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Renal Replasman Tedavisi Almamış Kronik Böbrek Hastalarında Hepatit B ve C Seroprevalansı

Seroprevalance of the Hepatitis B and C in Patients with Chronic Kidney Disease without History of Renal Replacement Therapy

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2013
DOI: 
10.5262/tndt.2013.1002.07

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIVE: Hepatitis B (HBV) and hepatitis C (HCV) viruses are signifi cant causes of morbidity and mortality in patients with chronic kidney disease (CKD). There is insuffi cient data on seroprevalence of HBV and HCV in CKD patients without renal replacement therapy (RRT). MATERIAL and METHODS: Patients diagnosed as having CKD without RRT were analyzed. Seven hundred and eighty cases included study. RESULTS: The seroprevalence of HbsAg and Anti-HCV were 3.5% and 1.3%, respectively. The seroprevalence of Anti-HBsAb analyzed in 456 (58.4%) patients was 39.3%. The seroprevalence of HBsAg and Anti-HCV did not differ between the patients in early stage (stage 3) and advanced stage CKD (Stage 4 and 5) (p=0.26 and p=0.88, respectively). Seropositivity of Anti-HBsAb was 41.9% in early stage and 33.6% in advanced stage CKD (p=0.88). No difference was detected in seroprevalence of HbsAg and Anti-HCV when patients were grouped regarding the underlying disorders of CKD (p=0.95 and p=0.25, respectively). CONCLUSION: Higher seroprevalence of Anti-HCV in hemodialysis patients, according to studies carried out in our country, may be secondary to the exposure to HCV during hemodialysis procedure. High seropositivity of Anti-HBsAb in early stage CKD, although not statistically signifi cant, may point out the necessity of hepatitis B immunization earlier in the course of CKD. Screening the patients with CKD without RRT for HBsAg and Anti-HCV serologies would be applicable although there is no established consensus in guidelines.
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Abstract (Original Language): 
AMAÇ: Hepatit B (HBV) ve hepatit C (HCV) virüsleri, kronik böbrek hastalarında önemli bir morbidite ve mortalite nedenidir. Renal replasman tedavisi (RRT) almamış kronik böbrek hastalarında HBV ve HCV seroprevalansı için yeterli veri bulunmamaktadır. GEREÇ ve YÖNTEMLER: RRT almamış kronik böbrek hastalıklı (KBH) olgular retrospektif olarak analiz edildi. Yedi yüz seksen olgu çalışmaya dahil edildi. BULGULAR: HBsAg ve Anti-HCV seroprevalansı sırasıyla %3,5 ve %1,3 olarak saptandı. Anti- HBsAb seroprevalansının 456 (%58,4) hastada değerlendirildiği ve %39,3 olduğu tespit edildi. Olgular, KBH evreleri açısından değerlendirildiğinde, erken evre (evre 3 KBH) ile ileri evre (evre 4 ve 5 KBH) KBH grupları arasında HBsAg ve Anti-HCV seroprevalansı açısından istatistiksel anlamlı fark bulunmadı (sırasıyla p=0,26 ve p=0,88). Anti-HBsAb seropozitifl iği erken evre KBH’da %41,9, ileri evre KBH’da %33,6 olarak tespit edildi (p=0,88). Kronik böbrek hastalığı etiyolojisi açısından altta yatan hastalıklarda, HBsAg ve Anti-HCV seroprevalansı benzer sıklıkta saptandı (sırasıyla p=0.95 ve p=0.25). SONUÇ: Ülkemizde daha önce yayımlanan çalışmalar ışığında hemodiyaliz hastalarında, RRT almamış KBH hastalarına göre daha yüksek Anti-HCV seroprevalansı, hemodiyaliz prosedürü sırasında HCV maruziyeti ilişkili olabilir. Erken evre KBH’da Anti-HBsAb seropozitifl iğinin istatistiksel anlamlı olmasa da daha fazla olması, KBH erken evrelerinde hepatit B aşılamasının daha etkin olabileceğini düşündürmektedir. RRT almamış KBH olgularında HBsAg ve Anti-HCV serolojik değerlendirmesi, kılavuz düzeyinde fi kir birliği bulunmamakla birlikte uygun olabilir.
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