Publication: Diabetes mellitus, lichen planus hastalarında ve damar içi madde kullanıcılarında hepatit c virüsü taşıyıcılığı ve genotipleri
Abstract
Viral hepatitler, gerek dünyada gerekse ülkemizde en önemli karaciğer hastalıkları grubunu oluşturmaktadır. Temel viroloji ve moleküler biyolojide yaşanan gelişmeler HCV enfeksiyonlarının epidemiyolojisi, patojenitesi ve tedaviye cevapları hakkında birçok bilgi edinmemizi sağlamıştır. Fakat HCV enfeksiyonun doğal gelişimi ve klinik sonuçları hala çözülememiş sorunlardır. Farklı hepatit C virüsü genotiplerinin dünya üzerinde değişik coğrafi dağılım gösterdikleri, klinik seyri etkileyebildikleri ve tedaviye alınan yanıtsızlıktan sorumlu olabildikleri bilinmektedir. Farklı genotiplerin, farklı hastalık gruplarındaki rolünü değerlendirmek ve ülkemizdeki baskın genotipin Akdeniz ülkelerinde sık rastlanan genotip ile uyumlu olup olmadığını belirlemeyi amaçladık. Çalışmaya diabetes mellitus tanısı konmuş 85 hasta, lichen planus tanısı konmuş 40 hasta ve damar içi madde bağımlısı 63 hasta olmak üzere toplam 188 hasta dahil edildi. Serum örneklerinin HCV RNA varlığı PZR yöntemi ile gösterildi. Pozitif çıkan toplam 31 hasta ise restriksiyon parça uzunluk polimorfizmi (RFLP) Yöntemi ile HCV genotipleri açısından araştırıldı. Çalışmaya alınan toplam 85 diyabet hastasının 8'inde (%9,4) oranında, lichen planuslu 40 hastanın 3'ünde (%7,5) oranında ve damar içi madde bağımlısı 63 hastanın 20'sinde (%31,7) oranında HCV RNA pozitifliği saptandı. HCV RNA pozitif diabetes mellituslu 8 hastanın tümü HCV genotipi açısından tip 1b, lichen planuslu 3 hastanın tümü tip 1b ve damar içi madde bağımlısı 20 hastanın 17'si tip 3a, kalan 3 hasta ise tip 1b ile enfekte bulundu. Elde edilen bu sonuçlar doğrultusunda HCV enfeksiyonu için yüksek risk grubu olan damar içi madde bağımlılarında baskın genotip dünya literatürüyle uyumlu olarak 3a saptandı. Orta risk grubunda olan diabetes mellitus ve lichen planusta baskın olan genotipin ülkemiz coğrafyasıyla uyumlu tip 1b olduğu belirlendi.
GENOTYPES AND CARRIAGE OF HEPATITIS C VIRUS IN DIABETES MELLITUS, LICHEN PLANUS AND INTRAVENOUS DRUG ABUSER Viral hepatitis constitutes the most important group of liver diseases in both our country and the world. Today, the progresses in the fields of basic virology and moleculer biology improved our knowledge about the epidemiology, pathogenicity of HCV infection and the response of this infection to treatment. But questions regarding to the naturel course and clinical consequences of HCV infection are still not answered, yet. It is now known that HCV genotypes have different geographic distribution, can effect the clinical course of disease and even can be responsible from the unresponsiveness to the treatment. In this study, it was planned to determine the role of different HCV genotypes in different diseases and try to find out whether the dominant genotype in our country is consistent with the most frequent genotype in the mediterranean countries. 85 patients with diabetes mellitus, 40 patients with lichen planus and 63 intravenous drug abusers are included in this study. HCV RNA detection was done by PCR. The sera of 31 patients, determined as HCV RNA (+), were used for genotype detection by RFLP. HCV RNA was positive in 8 of 85 (9,4%) patients with diabetes mellitus, 3 of 40 (7,5%) patients with lichen planus 20 of 63 (31,7%) intravenous drug abusers. All HCV RNA(+) patients with diabetes mellitus and lichen planus were found to have genotype Ib. In the 20 HCV RNA (+)intravenous drug abusers group, 17 patients had 3a, and 3 patients had Ib genotype. Given the results above, it was concluded that, in our country genotype 3a is the dominant genotype in intravenous drug abusers who constitute the high risk group for HCV infection this finding is consistent with the literature. For patients with diabetes mellitus and lichen planus who form the intermediate risk group, the dominant genotype is found to be Ib, as it is in mediterian countries.
GENOTYPES AND CARRIAGE OF HEPATITIS C VIRUS IN DIABETES MELLITUS, LICHEN PLANUS AND INTRAVENOUS DRUG ABUSER Viral hepatitis constitutes the most important group of liver diseases in both our country and the world. Today, the progresses in the fields of basic virology and moleculer biology improved our knowledge about the epidemiology, pathogenicity of HCV infection and the response of this infection to treatment. But questions regarding to the naturel course and clinical consequences of HCV infection are still not answered, yet. It is now known that HCV genotypes have different geographic distribution, can effect the clinical course of disease and even can be responsible from the unresponsiveness to the treatment. In this study, it was planned to determine the role of different HCV genotypes in different diseases and try to find out whether the dominant genotype in our country is consistent with the most frequent genotype in the mediterranean countries. 85 patients with diabetes mellitus, 40 patients with lichen planus and 63 intravenous drug abusers are included in this study. HCV RNA detection was done by PCR. The sera of 31 patients, determined as HCV RNA (+), were used for genotype detection by RFLP. HCV RNA was positive in 8 of 85 (9,4%) patients with diabetes mellitus, 3 of 40 (7,5%) patients with lichen planus 20 of 63 (31,7%) intravenous drug abusers. All HCV RNA(+) patients with diabetes mellitus and lichen planus were found to have genotype Ib. In the 20 HCV RNA (+)intravenous drug abusers group, 17 patients had 3a, and 3 patients had Ib genotype. Given the results above, it was concluded that, in our country genotype 3a is the dominant genotype in intravenous drug abusers who constitute the high risk group for HCV infection this finding is consistent with the literature. For patients with diabetes mellitus and lichen planus who form the intermediate risk group, the dominant genotype is found to be Ib, as it is in mediterian countries.