MEDİKAL ONKOLOJİ HASTALARINDA HEPATİT B SEROPREVELANSI
Süreyya Gül Yurtsever, Selçuk Kaya, Tamer Arkalı, Tuba Müderris, Pelin Günaydın, Yüksel Küçükzeybek
ORCID ID: SGY
Süreyya Gül Yurtsever https://orcid.org/0000-0002-4421-230x
ORCID ID: SK
Selçuk Kaya https://orcid.org/0000-0002-8637-6345
ORCID ID: TA
Tamer Arkalı https://orcid.org/0000-0001-7186-6504
ORCID ID: TM
Tuba Müderris https://orcid.org/0000-0002-8538-5864
ORCID ID: PG
Pelin Günaydın https://orcid.org/0000-0003-4161-4095
ORCID ID: YK
Yüksel Küçükzeybek https://orcid.org/0000-0003-3173-7999
ÖZET
Amaç: Kanser hastalarına uygulanan kemoterapi Hepatit B Virüs reaktivasyonuna (HBVr) neden olabilmektedir. Klinik rehberlerin çoğu kemoterapi öncesi Hepatit B enfeksiyonu açısından tarama testi önermektedir. Bu çalışmada; hastanemizde takip edilen ve kemoterapi alan hastalarda kemoterapi öncesi hastane bilgisayar veri tabanından retrospektif olarak Hepatit B seroprevelansının belirlenmesi, anti-HBs negatifliği olan hastaların aşılanıp aşılanmadığının değerlendirilmesi amaçlanmıştır.
Materyal ve Metot: Bu çalışmaya Eylül 2013 - Eylül 2017 tarihleri arasında hastanemizin Medikal Onkoloji polikliniğinde tanı ve tedavi alarak takip edilen 1310 hastadan solid organ malignitesi nedeniyle kemoterapi alan 615 hasta dahil edildi. Hastaların demografik özellikleri ve laboratuvar sonuçları hastane bilgisayar veri tabanında retrospektif olarak tarandı. Hastaların HBsAg, anti-HBs, anti HBc total ELISA, HBV DNA düzeyleri ile tarandı.
Bulgular: Kemoterapi alan 615 hastanın 353’ünün (%57,4) kadın, 262’sinin (%42,6) erkek olduğu, yaş ortalaması 58,50±13.7 (19-95) olduğu tespit edildi. Hastalarımızda HBsAg pozitifliği 28 hastada (%5), anti-HBs pozitifliği 409 hastada (%66,5), anti-HBs negatifliği 206 hastada (%33,5), anti HBc total pozitifliği 195 hastada (%31,7) oranında bulundu. Çalışmamızda 16 hastada HBV DNA pozitifliği tespit edildi.
Sonuç: Solid organ malignitesi nedeniyle kemoterapi alan hastalar HBVr, karaciğer yetmezliği, kemoterapiye ara verme gibi risk faktörleri de göz önüne alınarak HBV enfeksiyonu açısından taranmalı, anti-HBs negatif olgularda aşılama yapılmalıdır.
Anahtar Kelimeler: HBV, seroprevalans, kemoterapi, solid organ malignitesi. Nobel Med 2020; 16(3): 29-34
HEPATITIS B SEROPREVELANCE IN MEDICAL ONCOLOGY PATIENTS
ABSTRACT
Objective: Chemotherapy can lead to hepatitis B virus reactivation (HBVr) in oncological patients. Most of clinical guidelines recommend screening tests for hepatitis B infection before chemotherapy. The aim of this study was to determine the seroprevalence of Hepatitis B before chemotherapy retrospectively by using the hospital computer database in patients who were followed up in our hospital and received chemotherapy, and asses whether or not vaccination is performed in patients who are anti-HBs negative.
Material and Method: A total of 615 patients who underwent chemotherapy for solid organ malignancy from 1310 patients who were diagnosed and treated in the medical oncology outpatient clinic of our hospital between September 2013 and September 2017 were included in this study. The demographic characteristics and laboratory results of the patients were retrospectively reviewed in
the hospital computer database. HBsAg, anti-HBs, anti-HBc total ELISA, HBV DNA levels of the patients were evaluated.
Results: Of the 615 patients receiving chemotherapy, 353 (57.4%) were females and 262 (42.6%) were males. The mean age of the patients who had chemotherapy for solid organ malignancy was 58.50 (19-95 years). In these patients, HBsAg positivity was found in 28 patients (5%), anti-HBs positivity was found in 409 patients (66.5%), anti-HBs negative was found in 206 patients (33.5%), anti-HBc total positivity was found in 195 patients (31.7%). HBV DNA positivity was detected in 16 patients.
Conclusion: Risk factors such as HBVr, hepatic failure and chemotherapy interruption should be taken into consideration in patients receiving chemotherapy for solid organ malignancy and these patients should be screened for HBV infection and vaccination should be performed in anti-HBs negative cases.
Keywords: HBV, seroprevalence, chemotherapy, neoplasm, malignant. Nobel Med 2020; 16(3): 29-34
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