İzole Anti-HBc total pozitif olgularda Real-Time PCR yöntemi ile HBV-DNA arastırılması ve bu olguların Kan Bankacılıgı açısından önemi
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Date
2006
Authors
Bal, Salih Haldun
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Hepatit B virüsü (HBV)'nün transfüzyonla geçişi günümüzde azalmış olsa da halentransfüzyon tıbbının en önemli sorunlarından biridir. Bu geçişi önlemek amacıyla tümdonörlerde HBsAg taranmakta, ancak bu uygulama HBV enfeksiyonunun doğal seyrinin özellikleri nedeniyle yetersiz kalabilmektedir. Yapılan çeşitli çalışmalar HBsAg'nin negatif olduğu donörlerden yapılan transfüzyonlarda da hepatit Bvirusunun bulaşabildiğini göstermektedir. Bu durumun önüne geçebilmek amacıyla donörlerde ALT bakılması, donör kanlarından hazırlanan havuzlarda Polimeraz Zincir Reaksiyonu (PCR) ile HBV-DNA bakılması gibi yöntemlerin etkinliği araştırılmıştır.Bazı çalışmalarda HBsAg negatif olgularda anti-HBc düzeylerine bakılmış, anti-HBc'nin pozitif bulunduğu olgularda da Nükleer Amplifikasyon Tekniği (NAT)yöntemiyle virüsün varlığı gösterilmiştir. Bu çalışma ile amacımız bölgemizde HBsAg negatif, anti-HBc pozitif olan olgularda HBV-DNA pozitifliği oranını saptamak ve kan bankacılığı açısından önemini incelemektir.Bu amaçla, HBsAg negatif bulunmuş olan tüm donör örneklerinde anti-HBc total çalışılmış, anti-HBc total pozitif örneklerde, anti-HBs çalışılmış ve anti-HBs-pozitif örnekler çalışma dışı bırakılmıştır. HBsAg negatif, anti-HBc total pozitif, anti-HBs negatif bulunan örneklerde Real-Time PCR yöntemi ile HBV-DNA araştırılmıştır.Bu çalışmada, 9282 HBsAg negatif donör serumu kullanılmış, % 2,7'sinde izoleanti-HBc total pozitif bulunmuştur. HBsAg negatif donörlerden alınan, izole anti-HBctotal pozitif serumların % 0,45'ünde, toplamın ise % 0,012'sinde HBV-DNA tespit edilmiştir.Bu da 8333 transfüzyonda 1 kişiye rutin tarama testlerine rağmen bulaşabileceğini göstermektedir.
Eventhough, currently there is a decrease of HBV transmission with transfusion, it is still one of the main problems in transfusion medicine. To prevent the transmission of infection, HBsAg is being screened in all blood donors, but this application may be insufficient because of the nature of the HBV infection. Current studies showed that HBV is transmissible to recipients from HBsAg negative blood donors. To prevent this situation, the efficiency of methods like ALT screening in blood donors and HBV-DNA screening with Polimerase Chain Reaction (PCR) in the mini pools from blood donors have been investigated. In some studies, anti-HBc levels were investigated in HBsAg (-) blood donors and existence of virus was detected with Nuclear Amplification Technique (NAT) in anti-HBc (+) cases. Our purpose in this study is to detect HBV-DNA positivity ratio in HBsAg (-), anti-HBc (+) cases and to analyse its importance for Blood Banking in our region. For this purpose, anti-HBc total was investigated in all HBsAg (-) blood donor samples. Anti-HBs was investigated in anti-HBc (+) samples and anti-HBs (+) samples were excluded from study. HBV-DNA was investigated in HBsAg (-), anti-HBc (+), antiHBs (-) samples with Real-Time PCR method. In this study, 9282 HBsAg (-) donor sera was investigated and isolated anti-HBc total positivity was % 2,7 in these sera. HBV-DNA was positive in 1 (% 0,012) of all blood donor sera and % 0,45 of isolated anti-HBc total positive sera from donors who have negative HBsAg.The result shows that 1 HBV transmission may be possible in every 8333 transfusion, despite routine donor screening.
Eventhough, currently there is a decrease of HBV transmission with transfusion, it is still one of the main problems in transfusion medicine. To prevent the transmission of infection, HBsAg is being screened in all blood donors, but this application may be insufficient because of the nature of the HBV infection. Current studies showed that HBV is transmissible to recipients from HBsAg negative blood donors. To prevent this situation, the efficiency of methods like ALT screening in blood donors and HBV-DNA screening with Polimerase Chain Reaction (PCR) in the mini pools from blood donors have been investigated. In some studies, anti-HBc levels were investigated in HBsAg (-) blood donors and existence of virus was detected with Nuclear Amplification Technique (NAT) in anti-HBc (+) cases. Our purpose in this study is to detect HBV-DNA positivity ratio in HBsAg (-), anti-HBc (+) cases and to analyse its importance for Blood Banking in our region. For this purpose, anti-HBc total was investigated in all HBsAg (-) blood donor samples. Anti-HBs was investigated in anti-HBc (+) samples and anti-HBs (+) samples were excluded from study. HBV-DNA was investigated in HBsAg (-), anti-HBc (+), antiHBs (-) samples with Real-Time PCR method. In this study, 9282 HBsAg (-) donor sera was investigated and isolated anti-HBc total positivity was % 2,7 in these sera. HBV-DNA was positive in 1 (% 0,012) of all blood donor sera and % 0,45 of isolated anti-HBc total positive sera from donors who have negative HBsAg.The result shows that 1 HBV transmission may be possible in every 8333 transfusion, despite routine donor screening.
Description
Keywords
Anti-HBc, HBV-DNA, Transfüzyon, Transfusion
Citation
Bal, S. H. (2006). İzole Anti-HBc total pozitif olgularda Real-Time PCR yöntemi ile HBV-DNA arastırılması ve bu olguların Kan Bankacılıgı açısından önemi. Yayınlanmamış yüksek lisans tezi. Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.