Hemodiyaliz hastalarında gizli Hepatit B enfeksiyonunun polimeraz zincir reaksiyonu ile araştırılması

Abstract

Aim: It is known as the occult Hepatitis B that Hepatitis B virus DNA (HBV DNA) exists in serum very little if Hepatitis B virus surface antigen in serum is negative. The studies about occult Hepatitis B infection prevalence are limited in patients who undergo hemodialysis implements for along time. HBV existence is able to continue in plasma and liver tissue of some patients whose HBsAg test is negative. This condition causes many diagnostic problems. It is very crucial the description of people who have this clinical risk of HBV transmission in the community, especially in dialysis units. This study is aimed to determine the prevalence of occult Hepatitis B in dialysis patients. Material and Methods: 160 HBsAg-negative patients and 28 predialysis total of 188 patients were included in this study. 5 ml venous blood samples taken from the patients into sterile vacutainer tubes contain anticoagulant. Blood tubes to separate serum 800-1600 x g for 20 min. centrifuged. The separated serum was collected into polypropylene tubes and was stored at -20 oC until the applied test procedure. For the detection of HBV DNA; HBV Isolation Device (Magnesia 16 Geneworks Anatolia, Turkey) and HBV DNA isolation kit (16/201 viral nucleic acid isolation kit) was used and isolated, then serum were tagged on the elution tube. Real-Time PCR Device (Montanide 483 Geneworks Anatolia, Turkey) and Real-time PCR kit (Bosphore Quantification Kit V2) was used in PCR process. Real Time PCR kit, which is used in the study, was detected whole HBV genotypes between A and H of the Hepatit B virus DNA in human serum or plasma sample. Analytical sensitivity of the kit was 10 IU / mL linear range 1x101-1x109 IU/ml. Hepatitis B virus markers (HBsAg, anti-HBcAg, anti-HBs) ) were studied using commercial ELISA kits (Abbott ARCHITECT Qualitative Reagan Kit) and ELISA device (Abbott ARCHITECT i2000 SR), CRP (SIEMENS cardiophase to hsCRP the kit and SIEMENS BN II device. Likewise, aspartate aminotransferase (AST), alanine aminotransferase (ALT), (aspartate aminotransferase A / Alanine aminotransferase Roche Cobas INTEGRA / cobas c system) were studied using with test kits Roche Cobas 501 devices. Results: In 11.3% of hemodialysis patients (18/160) HBV DNA positivity (occult Hepatitis B infection) were detected. Predialysis patients who are in the control group was not observed HBV DNA positivity (0/28). Anti-HBs positivity in 142 hemodialysis patients (88.7%), while 14 predialysis patients (50%) were found (p <0.05). There was no statistically significant difference between the other parameters. Conclusions : Dialysis centers are areas of risk for transmission of HBV. HBV DNA screening of all patients undergoing dialysis must be performed. In addition; suggested to vaccination of susceptible patients, GHB has been diagnosed patients isolating dialyzer, the diagnosis of HBV patients receiving a specific service area. Key Words: HBV, occult Hepatitis B, hemodialysis