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KRONİK HCV ÎNFEKSÎYONU OLAN HEMODİYALİZ HASTALARINDA ANTİ-HCV IgM'İN VİREMİ (HCV-RNA) ÎLE İLİŞKİSİ

THE RELATIONSHIP BETWEEN ANTI-HCV IgM AND VIREMIA (HCV-RNA) IN THE HEMODIALYSIS PATIENTS WITH CHRONIC HCV INFECTION

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Abstract (2. Language): 
İn the present study, anti-HCV IgM (EIA, Abbott), HCV-RNA by PCR and alanine aminotransferase (ALT) levels were determined in 30 hemodialysis patients (16 F, 14 M) detected for anti-HCV positivity (ELISA-I1, Abbott) at least for 6 months, and the relationship among anti-HCV IgM, HCV RNA and ALT levels were investigated. Anti-HCVIgM in 13patients (43%) and HCV-RNA in 17 patients (56%) were found to be positive. High ALT levels were present in 11 patients. There was no difference between anti-HCV positive and negative patients in respect to age, sex, ALT levels and viremia. Histopathological findings of 8 liver biopsies showed chronic active hepatitis (CAH) in 6 patients and chronic persistent hepatitis in 2 patients. Anti-HCV IgM was positive in 3 of 6 patients with CAH and negative in the others. Finaly we found that, in chronic HCV infection anti-HCV IgM positivity persisted for a long time, but there was no association between anti-HCV IgM positivity and ALT levels, histopathological patterns and viremia. Therefore, we belive that anti-HCV IgM test does not provide additional contribution to the diagnosis and does not superior to the anti- HCV (ELISA -II) test.
Abstract (Original Language): 
Bu çalışmada en az 6 aydan beri anti-HCV'sipozitif (ELISA -II Abbott) olan 30 hemodiyaliz hastasında (16 K, 14 E) anti-HCVIgM(EIA, Abbott), HCV-RNA (PCR) ve alanin aminotransferaz (ALT) düzeyleri tayin edilerek, anti-HCV IgM'in viremi ve ALT düzeyleri ile ilişkisi araştırıldı. Anti-HCV'si pozitif olan 30hastanın 13'ünde (%43.33) anti-HCV IgM, 17'sinde de (%56.56) HCV-RNA pozitif bulundu. Olguların 11'inde (%36.36) ALT yüksekliği mevcuttu. Anti-HCVIgM'i pozitif olan ve olmayan olgular arasında yaş, cinsiyet, ALTdüzeyi ve viremi yönünden önemli bir farklılık yoktu. Karaciğer biyopsisi yapılan 8 hastanın 6'sında kronik aktif hepatit (KAH), 2'sinde ise kronik persistan hepatit mevcuttu. KAH'i olan 6 olgunun 3'ünde anti-HCV IgM pozitif iken, diğer 3'ünde ise negatif bulundu. Sonuç olarak, kronik olgularda anti-HCV IgM pozitifliğinin uzun süre devam ettiği; ancak ALT düzeyleri, histopatolojik tanı ve viremi ile ilişkisinin olmadığı tesbit edilmiştir. Bu yüzden anti-HCV IgM'in tanıya ilave katkı sağlamadığı ve anti-HCV (ELİSA-II) testine üstünlüğü olmadığı kanaatindeyiz
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