Non-Hodgkin Lenfomalý Hastalarda Hepatit B ve C Virüs Seroprevalansý: Tek Merkez Deneyimi

Hepatitis B and C viruses (HBV and HCV) are hepatotrophic viruses that can also proliferate in lymphoid tissues. Both of them can be cause chronic antigenic stimulation and may be related vvith lymphoproliferative disorders. Aim of this study is to evaluate HBV and HCV viruses seroprevalence in non-Hodgkin’s lymphoma (NHL) patients in our cancer çenter and their rela-tion vvith patient characteristics. We investigated hepatitis B virüs surface antigen (HbsAg) and anti-hepatitis C virüs antigen (anti-HCV-Ab) frequency in one hundred sixty four NHL patients retrospectively who admitted in our hospital betvveen November 2001- March 2008. We overvievved in the study HBV and HCV infected patients’ disease characteristics. HBsAg and anti-HCV-Ab tests had been applied by Enzyme-Linked Ýmmunosorbent Assay (ELISA) for these patients as a part of initial evaluating process at their first visit. The control group consisted of non-cancer patients treated in orthopedi clinics of our hospital (n= 165). Histologically confirmed 164 NHL patients vvere enrolled in this study. Among those 159 vvere B-cell lymphoma patients and the rest 5 vvere T-cell origin lymphoma patients. Tvventy three patients of 159 patients (14%) vvere diagnosed as low grade lymphoma. Ninety one patients (55%) vvere male and seventy three patients (45%) vvere female. HBsAg vvas found positive in fifteen patients (9.1%). Three patients had extranodai and nine patients had nodal diffuse large B-cell lymphoma (DLBCL). Rest of these patients had low grade iymhomas. Anti-HCV-Ab vvas positive in three (1.8%) patients, additionally HBsAg positivity vvas detected in the same three patients. One of them had splenic other two patients had diffuse large B-cell tymphomas. HBsAg prevalence vvas found higher but anti-HCV-Ab prevaience vvas found similar betvveen NHL and control group (9.1 vs 3%, p= 0.0366 and 1.8 vs 1.2%, p= 0.9945 respectiveiy). Ali of patients received chemotherapy except one patient at stage I follicular lymphoma who had HBsAg positive. Six patients infected HBV and/or HCV ývere treated antiviral agents. Two patients among 15 who did not received prophylactic antiviral therapy during their cytotoxic treatment suffered from reactivation of HBV infection (%13) These findings supported that hepatitis carrier frequency in NHL patients more than non-cancer patients population according to our cancer çenter data. For these reason hepatits B and C markers should be evaluated before NHL treatment in our country.

Hepatitis B and C Virüs Seroprevalance of the Patients vvith Non-Hodgkin’s Lymphoma: Single Çenter Experience

Hepatit B ve C virüsleri (HBV ve HCV) lenfoid dokularda da çoðalabilen, hepatotropik virüslerdir. Her iki virüs de kronik anti-jenik uyarýma neden olabilir ve lenfoproliferatif hastalýklarla iliþkili olabilir. Bu çalýþma ile bizim merkezimizdeki non-Hodgkin len-foma (NHL) hastalarýnda HCV ve HBV seroprevalansý ve bunun hasta karakteristikleri ile iliþkisini deðerlendirmek amaçlandý. Bu çalýþmada retrospektif olarak Ankara Onkoloji Hastanesine Kasým 2001-Mart 2008 tarihleri arasýnda kabul edilen 164 NHL hastasýnda hepatit B virüs yüzey antijeni (HbsAg) ve anti-hepatit C virüs antijeni (anti-HCV-Ab) sýklýðý deðerlendirildi Bu deðerlendirme taný sýrasýnda ve “Enzyme Linked immunosorbent Assay (ELISA)’’ yöntemi ile yapýldý. Kontrol grubu olarak hastanemiz ortopedi kliniðine baþvuran kanser dýþý 165 hasta alýndý. Çalýþmaya alýnan histolojik olarak tanýsý doðrulanmýþ 164 NHL hastasýnýn 159'unu B hücreli lenfomalar, 5'ini T hücreli lenfomalar oluþturmaktaydý. Yüz elli dokuz hastanýn 23 (%14)’ü düþük greydli lenfoma hastalarýydý. Hastalarýn 91 (%55)’i erkek, 73 (%45)'ü kadýndý. Hastalarýn 15 (%9.1)’inde HbsAg pozitif bulundu. Bu hastalarýn 3’ü ekstranodal, 9’u yaygýn büyük hücreli lenfoma, geri kalan 3 hastada ise düþük greydli lenfoma saptandý. Anti-HCV-Ab, 3 (%1.8) hastada pozitif bulundu. Bu hastalarda ayný zamanda HbsAg pozitifliði de mevcuttu. Hastalardan biri spienik lenfoma, diðer 2 hasta yaygýn büyük hücreli lenfoma tanýsý almýþtý. Kontrol grubuna göre NHL hastalarýnda HbsAg seroprevalansý yüksek, ama anti-HCV-Ab prevalansý benzer olarak bulundu (9.1 vs %3, p= 0.0366 ve 1.8 v-s %1.2, p= 0.9945 sýrasý ile). HbsAg pozitif olan evre I foliküler lenfoma hastasý dýþýnda diðer tüm hastalar kemoterapi almýþ olup HBV veya HCV ile infekte hastalarýn 6’sýnýn antiviral ajanlarla tedavi aldýðý tespit edildi. On beþ hastanýn antiviral tedavi almayan 2 (%13) tanesinde sitotoksik tedavi esnasýnda HBV infeksiyonu reaktivasyonu gözlendi. Bu bulgular bizim merkezimizde NHL hastalarda hepatit taþýyýcý sýklýðýnýn kanser olmayan hasta popülasyonuna göre yüksek olduðunu göstermektedir. Bu nedenle ülkemizde NHL hastalarýnda tedaviye baþlanmadan önce HCV ve HBV belirteçleri deðerlendirilmelidir.