You are here

DİYALİZ HASTALARINDA HEPATİT C İNFEKSİYONU OLUŞUMUNDA DOKU ANTİJENLERİNİN ROLÜ

Share
THE ROLE OF TISSUE ANTIGENS IN HEPATITIS C INFECTION THE OCCURENCE OF IN DIALYSIS PATIENTS

Journal Name:

FULL TEXT (PDF): 

Volume:

Publication Year:

Number:

Sayfa Aralığı:: 
9-13

Publication Language:

Abstract (Original Language): 
Bu çalışmada, diyaliz hastalarında HCV infeksiyonu ile doku antijenleri (HLA) arasındaki olası ilişki araştırılmıştır. Çalışma, merkezimizde diyalize giren 66sı erkek, 43 ü kadın ve yaş ortalaması 37 (15-70) olan 109 kronik böbrek yetmezlikli hastada yapılmıştır. Seksen ikisi (%75) hemodiyaliz (HD), 27 si (%25) kronik periton diyalizi (SAPD) yapılan bu hastaların diyaliz süresi, ortalama 49 (3-160) ay idi. HCV antikor prevalansı, genel olarak diyaliz hastalarında %48.6 idi., HD hastalanndaki HCV antikor pozitifliği oram(%59.7), SAPD hastalarına (%14.8) göre anlamlı derecede yüksekti (p:0.0000). HCV antikoru saptanan hastalarda diyaliz süresinin (61.9±4.9 ay) HCV negatif hastalara (36.9±3.2 ay) göre anlamlı şekilde uzun olduğu saptandı (p:0.0000). ALT yüksekliği, HCV antikoru pozitif hastalarda (%64.2) negatif olan hastalara (%12.5) göre anlamlı derecede yüksekti (p.0.0000). HCV antikoru ile HLA-A, B, C ve DR antijenlerinin sıklığı arasında ilişki araştırıldığında (Ki-Kare) HCV antikor varlığı ile HLA A28 (p:0.057), DR52 (p:0.047) arasında anlamlı ters ilişki bulundu. HCV antikoru saptanan hastalarda, ALT yüksekliği ile HLA antijenleri arasında ilişki incelendiğinde ALT si yüksek olan olgularda HLA A3 (p:0.03), A30 (p:0.079), B22 (p:0.079) sıklığınının daha fazla olduğu dikkati çekti. Sonuçlarımız, diyaliz hastalanndaki HCV infeksiyonu oluşumunda, diyaliz tipi ve süresinin çok önemli risk faktörleri olduğunu vurgulamaktadır. Bunun yanısıra bazı doku antijenlerinin varlığının ve/veya yokluğunun, konağın immün yanıtını değiştirerek HCV infeksiyonu ve buna bağlı kronik karaciğer hastalığına katkıda bulunabileceği düşünülmüştür
Abstract (2. Language): 
The possible role of HLA antigens in the occurence and the chronicity of Hepatitis C Infection (HCV) in dialysis patients is investigated in this study. The study was performed on a total of 109 patients, 66 of whom were male and 43 were female, and the mean age was 37 (15-70). Eighty-two (75%) were on hemodialysis(HD), twenty seven were on continouos ambulatory peritoneal dialysis (CAPD); and the mean duration of dialysis was 49 (3-160) months. Prevelance of anti-HCV was 48.6% in the whole group of patients. The prevelance of anti-HCV in the HD group was significantly higher than that of CAPD patients (59.7% and 14.8%. respectively; p.0.0000). The duration of dialysis in patients with anti-HCV (61.9±4.9 months) was significantly longer than that of anti-HCV negative patients (36.93.2 monthsj. (p.0.0000). The prevelance of ALT elevations in anti-HCV positive patients (64.2%) was significantly higher than that of anti-HCV negative patients (12.5%), (p:0.0000). When the relations between anti-HCV and the frequency ofHLA-A, B, C and DR antigens were assessed, an inverse relationship between the presence of anti-HCV antibody and HLA-A28 (p:0.057), DR52 (p:0.047) was found. When the relation between the ALT levels and HLA antigens was investigated the frequency of HLA-A 3 (p:0.03), A30 (p:0.079) and B22 (p:0.079) was significantly high in anti-HCV positive patients. Our results suggest that, the type and duration of dialysis were important risk factors in the occurence of HCV infection. Besides this, the presence or absence of some tissue antigens may play role in the development of chronic liver disease by modulating the immune response of the host.

Keywords (Original Language):

REFERENCES

References: 

1. Biugera M, Vidal L Sanchez-Tapias JM, et al. Incidence and faetures of liver disease in patients on chronic hemodialysis. J Clin Gastroenterol 1990;2:298-302.
2. Akpolat
T
, Arık N, Günaydın M et al. Prevalance anti-HCV among haemodialysis patients in Turkey: a multicenter study. Nephrol Dial Transplant 1995;10:479-480.
3.
Süleymanla
r G, Süleymanlar İ, Sezer T ve ark. Hemodiyaliz veya sürekli ayaktan periton diyaliz uygulanan kronik böbrek yetmezliği hastalarında hepatit C virus infeksiyonu: Karşılaştırmalı analiz sonuçlan. Türk J Gastroenterol 1997;8:21-27.
4. Scherlock S, Dooley J. Diseases of the Liver and Biliary
System (10th Edition). Blackwell Science 1997;pp303-
335.
5. Wejstal R. Immune-mediated liver damage in chronic hepatitis C. Scand J Gastroenterol 1995;30:609-613.
6. Dusheiko G, Schmilovitz-Weiss H, Brown D et al. Hepatitis C virus genotypes: an investigation of type-specific differences in geographic origin and disease. Lancet 1995;346:1006-7.
7. Koziel MJ. The role of immune response in the pathogenesis of hepatitis C virus infection. J Viral Hepat 1997;4Suppl2:31-41.
8. Peano G, Menardi G, Ponzetto A, Fenoglio LM. HLA-DR5 antigen. A genetic factor influencing the outcome of hepatitis C virus infection ? Arch Intern Med
1994;154:2733-6.
9. Higashi Y, Kamikawaji N, Suko H, Ando M. Analysis of HLA allels in Japanese patients with cirrhosis due to chronic hepatitis C. J Gastroenterol Hepatol 1996; 11: 241-6.
10. Kuzushita N, Hayashi N, Moribe T et al. Influence of HLA hapiotypes on the clinical course of individuals infected with hepatitis C virus. Hepatology 1998;27:240-244.
11. Miiller GY, Zabaleta ME, Arminio A et al. Risk factors
for dialysis-associated hepatitis C in Venezüella. Kidney
Int 1992;41:1055-1058.
12. Knudsen F, Wanthin P, Rasmussen K et al. Hepatitis C in Dialysis Patients: Relationship to Blood Transfusions, Dialysis and liver disease. Kidney Int 1993;43:1353-
1356
13. Chan TM, Lok ASF, Cheng IKP, Hepatitis C infection
among dialysis patients: A comparison between patients on maintenance hemodialysis and continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 1991;6:944-947.
14. Laiw YF, Lee CS, Tsai SL, et al. T-cell-mediated autologous hepatocytotoxieity in patients with hepatitis C virus infection. Hepatology 1995;22: 1368-73.
15. Apple RJ, Erlich HA, Klitz W. HLA DR-DQ
associations with cervical carcinoma show
papillomavirus-type specificity. Nature Genet 1994;6:157-62.
16. Thursz MR, Kwiatkowski D, Allsopp CEM, et al.
Association between an MHC class II allele and clearence of the hepatitis B virus in Gambia. N Engl J
Med 1995;332:1065-9.
17. Kuzushita N; Hayashi N, Moribe T et al. Influence of HLA hapiotypes on the clinical course of individuals infected with hepatitis C virus. Hepatology 1998;27:240-244.
18. Verdon R, Pol S, Landais P, et al. Absence of association between HLA antigens and chronicity of viral hepatitis in hemodialyzed patients. J Hepatol 1994;21:388-93.
13

Thank you for copying data from http://www.arastirmax.com