\u00a0 <\/span>hasta say\u0131s\u0131 370 (%0.4) idi. Sonucu reaktif olan 370 hastan\u0131n 162 (%43.8)\u2019si erkek, 208 (%56.2)\u2019i kad\u0131nd\u0131. Anti-HCV reaktif hastalar incelendi\u011finde, erkek hastalar\u0131n S\\Co de\u011ferleri 1.01-17.87 mI\u00dc\/ml (ortalama\u00b1SS=6.14\u00b15.57) aras\u0131nda, kad\u0131n hastalar\u0131n ise 1.01-25.53 mI\u00dc\/ml (ortalama\u00b1SS=5.75\u00b15.50) aras\u0131nda idi; fakat cinsiyete g\u00f6re anti-HCV pozitif hastalar\u0131n S\\Co de\u011ferinin anlaml\u0131 fark g\u00f6stermedi\u011fi tespit edildi (p<\/i>=0.756).<\/p>\nOrtalama S\/Co de\u011ferlerinin ya\u015f ile birlikte artt\u0131\u011f\u0131 ve en y\u00fcksek ortalama de\u011ferin (7.36\u00b15.92) 61 ya\u015f ve \u00fczerindeki hasta grubunda oldu\u011fu g\u00f6r\u00fcld\u00fc. Ya\u015f ile anti-HCV d\u00fczeyi aras\u0131nda d\u00fc\u015f\u00fck d\u00fczeyde ili\u015fki olmakla birlikte (korelasyon katsay\u0131s\u0131=0.238), bu ili\u015fkinin istatistiksel olarak anlaml\u0131 oldu\u011fu tespit edildi (p<\/i>\u22640.001) (Tablo 1).<\/p>\n
Ya\u015f gruplar\u0131 kendi aras\u0131nda ortalama S\/Co de\u011ferleri a\u00e7\u0131s\u0131ndan kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda, 0-20 ya\u015f ile 21-40 ya\u015f aras\u0131nda ve 41-60 ile \u226561 ya\u015f aras\u0131nda istatistiksel olarak anlaml\u0131 d\u00fczeyde fark bulunamazken, di\u011fer t\u00fcm ya\u015f gruplar\u0131 aras\u0131ndaki fark\u0131n istatistiksel olarak anlaml\u0131 d\u00fczeyde oldu\u011fu tespit edildi (Tablo 2).<\/p>\n
Anti-HCV reaktif olan 370 hastadan HCV-RNA sonu\u00e7lar\u0131na ula\u015f\u0131labilen 130 hasta incelendi\u011finde, 37 (%28.5) hastan\u0131n HCV-RNA sonucu pozitif, 93 (%71.5) hastan\u0131n ise negatifti. Test sonucu HCV-RNA pozitif ve negatif olan hastalar\u0131n S\/Co de\u011ferleri kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda, HCV-RNA pozitif hastalarda ortalama de\u011fer belirgin olarak y\u00fcksek tespit edildi; bu fark da istatistiksel olarak anlaml\u0131 d\u00fczeydeydi (p<\/i>\u22640.001) (Tablo 3).<\/p>\n
\u00c7al\u0131\u015fmam\u0131za dahil edilen ve HCV-RNA sonucuna bak\u0131lan 130 hastan\u0131n ya\u015f gruplar\u0131na g\u00f6re da\u011f\u0131l\u0131m\u0131 incelendi\u011finde, HCV-RNA pozitif hastalar\u0131n en fazla \u226561 ya\u015f (%62.2), en az ise 0-20 ya\u015f (%5.4) olan grupta bulundu\u011fu g\u00f6r\u00fcld\u00fc. Ya\u015f gruplar\u0131na g\u00f6re de HCV-RNA pozitifli\u011fi a\u00e7\u0131s\u0131ndan istatistiksel olarak anlaml\u0131 d\u00fczeyde fark tespit edildi (p<\/i>=0.012) (Tablo 4).<\/p>\n
Anti-HCV reaktif hastalar S\/Co de\u011ferlerine g\u00f6re; 1-5 mI\u00dc\/ml, 5.1-10 mI\u00dc\/ml ve \u226510.1 mI\u00dc\/ml olmak \u00fczere \u00fc\u00e7 grupta incelendi; S\/Co de\u011feri 1-5 mI\u00dc\/ml olan 56 (%43.1) hasta, 5.1-10 mI\u00dc\/ml olan 16 (%12.3) hasta ve \u226510.1 mI\u00dc\/ml olan 58 (%44.6) hasta bulunmaktayd\u0131 (Tablo 5). S\/Co de\u011feri 1-5 mI\u00dc\/ml aras\u0131nda olan 56 hastan\u0131n sadece 1 (%1.8)\u2019inde HCV-RNA pozitif saptan\u0131rken, S\/Co de\u011ferinin 5.1-10 mI\u00dc\/ml aras\u0131nda oldu\u011fu grupta bu oran %25, S\/Co de\u011ferinin \u226510.1 mIU\/ml oldu\u011fu grupta ise %55.2 idi. Gruplar aras\u0131ndaki bu fark istatistiksel olarak da anlaml\u0131 d\u00fczeydeydi (p<\/i>\u22640.001). \u00a0 \u00a0<\/span><\/p>\nHastal\u0131k Kontrol ve Korunma Merkezleri\u2019nin \u00f6nerisi do\u011frultusunda, anti-HCV reaktif hastalar HCV-RNA pozitifli\u011fi a\u00e7\u0131s\u0131ndan S\/Co de\u011ferlerine g\u00f6re 1.0-3.8 mI\u00dc\/ml ve\u00a0 <\/span>\u22653.9 mI\u00dc\/ml olmak \u00fczere iki gruba ayr\u0131ld\u0131 (2);\u00a0 <\/span>S\/Co de\u011feri 1-3.8 mI\u00dc\/ml olan 49 (%37.7) hasta ve\u00a0 <\/span>\u22653.9 mI\u00dc\/ml olan 81 (%62.3) hasta mevcuttu. S\/Co de\u011feri 1-3.8 mI\u00dc\/ml olan hastalar\u0131n sadece 1 (%2)\u2019inde HCV-RNA pozitif saptan\u0131rken, S\/Co de\u011feri \u22653.9 mI\u00dc\/ml olan hastalarda HCV-RNA pozitifli\u011fi oran\u0131 %44.4 olarak tespit edildi; gruplar aras\u0131ndaki bu fark istatistiksel olarak da anlaml\u0131 d\u00fczeydeydi (p<\/i>\u22640.001) (Tablo 6). <\/span><\/p>\n\u0130RDELEME<\/h2>\n
D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc\u2019ne g\u00f6re, d\u00fcnya \u00e7ap\u0131nda 185 milyondan fazla birey HCV ile infekte olup her y\u0131l yakla\u015f\u0131k 700 000\u2019i hayat\u0131n\u0131 kaybetmektedir. T\u00fcrkiye\u2019de yap\u0131lan farkl\u0131 \u00e7al\u0131\u015fmalarda ve toplum temelli ilk \u00e7al\u0131\u015fma olan TURHEP\u2019te HCV seroprevalans\u0131 ortalama %1 (%0.4-%1.5) olarak rapor edilmi\u015ftir (4-5). \u00c7al\u0131\u015fmam\u0131zda da 86 177 hastan\u0131n %0.4\u2019\u00fc anti-HCV reaktif tespit edildi. Bal\u0131kesir\u2019de yap\u0131lan farkl\u0131 bir \u00e7al\u0131\u015fmada da ameliyat \u00f6ncesi hastalar\u0131n anti-HCV reaktivite oranlar\u0131 \u00e7al\u0131\u015fmam\u0131za benzer \u015fekilde %0.33 olarak bildirilmi\u015ftir (6). Bunlar aras\u0131nda yalanc\u0131 pozitifliklerin de oldu\u011fu d\u00fc\u015f\u00fcn\u00fcld\u00fc\u011f\u00fcnde Bal\u0131kesir b\u00f6lgesinde HCV seroprevalans\u0131n\u0131n olduk\u00e7a d\u00fc\u015f\u00fck oldu\u011fu tahmin edilebilir.<\/p>\n
\u00c7al\u0131\u015fmam\u0131zda, anti-HCV reaktif olan 370 hastan\u0131n 162 (%43.8)\u2019si erkek, 208 (%56.2)\u2019i kad\u0131nd\u0131. T\u00fcrkiye\u2019de yap\u0131lan farkl\u0131 \u00e7al\u0131\u015fmalarda da anti-HCV seropozitifli\u011finin cinsiyete g\u00f6re da\u011f\u0131l\u0131m\u0131nda anlaml\u0131 d\u00fczeyde bir fark bulunamam\u0131\u015ft\u0131r (4,7,8). Anti-HCV pozitif grupta erkek hastalar\u0131n ortalama S\\Co de\u011feri de kad\u0131n hastalardan y\u00fcksek olmakla birlikte bu fark istatistiksel olarak anlaml\u0131 d\u00fczeyde bulunmad\u0131. Anti-HCV reaktif olan hastalar ya\u015f gruplar\u0131na g\u00f6re kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda, ortalama S\/Co de\u011ferlerinin ya\u015f ile birlikte artt\u0131\u011f\u0131, en y\u00fcksek ortalama de\u011ferin 61 ya\u015f ve \u00fczerindeki grupta oldu\u011fu g\u00f6r\u00fcld\u00fc (Tablo 1). Ya\u015f ile anti-HCV d\u00fczeyi aras\u0131nda d\u00fc\u015f\u00fck d\u00fczey ili\u015fki olmakla birlikte bu ili\u015fkinin istatistiksel olarak anlaml\u0131 d\u00fczeyde oldu\u011fu belirlendi. Sar\u0131ba\u015f ve arkada\u015flar\u0131n\u0131n (7) \u00e7al\u0131\u015fmas\u0131nda <\/b>da ya\u015f gruplar\u0131na bak\u0131ld\u0131\u011f\u0131nda en y\u00fcksek oran 40 ya\u015f \u00fczerinde bulunmu\u015ftur; Asan ve arkada\u015flar\u0131n\u0131n (9) \u00e7al\u0131\u015fmas\u0131nda ise hastalar\u0131n %54\u2019\u00fcn\u00fcn 50 ya\u015f ve \u00fczeri oldu\u011fu g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Bu sonu\u00e7lar bizim \u00e7al\u0131\u015fmam\u0131zla uyumlu olup ya\u015f ile birlikte artan, \u00f6zellikle d\u00fc\u015f\u00fck d\u00fczey anti-HCV pozitifli\u011finin ge\u00e7irilmi\u015f infeksiyona ba\u011fl\u0131 olabilece\u011fi de \u00f6ne s\u00fcr\u00fclmektedir (10). TURHEP \u00e7al\u0131\u015fmas\u0131nda, risk fakt\u00f6rleri a\u00e7\u0131s\u0131ndan erkek cinsiyet, d\u00fc\u015f\u00fck e\u011fitim d\u00fczeyi, evli olmak, G\u00fcneydo\u011fu Anadolu b\u00f6lgesinde ya\u015famak, hepatitli hasta ile yak\u0131n temas, ortodental m\u00fcdahaleler ve daha \u00f6nce tek kullan\u0131ml\u0131k olmayan enjekt\u00f6r kullan\u0131m\u0131 incelenmi\u015f ve artan HCV prevalans\u0131 ile ili\u015fkili tek risk fakt\u00f6r\u00fcn\u00fcn 50 ya\u015f \u00fczerinde olmak oldu\u011fu bildirilmi\u015ftir (4).<\/p>\n
Abbott HCV EIA 2.0 ve ORTHO\u00ae<\/sup> HCV ver. 3.0 ELISA \u00f6zg\u00fcll\u00fc\u011f\u00fcn\u00fcn >%99 oldu\u011fu bildirilmekle birlikte; anti-HCV prevalans\u0131n\u0131n <%10 oldu\u011fu ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 yeterli pop\u00fclasyonlarda ELISA testlerinde yalanc\u0131 pozitifli\u011fin yakla\u015f\u0131k %35 (%15-%60), ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 bask\u0131lanm\u0131\u015f pop\u00fclasyonlarda (\u00f6rne\u011fin hemodiyaliz hastalar\u0131) ise yalanc\u0131 pozitif sonu\u00e7lar\u0131n yakla\u015f\u0131k %15 oldu\u011fu bildirilmi\u015ftir (11-18). Do\u011frulama i\u00e7in RIBA testleri kullan\u0131lmakta iken belirsiz sonu\u00e7lar\u0131n s\u0131k g\u00f6r\u00fclmesi nedeniyle 2013 y\u0131l\u0131nda CDC taraf\u0131ndan HCV tan\u0131 algoritmas\u0131ndan \u00e7\u0131kar\u0131lm\u0131\u015f, tekrarlayan reaktivite durumunda HCV-RNA \u00e7al\u0131\u015f\u0131lmas\u0131 \u00f6nerilmi\u015ftir (19). \u00c7al\u0131\u015fmam\u0131zda, anti-HCV reaktif 370 hastadan HCV-RNA sonu\u00e7lar\u0131na ula\u015f\u0131labilen 130 (%35.1) hasta incelendi\u011finde, 37 (%28.5) hastada HCV-RNA pozitif, 93 (%71.5) hastada ise negatif bulundu; \u00fclkemizden yap\u0131lan \u00e7e\u015fitli \u00e7al\u0131\u015fmalarda da anti-HCV reaktif hastalarda HCV-RNA negatifli\u011finin %27.4 ile %63.5 aras\u0131nda de\u011fi\u015fti\u011fi g\u00f6r\u00fclm\u00fc\u015ft\u00fcr (20). <\/b>Bizim \u00e7al\u0131\u015fmam\u0131zda anti-HCV yalanc\u0131 pozitifli\u011finin daha y\u00fcksek olmas\u0131 b\u00f6lgemizde HCV seroprevalans\u0131n\u0131n T\u00fcrkiye ortalamas\u0131n\u0131n da alt\u0131nda olabilece\u011fini d\u00fc\u015f\u00fcnd\u00fcrmektedir fakat bunu kesin olarak s\u00f6yleyebilmek i\u00e7in anti-HCV reaktif b\u00fct\u00fcn hastalara HCV-RNA bak\u0131lm\u0131\u015f olmas\u0131, karaci\u011fer fonksiyon testleri gibi di\u011fer laboratuvar test sonu\u00e7lar\u0131n\u0131n ve hastalar\u0131n klinik bilgilerinin ve takiplerinin olmas\u0131 gerekmektedir. \u00c7al\u0131\u015fmam\u0131zda anti HCV pozitif hastalar\u0131n sadece %35.1\u2019inin HCV RNA verisine ula\u015f\u0131labilmi\u015f olmas\u0131, di\u011fer laboratuvar bulgular\u0131 ve klinik verilerinin olmamas\u0131 \u00e7al\u0131\u015fmam\u0131z\u0131n k\u0131s\u0131tl\u0131l\u0131klar\u0131ndand\u0131r.<\/p>\nHCV-RNA pozitif hastalar\u0131n, en fazla \u226561 ya\u015f olan grupta (%62.2), en az ise 0-20 ya\u015f grubunda (%5.4) bulundu\u011fu g\u00f6r\u00fcld\u00fc. <\/b>Ya\u015f gruplar\u0131na g\u00f6re HCV-RNA pozitifli\u011fi a\u00e7\u0131s\u0131ndan istatistiksel olarak anlaml\u0131 d\u00fczeyde fark bulundu. Anti-HCV prevalans\u0131n\u0131n da ya\u015f ile artt\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fcld\u00fc\u011f\u00fcnde, HCV infeksiyonunun g\u00f6stergesi olan HCV-RNA pozitifli\u011finin de ya\u015f ile artmas\u0131 beklenen bir sonu\u00e7tur. Fakat bu verinin daha geni\u015f kapsaml\u0131 \u00e7al\u0131\u015fmalarla do\u011frulanmas\u0131 gerekmektedir.\u00a0 \u00a0<\/span><\/p>\n\u00dcretici firmalar\u0131n \u00f6nerileri do\u011frultusunda S\\Co de\u011ferlerinde 1 mI\u00dc\/ml\u2019den b\u00fcy\u00fck sonu\u00e7lar reaktif kabul edildi\u011finde, d\u00fc\u015f\u00fck d\u00fczey anti-HCV reaktifliklerinde HCV-RNA negatifli\u011finin %86\u2019ya kadar ula\u015ft\u0131\u011f\u0131 bildirilmi\u015ftir (21). Hastal\u0131k Kontrol ve Korunma Merkezleri’nin 2003 y\u0131l\u0131nda yay\u0131mlad\u0131\u011f\u0131 rehber kapsam\u0131nda, lisansl\u0131 \u201cenzyme-immunoassay\u201d (EIA) testlerde, ortalama S\/Co oranlar\u0131 >3.8 mI\u00dc\/ml olan numuneler i\u00e7in anti-HCV reaktif olarak rapor edilmesinin, ger\u00e7ek anti-HCV durumunu y\u00fcksek oranda tahmin edece\u011fi bildirilmi\u015ftir (2). Sayan ve arkada\u015flar\u0131n\u0131n (22) yapt\u0131klar\u0131 \u00e7al\u0131\u015fmada, S\/Co i\u00e7in en uygun e\u015fik de\u011fer 3.8 mI\u00dc\/ml olarak tespit edilmi\u015ftir. Memiko\u011flu ve arkada\u015flar\u0131 (23) \u00e7al\u0131\u015fmalar\u0131nda, anti-HCV i\u00e7in e\u015fik de\u011ferin \u22655 mI\u00dc\/ml olarak da al\u0131nabilece\u011fini ve do\u011frulama gerektirecek \u00f6rnek say\u0131s\u0131n\u0131n \u00e7ok daha az olaca\u011f\u0131n\u0131 vurgulam\u0131\u015ft\u0131r. Alter ve arkada\u015flar\u0131 (2) taraf\u0131ndan 24 700 hasta ile yap\u0131lan \u00e7al\u0131\u015fmada, e\u015fik de\u011fer \u22653.8 mI\u00dc\/ml oldu\u011funda HCV-RNA pozitifli\u011fi %80\u2019e, RIBA pozitifli\u011fi ise %97\u2019ye y\u00fckselmi\u015ftir. Seo ve arkada\u015flar\u0131 (24) anti-HCV testi reaktif 661 hasta ile yapt\u0131klar\u0131 \u00e7al\u0131\u015fmada, viremi varl\u0131\u011f\u0131n\u0131 belirlemede en uygun \u201ccut-off\u201d de\u011ferini 10.9 mI\u00dc\/ml tespit etmi\u015f ve bu durumda duyarl\u0131l\u0131\u011f\u0131n %94.4\u2019e \u00e7\u0131kt\u0131\u011f\u0131n\u0131 bildirmi\u015ftir (24). Sar\u0131ba\u015f ve arkada\u015flar\u0131 (7), bizim kulland\u0131\u011f\u0131m\u0131z kitin ayn\u0131s\u0131n\u0131 kullanarak yapt\u0131klar\u0131 \u00e7al\u0131\u015fmada, S\/Co e\u015fik de\u011feri i\u00e7in 7.8 mI\u00dc\/ml; Ayd\u0131n ve arkada\u015flar\u0131 (25) ise 7.13 mI\u00dc\/ml \u00f6nermi\u015ftir. \u00c7al\u0131\u015fmam\u0131zda, anti-HCV reaktif 370 hastadan HCV-RNA sonu\u00e7lar\u0131na ula\u015f\u0131labilen 130 hasta incelendi\u011finde, HCV-RNA pozitif hastalarda ortalama S\/Co de\u011feri belirgin olarak y\u00fcksek tespit edildi ve bu fark da istatistiksel olarak anlaml\u0131 d\u00fczeydeydi; S\/Co de\u011feri 1.33 mI\u00dc\/ml olup HCV-RNA pozitif olan 14 ya\u015f\u0131nda bir \u00e7ocuk hasta d\u0131\u015f\u0131nda HCV RNA pozitif bulunanlarda minimum S\\Co de\u011ferinin 6.4 mI\u00dc\/ml oldu\u011fu g\u00f6r\u00fcld\u00fc.<\/p>\n
Hastal\u0131k Kontrol ve Korunma Merkezleri\u2019nin e\u015fik de\u011fer \u00f6nerisi do\u011frultusunda 130 hasta S\/Co de\u011ferlerine g\u00f6re 1.0-3.8 mI\u00dc\/ml ve \u22653.9 mI\u00dc\/ml olmak \u00fczere iki gruba ayr\u0131ld\u0131\u011f\u0131nda, birinci grupta bulunan 49 hastan\u0131n sadece 1 (%2)\u2019inde HCV-RNA pozitifli\u011fi saptan\u0131rken, S\/Co de\u011feri \u22653.9 mI\u00dc\/ml olan 81 hastan\u0131n %44\u2019\u00fcn\u00fcn HCV-RNA pozitif oldu\u011fu ve gruplar aras\u0131ndaki bu fark\u0131n istatistiksel olarak da anlaml\u0131 d\u00fczeyde oldu\u011fu bulundu. Hastalar S\/Co de\u011ferlerine g\u00f6re 1-5 mI\u00dc\/ml, 5.1-10 mI\u00dc\/ml ve \u226510.1 mI\u00dc\/ml olmak \u00fczere \u00fc\u00e7 gruba ayr\u0131ld\u0131\u011f\u0131nda ise S\/Co de\u011feri 1-5 mI\u00dc\/ml aras\u0131nda olan 56 hastan\u0131n %1.8\u2019inde, 5.1-10 mI\u00dc\/ml aras\u0131nda olan 16 hastan\u0131n %25\u2019inde ve \u226510.1 mI\u00dc\/ml olan 58 hastan\u0131n %55.2\u2019sinde HCV RNA pozitif tespit edildi. Bir ba\u015fka deyi\u015fle, \u00e7al\u0131\u015fmam\u0131zda anti HCV pozitifli\u011fi i\u00e7in e\u015fik de\u011fer 1 mI\u00dc\/ml al\u0131nd\u0131\u011f\u0131nda yalanc\u0131 pozitiflik %71.5, 3.8 mI\u00dc\/ml al\u0131nd\u0131\u011f\u0131nda %56 ve 5 mI\u00dc\/ml al\u0131nd\u0131\u011f\u0131nda %51 olarak bulundu; yeni e\u015fik de\u011ferler ile sadece bir hastan\u0131n yalanc\u0131 negatif olarak saptanabildi\u011fi g\u00f6r\u00fcld\u00fc. \u00c7al\u0131\u015fmam\u0131zda, az say\u0131da hastan\u0131n HCV-RNA sonucuna ula\u015f\u0131labilmi\u015f olmas\u0131na ra\u011fmen e\u015fik de\u011ferin 5.1 mI\u00dc\/ml \u00fczerinde oldu\u011fu durumlarda anti HCV testinin yalanc\u0131 negatif olarak yorumlanaca\u011f\u0131 hastalar\u0131n say\u0131s\u0131n\u0131n artt\u0131\u011f\u0131 g\u00f6r\u00fclmektedir. Memiko\u011flu ve arkada\u015flar\u0131 (23), anti-HCV i\u00e7in e\u015fik de\u011ferin\u00a0 <\/span>\u22655 mI\u00dc\/ml olarak da al\u0131nabilece\u011fini ve do\u011frulama gerektirecek \u00f6rnek say\u0131s\u0131n\u0131n \u00e7ok daha az olaca\u011f\u0131n\u0131 vurgulam\u0131\u015ft\u0131r;\u00a0 <\/span>\u00e7al\u0131\u015fmam\u0131zda da e\u015fik de\u011fer 3.8 mI\u00dc\/ml veya 5 mI\u00dc\/ml al\u0131nd\u0131\u011f\u0131nda yalanc\u0131 negatiflik a\u00e7\u0131s\u0131ndan fark g\u00f6r\u00fclemedi. Ancak \u00e7al\u0131\u015fmam\u0131zda HCV-RNA sonucuna ula\u015f\u0131labilen hasta say\u0131s\u0131 az oldu\u011fu i\u00e7in bu sonucun daha kapsaml\u0131 \u00e7al\u0131\u015fmalarla desteklenmesinin uygun olaca\u011f\u0131n\u0131 d\u00fc\u015f\u00fcnmekteyiz. T\u00fcm bu veriler ve CDC\u2019nin \u00f6nerileri do\u011frultusunda; anti-HCV tarama testi S\/Co oranlar\u0131 >3.8 mI\u00dc\/ml olan tekrarlayan reaktif numuneler i\u00e7in sonu\u00e7lar\u0131n reaktif olarak rapor edilmesi ve m\u00fcmk\u00fcnse refleks tamamlay\u0131c\u0131 test olarak HCV RNA bak\u0131lmas\u0131 \u015feklinde bir algoritman\u0131n ulusal algoritmalar olu\u015fturulana dek kullan\u0131lmas\u0131 uygun g\u00f6r\u00fcnmektedir. <\/span><\/p>\n\u00c7al\u0131\u015fmam\u0131z bu konuda Bal\u0131kesir ilinde yap\u0131lm\u0131\u015f olan ilk kapsaml\u0131 \u00e7al\u0131\u015fma olmakla birlikte; retrospektif olmas\u0131, nispeten k\u00fc\u00e7\u00fck \u00f6rneklem say\u0131s\u0131, \u00e7al\u0131\u015fmaya dahil edilen anti-HCV reaktifli\u011fi saptanan hastalar\u0131n t\u00fcm\u00fcne HCV-RNA bak\u0131lamam\u0131\u015f olmas\u0131 ve bu hastalar\u0131n klinik verilerine\/takiplerine eri\u015filememi\u015f olmas\u0131 \u00e7al\u0131\u015fmam\u0131z\u0131n k\u0131s\u0131tl\u0131l\u0131klar\u0131n\u0131 olu\u015fturmaktad\u0131r. Literat\u00fcrde de vurguland\u0131\u011f\u0131 \u00fczere anti-HCV testleri i\u00e7in \u00fclkelerin kendi pop\u00fclasyonlar\u0131n\u0131 temsil edecek \u015fekilde kapsaml\u0131 \u00e7al\u0131\u015fmalar yapmas\u0131, yayg\u0131n kullan\u0131mda olan kitler i\u00e7in e\u015fik de\u011fer belirlemesi ve bunu algoritmalarla uygulanabilir hale getirmesi b\u00fcy\u00fck \u00f6nem ta\u015f\u0131maktad\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":"
G\u0130R\u0130\u015e Hepatit C virusuna kar\u015f\u0131 (anti-HCV) antikor saptamaya y\u00f6nelik testler ilk olarak 1990 y\u0131l\u0131nda ABD G\u0131da ve \u0130la\u00e7 Dairesi (U.S. Food and Drug Administration \u2013 FDA) taraf\u0131ndan lisanslanm\u0131\u015f olup HCV infeksiyonunun klinik te\u015fhisi ve taranmas\u0131 i\u00e7in yayg\u0131n olarak kullan\u0131lmaktad\u0131r (1). Hepatit C virusu prevalans\u0131n\u0131n %10\u2019un alt\u0131nda oldu\u011fu pop\u00fclasyonlarda yalanc\u0131 pozitif sonu\u00e7lara daha s\u0131k rastlanmakta olup […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[5742,5743,5744],"class_list":["post-27253","post","type-post","status-publish","format-standard","hentry","category-ozgun-arastirma","tag-anti-hcv","tag-esik-deger","tag-hcv-rna"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/27253","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=27253"}],"version-history":[{"count":3,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/27253\/revisions"}],"predecessor-version":[{"id":27541,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/27253\/revisions\/27541"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=27253"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=27253"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=27253"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
![\"\"](\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2023\/09\/KD.C36.S3_4453_Tablo.1.png\")
<\/a>