İmmunsupresif ilaç tedavisi alan hastalarda Hepatit B reaktivasyonu ve antiviral tedavinin etkinliği
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Dosyalar
Tarih
2019
Yazarlar
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Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada bir üniversite hastanesinde immün baskılayıcı tedaviler alan hastaların bazı sosyodemografik özellikleri ile HBV reaktivasyon oranları ve antiviral tedavinin etkinliğinin belirlenmesi amaçlanmıştır. Yöntem: Araştırmada örneklem seçilmemiş olup 2010-2019 yılları arasında belirtilen polikliniklerde rutin olarak takip edilen immünsüpresif hastalar, antiviral kullanan ve kullanmayan olarak gruplanmış ve hepatit B reaktivasyonu açısından değerlendirilmiştir. Veriler için uygun analizler SPSS 21.0 programı ile yapılmış ve p<0,05 olması anlamlı kabul edilmiştir. Bulgular: Hastaların %55,0'ı (n=83) erkek, %45,0'ı (n=68) kadın, yaş ortalaması 54,5±12,0'dır. Çalışmaya dahil edilen hastaların %68,9'unun (n=104) HBV reaktivasyon riski orta derecede, %23,8'inin (n=36) yüksek derecededir. Hastaların %79,5'i (n=120) antiviral ilaç kullanan kişilerden oluşmaktadır (%60,8'i Tenofavir, %37,5'i Entekavir). HBV reaktivasyon riski daha fazla olan kişiler istatistiksel olarak anlamlı düzeyde daha fazla sıklıkta antiviral ilaç kullanmaktadır (p=0,008). Antiviral kullanmayan kişilerin ilk kan değerlerinde HBV DNA istatistiksel olarak anlamlı düzeyde daha fazla sıklıkta pozitiftir (p=0,03). Tenofovir kullanan hastaların kan direkt bilirubin değeri Entekavir kullanan hastalara göre istatistiksel olarak anlamlı düzeyde daha yüksektir (p=0,001). Antiviral kullanan ve kullanmayan hastalarda HBV reaktivasyonu görülmedi ve çalışmaya dahil edilen hastaların tamamı halen yaşantısını sürdürmektedir. Sonuç: Bu çalışmanın sonuçları göz önünde bulundurularak yapılacak çok merkezli, mümkünse randomize kontrollü ya da kohort çalışmaları bağışıklık sistemi baskılanan hastalarda oluşabilecek HBV reaktivasyonunun nedenlerine ve sonuçlarına yönelik bilgi seviyesini arttırarak, gerekli önlemlerin alınması ve tedavi protokollerinin şekillenmesine yardımcı olacaktır.
Aim: The aim of this study was to determine some sociodemographic characteristics, HBV reactivation rates and the effectiveness of antiviral therapy in patients receiving immunosuppressive therapies in a university hospital. Method: The sample was not selected in the study and immunosuppressive patients who were followed up routinely in the outpatient clinics between 2010-2019 were grouped as antiviral and non-antiviral and evaluated for hepatitis B reactivation. SPSS 21.0 program was used for data analysis and p <0.05 was considered significant. Results:55.0% (n=83) of the patients were male, 45.0% (n=68) were female and the mean age was 54.5 ± 12.0. 68.9% (n=104) of the patients included in the study had moderate HBV reactivation risk and 23.8% (n = 36) had a high risk. 79.5% (n=120) of the patients were using antiviral drugs (60.8% Tenofavir, 37.5% Entecavir). People with a higher risk of HBV reactivation use antiviral drugs at a significantly higher frequency (p = 0.008). HBV DNA was significantly more positive in the first blood values of the non-antiviral users (p=0.03). HBV reactivation was not observed in patients receiving antiviral and non-antiviral treatment, and all patients included in the study are still alive. Conclusion: This study will increase the level of knowledge about the causes and consequences of HBV reactivation in immunocompromised patients and help to take necessary precautions and shape treatment protocols. Keywords. Gastroenterology; Immunosuppressive Treatment; Hepatitis B Reactivation; Antiviral Treatment Efficacy.
Aim: The aim of this study was to determine some sociodemographic characteristics, HBV reactivation rates and the effectiveness of antiviral therapy in patients receiving immunosuppressive therapies in a university hospital. Method: The sample was not selected in the study and immunosuppressive patients who were followed up routinely in the outpatient clinics between 2010-2019 were grouped as antiviral and non-antiviral and evaluated for hepatitis B reactivation. SPSS 21.0 program was used for data analysis and p <0.05 was considered significant. Results:55.0% (n=83) of the patients were male, 45.0% (n=68) were female and the mean age was 54.5 ± 12.0. 68.9% (n=104) of the patients included in the study had moderate HBV reactivation risk and 23.8% (n = 36) had a high risk. 79.5% (n=120) of the patients were using antiviral drugs (60.8% Tenofavir, 37.5% Entecavir). People with a higher risk of HBV reactivation use antiviral drugs at a significantly higher frequency (p = 0.008). HBV DNA was significantly more positive in the first blood values of the non-antiviral users (p=0.03). HBV reactivation was not observed in patients receiving antiviral and non-antiviral treatment, and all patients included in the study are still alive. Conclusion: This study will increase the level of knowledge about the causes and consequences of HBV reactivation in immunocompromised patients and help to take necessary precautions and shape treatment protocols. Keywords. Gastroenterology; Immunosuppressive Treatment; Hepatitis B Reactivation; Antiviral Treatment Efficacy.
Açıklama
Anahtar Kelimeler
Gastroenteroloji, Gastroenterology, Gastroenteroloji; İmmünsupresif Tedavi; Hepatit B Reaktivasyonu; Antiviral Tedavi Etkinliği.
