Solid organ ve hematolojik malignite tanısı konulan hastalarda kemoterapi öncesi hepatit B virüsü tarama oranları ve reaktivasyon sıklığının araştırılması
Küçük Resim Yok
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Bu çalışmanın amacı, solid organ ve hematolojik malignite nedeni ile kemoterapi alan hastalarda, hekimlerin tedavi öncesi hastaların Hepatit B virüsü (HBV) serolojisine ne sıklıkta baktığını ve bu HBV serolojisi bakılanlarda reaktivasyon oranlarını araştırmaktır. Material ve Metodlar: İnönü Üniversitesi Turgut Özal Tıp Merkezi Hematoloji ve Medikal Onkoloji Bilim Dalları'nda 01.01.2015-15.03.2017 tarihleri arasında, çeşitli solid tümör ve hematolojik maligniteleri nedeniyle ilk defa kemoterapi alan 1275 hastanın dosyası, retrospektif incelendi. Bulgular: Kemoterapi öncesi, toplam 1275 hastadan 14 (%1.09)'üne HBsAg, 3 (%0.23)'üne HBsAg ve anti-HBc total birlikte, 279 (%79)'una ise HBsAg, anti-HBs ve anti-HBc total birlikte bakıldığı saptanmıştır. 29 HBsAg pozitif hasta arasından 1 (%3.4), 24 izole anti-HBc total pozitif hasta arasından 1 (%4.1), 68 anti-HBc total ile anti-HBs'nin birlikte pozitif olduğu hasta arasından 1 (%1.4) hastada HBV reaktivasyonu geliştiği tespit edilmiştir. Sonuç: Kemoterapi tedavisi alan solid tümörlü hastalarda HBV serolojisi ideal taranma oranları, litertüre ile uyumlu olarak düşük saptanmıştır. Hematolojik malignitesi olan hastalarda ise HBV serolojisi taranma oranları literatür ile karşılaştırıldığında ideal sınırlar içerisindedir. İmmünsüpresif kullanacak her hastada; HBsAg, anti-HBc ve HBsAg veya anti-HBc pozitiflerde HBV DNA parametrelerinin bakılması gerekliliği ile ilgili takip eden hekimlere gerekli eğitimler verilmeli ve farkındalıkları artırılmalıdır. HBV reaktivasyonu risk değerlendirilmesi yapılarak, profilaktik tedavinin değerlendirilmesi ve HBV enfeksiyon takibinin iyi yapılmasının gerekliliği vurgulanmalıdır. Anahtar Kelime:HBV, reaktivasyon, immünsüpresif tedavi
İntroduction: The aim of the study is to investigate the prevalence of the how often physicians screening the HBV serology before chemotherapy treatment in patients who receiving solid organs and hematological malignancy. And also investigate the rates of the reactivation in this patient groups. Materials and Methods: A retrospective study of 1275 patients who applied Inonu University Turgut Ozal Medicine Center Hematology and Medical Oncology Clinic to received chemotherapy for a variety of solid tumor and hematological malignancies was performed. Results: Prior to chemotherapy, a total of 1275 patients were screened and 14 (%1.09) HBs Ag was assessed in the patients. In 3(%0.231) patients HBsAg and anti-HBc total were studied together and also HBsAg, anti-HBs and anti-HBc total were found together in 279 (79%) patients. When the screening of the 29 HBsAg positive patients %3.4 (1 patient) and in the 24 isolated anti-HBc total positive group also %4.1 (1 patient) and again anti-HBc total and anti HBs together positive patients among %1.4 (1 patient) developed HBV reactivation. Discussion: The ideal screening rates for HBV serology in solid tumor patients who received chemotherapy treatment were found to be low in agreement with the literture. In patients with hematologic malignancy, the screening rates of HBV serology are within the ideal limits when compared with the literature. Prophylaxis rates in patients who were screened is low and also, in the same group following rates are low too. Risk assessment of HBV reactivation and evaluation for prophylactic treatment should be made by physician. At the same, should be emphasized about following up the patients who will use immunsuppressive drugs for HBV infection. So, in this patients group HBV DNA, anti-HBc and HBsAg or anti-HBc parameters screening is necessary. Keyword:HBV, reactivasion, immunosuppressive therapy
İntroduction: The aim of the study is to investigate the prevalence of the how often physicians screening the HBV serology before chemotherapy treatment in patients who receiving solid organs and hematological malignancy. And also investigate the rates of the reactivation in this patient groups. Materials and Methods: A retrospective study of 1275 patients who applied Inonu University Turgut Ozal Medicine Center Hematology and Medical Oncology Clinic to received chemotherapy for a variety of solid tumor and hematological malignancies was performed. Results: Prior to chemotherapy, a total of 1275 patients were screened and 14 (%1.09) HBs Ag was assessed in the patients. In 3(%0.231) patients HBsAg and anti-HBc total were studied together and also HBsAg, anti-HBs and anti-HBc total were found together in 279 (79%) patients. When the screening of the 29 HBsAg positive patients %3.4 (1 patient) and in the 24 isolated anti-HBc total positive group also %4.1 (1 patient) and again anti-HBc total and anti HBs together positive patients among %1.4 (1 patient) developed HBV reactivation. Discussion: The ideal screening rates for HBV serology in solid tumor patients who received chemotherapy treatment were found to be low in agreement with the literture. In patients with hematologic malignancy, the screening rates of HBV serology are within the ideal limits when compared with the literature. Prophylaxis rates in patients who were screened is low and also, in the same group following rates are low too. Risk assessment of HBV reactivation and evaluation for prophylactic treatment should be made by physician. At the same, should be emphasized about following up the patients who will use immunsuppressive drugs for HBV infection. So, in this patients group HBV DNA, anti-HBc and HBsAg or anti-HBc parameters screening is necessary. Keyword:HBV, reactivasion, immunosuppressive therapy
Açıklama
Anahtar Kelimeler
Gastroenteroloji, Gastroenterology
