Kronik hepatit B profili gösteren olgularda HBV-DNA düzeyleri

Abstract

ÖZET Erciyes Üniversitesi Gevher Nesibe Hastanesi Gastroenteroloji ve İnfeksiyon Hastalıkları polikliniklerinde takip edilen asemptomatik hepatit B taşıyıcısı(AHBT) 50, antiviral tedavi uygulanan kronik hepatit B (KHB) ' li 31 hastada tanı ve izlemde 3. kuşak ELISA ile HBV göstergeleri ve hibridizasyonla HBV-DNA düzeyleri araştırıldı. KHB' li olgularda antiviral tedavi başlangıcından sonra bir yıl süreyle hibridizasyonla HBV-DNA düzeyleri araştırıldı. AHBT grupta HBV-DNA düzeyi ortanca değeri 0.0 (0- 2000)pg/ml olarak saptandı. HBeAg' si pozitif olan iki hastada da HBV-DNA' sı pozitif olarak belirlendi. Antiviral tedavi uygulanan KHB' li olgularda HBV-DNA düzeyi ortanca değeri 87.0 (0-2000)pg/ml olarak belirlendi. Bu grupta anti-HBe pozitif 22 (%71.0) 62hastanın 8 (%81.8)' inde, IIBeAg pozitif üç (%9.7) hastanın hepsinde (% 1 00) HBV- DNA pozitifliği bulundu. IIBV-DNA' sı pozitif olarak belirlenen iki AHBTolgunun iki (%100)' sinde, 27 KHB' li olgunun altı (%19.3)' sında, ALT değerleri normal sınırlarda idi. Antiviral tedavi uygulanan KHB' li olguların izlenmesinde HBV-DNA düzeyinin tedavi başlangıcından itibaren tedavi başlangıcına göre birinci aydan başlayarak her ayda (p ALT değerlerinin ise tedavi başlangıcından itibaren tedavi başlangıcına göre sadece üçüncü ayda (p istatistiksel olarak anlamlı bir fark bulundu. 64

SUMMARY HBV-DNA levels and HBV markers were investigated by hybridization and third generation ELIS A in 3 1 patients with chronic hepatitis B infection during antiviral treatment, and in 50 asymptomatic hepatitis B carriers in Erciyes University Gevher Nesibe Hospital Gastroenterology and Infectious Diseases Clinics,. HBV-DNA levels were investigated during one year after started antiviral treatment in patients with chronic hepatitis B virus infection. Median range of HBV-DNA levels was found 0.0 (0-2000) pg/ml in asymptomatic hepatitis B carriers. Of two HBeAg (+) patients, HBV- DNA levels were found positive in this group,. Median range of HBV-DNA levels were determined as 87.0 (0-2000) pg/ml in patients with chronic hepatitis B. Of 22 (71.0%) anti-HBe (+) patients with chronic 64hepatitis B, eight (81.8%) patients, and of three (9.7%) HBeAg positive patients, all(%100) patients were found HBV-DNA positive. Of 27 patients with chronic hepatitis B, whom HBV-DNA levels were determined as positive, six (19.3%) patients' ALT levels were found between normal ranges. Of two asymptomatic hepatitis B carriers, whom HBV-DNA levels were determined as positive, two (100%) patients' ALT levels were found between normal ranges. A statistically significant difference in detection of HBV-DNA levels by hybridization at monitoring of patients with chronic hepatitis B during antiviral treatment were determined at every months beginning from the first month of treatment, (p<0.05). A statistically significant difference between ALT levels at monitoring of patients with chronic hepatitis B were observed only at the third month of treatment (p<0.05) 65