Akut viral hepatitli olguların etyolojik, klinik, laboratuvar ve epidemiyolojik analizi

Abstract

ÖZET Dicle Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği'ne Kasım 1995 ile Mayıs 1998 tarihleri arasında yatırılan 152 akut viral hepatit olgusu prospektif olarak incelendi. Olguların 97`si erkek, 55'i kadın olup, yaş ortalaması 27,7 idi. Etyolojik olarak %58,2'sinde B hepatiti, %22,5'inde A hepatiti, %14,5'inde E hepatiti, %1,9'unda C hepatiti tesbit edilirken, %2,6'sında etyoloji saptanamadı. Hastalarımızda %93 halsizlik, %90 koyu renkli idrar yapma, %88 ikter, %84 iştahsızlık, %71 karın ağnsı, %65 bulantı, %55 artralji, %55 zayıflama, %47 hepatomegali, %46 miyalji, %41 akolik dışkılama, %40 kusma, %39 ateş, %29 boğaz ağnsı, %20 diyare, %10 splenomegali, %6 deri lezyonları saptandı. Ortalama ALT değerleri A hepatitinde 1227Ü061, B hepatitinde 1347±782, C hepatitinde 763±389, E hepatitinde 1248±287 olarak bulundu. Hepatit A'da %23, hepatit E olgularında ise %22,5 oranında aile içi temas öyküsü saptandı. B hepatitli olgularda bulaşma yolu olarak %16 cinsel temas, %15 sağlık çalışanı, %14 diş çekimi veya tedavisi, %5 ameliyat, %4 aile içi temas, % 3 kan transfuzyonu, %2 endoskopi, %1 doğum saptanırken %40'mda her hangi bir bulaşma yolu saptanamadı. C hepatitli 3 hastamızın l'inde cinsel temas, Tinde ameliyat tesbit edilirken, 1 olguda olası bir bulaşma yolu tesbit edilemedi. Etyolojisi saptanamayan 4 olgunun 2'sinde diş çekimi veya tedavisi, l'inde ameliyat ve kan transfuzyonu, l'inde cinsel temas öyküsü saptadık. Hastalarımızın 4'ünde fulminan hepatit tablosu görüldü. Bunların 3'ü B, l'i doğum yapmış E hepatiti olgusu idi. Bu fulminan hepatitli olguların 2'si hayatını kaybederken diğerleri iyileşti. 52SUMMARY A prevelance study was performed prospectively in Infectious Disease and Klmical Microbiology Department of Dicle University Hospital from November 1, 1995 through May 3 1, 1998 152 acute viral hepatitis cases were analyzed. Of the 152 cases 97 was male and 55 was female. The mean age of 152 patients was 27,2. Of the 152 cases 58,2% had hepatitis B, 22,5% had hepatitis A, 14,5% had hepatitis E, 1,9% had hepatitis C and 2,6% unknown type. The distribution of signs and symtomps were; weakness (93%), dark urine (90%), jaundice (88%), anorexia (84%), abdominal pain (71%), nausea (65%), arthralgia (55%), loss of weight (55%), hepatomegaly (47%), myalgia (46%), clay-colored stool (41%), vomitting (40%), fever (39%), throatache (29%), diarrhea (20%), splenomegaly (10%), skin lesions (6%). The mean of ALT values were 1227±1061 for hepatitis A, 1347+782 for hepatitis B, 768+389 for hepatitis C, 1248+287 for hepatitis E. The rate of household contact was 23% for hepatitis A, 22,5% for hepatitis E. In hepatitis B transmission ways were defined as sexual contact (16%), being health staff (15%), dental operation and treatment (14%), surgery (5%), household contact (4%), blood transfusion (3%), endoscopy (2%), birth (1%). The transmission way wasn't defined in 40% of them. 3 hepatitis C patients was analyzed. In one case transmission way was sexual contact, in one case that was surgery and in the last one no reason was defined. As we analyzed 4 cases that hat no etiologic source. We saw that dental operation and threatment was a reason in 2 cases. Sexual contact was a reason in one case, Surgery and blood transfusion was a reason in one case. The fulminant hepatitis was seen in 4 of 152 patients. 3 of them were hepatitis B and 1 of them was postpartum hepatitis E. 2 of these fulminant hepatitis cases was died. Others have recovered. 53

SUMMARY A prevelance study was performed prospectively in Infectious Disease and Klmical Microbiology Department of Dicle University Hospital from November 1, 1995 through May 3 1, 1998 152 acute viral hepatitis cases were analyzed. Of the 152 cases 97 was male and 55 was female. The mean age of 152 patients was 27,2. Of the 152 cases 58,2% had hepatitis B, 22,5% had hepatitis A, 14,5% had hepatitis E, 1,9% had hepatitis C and 2,6% unknown type. The distribution of signs and symtomps were; weakness (93%), dark urine (90%), jaundice (88%), anorexia (84%), abdominal pain (71%), nausea (65%), arthralgia (55%), loss of weight (55%), hepatomegaly (47%), myalgia (46%), clay-colored stool (41%), vomitting (40%), fever (39%), throatache (29%), diarrhea (20%), splenomegaly (10%), skin lesions (6%). The mean of ALT values were 1227±1061 for hepatitis A, 1347+782 for hepatitis B, 768+389 for hepatitis C, 1248+287 for hepatitis E. The rate of household contact was 23% for hepatitis A, 22,5% for hepatitis E. In hepatitis B transmission ways were defined as sexual contact (16%), being health staff (15%), dental operation and treatment (14%), surgery (5%), household contact (4%), blood transfusion (3%), endoscopy (2%), birth (1%). The transmission way wasn't defined in 40% of them. 3 hepatitis C patients was analyzed. In one case transmission way was sexual contact, in one case that was surgery and in the last one no reason was defined. As we analyzed 4 cases that hat no etiologic source. We saw that dental operation and threatment was a reason in 2 cases. Sexual contact was a reason in one case, Surgery and blood transfusion was a reason in one case. The fulminant hepatitis was seen in 4 of 152 patients. 3 of them were hepatitis B and 1 of them was postpartum hepatitis E. 2 of these fulminant hepatitis cases was died. Others have recovered. 53