hastalıklarıydı. HCV RNA bakılmayan tetkiklerin %58,8’i tarama amaçlı, %41,2’si preoperatif tetkik amacıyla istenmişti. HCV RNA bakılmayan 100 olguya yapılan HCV RNA tetkiki sonucunda, olguların %95’inin negatif, %5’inin ise pozitif olduğu belirlendi. Güncel başvurularında HCV RNA negatif olduğu saptananlarla karşılaştırıldığında, HCV RNA pozitif olanların ilk başvurularında değerlendirilen anti-HCV düzeyi istatistiksel olarak anlamlı düzeyde daha yüksekti (p<0,001). HCV RNA pozitifliği saptananların 4’ünde non-sirotik karaciğer saptanırken, 1 olguda karaciğer parankiminin kabalaşmış olduğu görüldü.
Sonuç: Çalışmamız anti-HCV pozitifliği olan hastaların ilgili hekimlerce ileri tetkik ve tedavi için sevk edilmesinde önemli eksiklikler olduğunu vurgulamaktadır. Kronik hepatit C için yoğun tarama ve doğrudan etkili antivirallere daha fazla erişim gereklidir.
In this study, it was aimed to determine the HCV-RNA request rate and positivity in patients with anti-HCV positivity, and to examine the current HCV-RNA levels of patients who were not tested for HCV-RNA after anti-HCV positivity was detected. In this prospective cohort study, patients who were tested for anti-HCV at Necmettin Erbakan University (NEU) Meram Medical Faculty Hospital between January 1, 2011 and December 31, 2020 were included. Among these cases, those who did not have HCV RNA were called for follow-up, and necessary tests and treatments were performed. The test results of 6.3% (n = 10.115) of 161.282 cases whose records were accessed were positive. The departments that most frequently requested anti-HCV tests were hepatology (8.9%) and obstetrics and gynecology 7.8%. 53.3% of the cases with anti-HCV positivity were male and the mean age was 55.12 ± 16.83 years. While 60.7% of the examinations were for screening purposes, 39.3% were preoperative examinations. It was observed that 74.0% (n = 7485) of the cases with anti-HCV positivity were positive for HCV RNA, and 3.4% (n = 342) were not tested for HCV RNA. After detecting positive anti-HCV, the departments that requested HCV RNA most frequently were 40.1% infectious diseases and 33.4% hepatology, while the most common departments that did not measure HCV RNA were 9.9% general surgery and 8.8% eye diseases. Of the tests not tested for HCV RNA, 58.8% were for screening purposes and 41.2% were for preoperative examination. As a result of HCV RNA analysis performed on 100 cases without HCV RNA, it was determined that 95% of the cases were negative and 5% were positive. Compared with those who were found to be HCV RNA negative at the current admission, the anti-HCV level at the first admission was statistically significantly higher in those with HCV RNA positivity (p<0.001). Non-cirrhotic liver was found in 4 of those with HCV RNA positivity, and coarsening of the liver parenchyma was observed in 1 patient. In conclusion, our study highlights that there are important shortcomings in the referral of patients with anti-HCV positivity for further examination and treatment by the relevant physicians. Intensive screening for chronic hepatitis C and greater access to direct-acting antivirals are needed.
In this study, it was aimed to determine the HCV-RNA request rate and positivity in patients with anti-HCV positivity, and to examine the current HCV-RNA levels of patients who were not tested for HCV-RNA after anti-HCV positivity was detected. In this prospective cohort study, patients who were tested for anti-HCV at Necmettin Erbakan University (NEU) Meram Medical Faculty Hospital between January 1, 2011 and December 31, 2020 were included. Among these cases, those who did not have HCV RNA were called for follow-up, and necessary tests and treatments were performed. The test results of 6.3% (n = 10.115) of 161.282 cases whose records were accessed were positive. The departments that most frequently requested anti-HCV tests were hepatology (8.9%) and obstetrics and gynecology 7.8%. 53.3% of the cases with anti-HCV positivity were male and the mean age was 55.12 ± 16.83 years. While 60.7% of the examinations were for screening purposes, 39.3% were preoperative examinations. It was observed that 74.0% (n = 7485) of the cases with anti-HCV positivity were positive for HCV RNA, and 3.4% (n = 342) were not tested for HCV RNA. After detecting positive anti-HCV, the departments that requested HCV RNA most frequently were 40.1% infectious diseases and 33.4% hepatology, while the most common departments that did not measure HCV RNA were 9.9% general surgery and 8.8% eye diseases. Of the tests not tested for HCV RNA, 58.8% were for screening purposes and 41.2% were for preoperative examination. As a result of HCV RNA analysis performed on 100 cases without HCV RNA, it was determined that 95% of the cases were negative and 5% were positive. Compared with those who were found to be HCV RNA negative at the current admission, the anti-HCV level at the first admission was statistically significantly higher in those with HCV RNA positivity (p<0.001). Non-cirrhotic liver was found in 4 of those with HCV RNA positivity, and coarsening of the liver parenchyma was observed in 1 patient. In conclusion, our study highlights that there are important shortcomings in the referral of patients with anti-HCV positivity for further examination and treatment by the relevant physicians. Intensive screening for chronic hepatitis C and greater access to direct-acting antivirals are needed.
Açıklama
Anahtar Kelimeler
Hepatit C virüsü, Prevalans, Tarama, Tedavi, Farkındalık, Hepatitis C virus, Prevalence, Screening, Treatment, Awareness
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Gönan. F. (2023). Anti-hcv bakılan olgularda hcv-rna sonuçlarının değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
