Determination of prevalence of hepati̇ti̇s B and hepatitis C i̇n rheumatoid arthritis at van region

AİM:Rheumatoid arthritis (RA) is an inflammatory polyarthropathy that affects approximately 1% of the world population. Hepatitis B (HBV) and Hepatitis C (HCV) viruses are the leading causes of chronic liver disease in more than 2 billion infected people worldwide.Immunosuppressive and immunomodulating drugs used in the treatment of RA can increase the incidence of hepatitis virus infections in RA.In our study, we aimed to determine the incidence of HBV and HCV in patients with RA in Van region and to investigate the effects of immunosuppressive and immunoregulatory drugs used by patients to the incidence of HBV and HCV. MATERIALS AND METHODS:This study included 403 consecutive patients with RA who were diagnosed as RA in the Rheumatology Departments of Yüzüncü Yıl University Faculty of Medicine and Health Sciences University Van Training and Research Hospital between January 2015 and January 2018. Demographic data and laboratory values of the patients were retrospectively reviewed.Patients were divided into 3 groups according to the type of drug they used. Disease modifier (DMARD) group drug user patients such as methotrexate, salazopril, hydroxychloroquine or Leflunamide were classified as group 1, group 2 included corticosteroids with DMARD users and group 3 included biological agenst and/or corticosteroids users. The statistical relationship between AST, ALT, ALP, GGT, CRP, ESR, RF, anti-CCP, HBsag, Anti-HBs and Anti HCV levels were investigated between the groups. Descriptive statistics for continuous variables from the features emphasized in our study were; mean, standard deviation, minimum and maximum values, while categorical variables are expressed as numbers and percentages.The statistical significance level was calculated as 0.05. RESULTS:The mean age of the patients was 50,943 ± 12,90; range(19-91) years. The disease duration was 4,876 3 ± 3,74; range (1-20) years.When the patients were grouped according to the treatment they received, 183 patients (45%) in the first group were using the disease modifier (DMARD) group such as Methotrexate, Salazopril, Hydroxychloroquine or Leflunamid, while 176 patients (43.6%) were receiving corticosteroids with DMARD,in the third group, 45 patients (11.1%) were using DMARD and / or corticosteroids with biological agents. HBsag, Anti-HCV and Anti-HBs positivity percentages of the patients were 2.8%, 0.8% and 28.1%, respectively.There was no statistically significant difference between the anti-HCV and anti-HBS values, but HBsag positivity rates were significantly higher in the third group. (P <0.05) CONCLUSİON:There is no significant increase in the prevalence of HBV and HCV in RA patients compared to the normal population, but the risk of hepatitis reactivation should be considered especially in the use of biological agents. All patients should be asked for pre-treatment viral hepatitis screening tests, and patients who need to be vaccinated should receive hepatitis vaccine. Although there are several studies evaluating the prevalence of HBV in our country, our study is the first study to evaluate the prevalence of HBV and HCV in patients with RA in Van region.