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2008, Cilt 22, Sayı 1, Sayfa(lar) 023-028
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THE SEROPREVALENCE OF HEPATITIS B AND HEPATITIS C IN HEMODIALYSIS PATIENTS
Fatma SIRMATEL1, Öcal SIRMATEL2, Celalettin USALAN3, Cem BARLIOĞLU4, Asım GÖYMEN5, Ersin KEPEKÇİ5, Hikmet GEZEN6, Mehmet CANDAN7, Özgür DAĞLI8
1Abant İzzet Baysal Üniversitesi İzzet Baysal Bolu Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Bolu
2Abant İzzet Baysal Üniversitesi İzzet Baysal Bolu Tıp Fakültesi, Radyoloji Anabilim Dalı, Bolu
3Gaziantep Üniversitesi Tıp Fakültesi, Nefrololoji Anabilim Dalı, Gaziantep
4Gaziantep Güneydoğu Hemodiyaliz Merkezi, Gaziantep
5Gaziantep Nefrotep Hemodiyaliz Merkezi, Gaziantep
6Gaziantep Devlet Hastanesi Hemodiyaliz Merkezi, Gaziantep
7Gaziantep SSK Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Uzmanı, Gaziantep
8Kilis Devlet Hastanesi Enfeksiyon Hastalıkları Uzmanı, Kilis
Keywords: hemodialysis, hepatitis B Virus (HBV), hepatitis C Virus (HCV), viral load, seroprevalence

The seroprevalence of parenterally transmitted hepatitis B (HBV) and hepatitis C (HCV) in hemodialysis patients is higher than in normal population. In this study, the aim was to determine the seroprevalence of HBV and HCV and to evaluate viral load and genotypes in hemodialysis patients. The study was done in 289 hemodialysis patients, applying to four different hemodilysis centers, between 2000 and 2003. The patients who had chronic viral hepatitis and native immunization were excluded. The liver function tests, viral hepatitis markers (HBsAg, anti-HBs, anti-HCV, anti-HAV IgG, anti-HEV, anti-HDV), the ages of patients, the duration of hemodialysis treatment of patients and risk factors for chronic viral hepatitis (curetage, tooth extraction, blood transfusion) were evaluated. The serum samples of patients which were positive for HBsAg and/or anti-HCV were tested with PCR method to detect viral load (HBV-DNA and HCV-RNA) and genotype. Sixty eight (23.5%) of 289 cases were asymptomatic hepatitis carriers, 34 of them were female and 34 male. The age range was 9-85 (45.2±16.9). Of the patients 44.6% were positive for anti-HBs, 8.76% for HBsAg, 14.9% for anti-HCV, and 0.8% for HBV plus HCV 0.8%. The mean hemodialysis treatment duration was 1-254 (53.3±47.3) days, ALT level was 2-83 (18.0±12.0) IU/ml, AST level was 2-144 (20.0±14.0) IU/ml. In 9 (30%) of 25 HBsAg positive cases the HBV-DNA levels and in 11 (25.6%) of 43 anti-HCV positive cases the HCV RNA levels were quantitavely high. In two patients despite HBsAg and anti-HCV co-positivity the viral load was negative. The genotypes of all HBV cases were genotype D, and HCV cases were genotype 1 b. All data were analysed with SPSS. Viral load levels of hepatitis carriers and risk factors, age and gender were not statistically significant. It was found that anti-HBs and anti-HCV positivity increased with duration of hemodialysis (p< 0.005). In hemodialysis patients, transmission of HBV and HCV is correlated with time. Possible transmissions could be hindered with preventive measures. For therapeutic measures viral load should be detected qantitatively in asymptomatic HBV and HCV carriers of hemodialysis patients and also genotypes should be considered.

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