Beta-2 Mi̇croglobuli̇n as A Prognostic Factor in Chronic Hepatitis B Treatment
Seda Sibel Günbay1, Özcan Deveci2, Canan Ağalar3, Tuna Demirdal4, Neşe Demirtürk4, Sedat Kaygusuz5, Dilek Kılıç51Dept. of Infectious diseases and Clinical Microbiology Erzurum Educ. and Research Hosp. Turkiye2Dept. of Infec. diseases and Clinical Micb. Faculty of Medicine, Unv. of Dicle, Diyarbakir, Turkiye
3Dept. of Infec. diseases and Clinical Micb. İstanbul, Fatih S. Mehmet Educ. and Resr. Hosp. Turkiye
4Dept. of Infec. diseases and Clinical Micb. Faculty of Med. Unv. of Afyon Kocatepe Afyon, Turkiye
5Dept. of Infec. diseases and Clinical Micb. Faculty of Med. Unv. of Kırıkkale, Kırıkkale, Turkiye
6Dept. of Family Medicine, Faculty of Medicine, University of Dicle, Diyarbakir, Turkiye
INTRODUCTION: The β-2 MG (Beta-2 microglobulin) levels in patients with chronic hepatitis B are observed to be significantly higher compared to the inactive carriers. In chronic hepatitis B infections treated with interferon, the β-2 MG levels have been observed to be higher during exacerbations. The aim of this study is to investigate the relationship between the β-2 MG levels before and after treatment in patients who are treated with interferon.
METHODS: The present study was conducted at the Kirikkale University Medical School, Department of Infectious Diseases and Clinical Microbiology. The study subjects were divided into two groups: Group 1 consisted of 22 patients who were both pre-treated for hepatitis B or were treatment- naive. They were also HBsAg (+) and HBV DNA (+). Their Knodell score was 4 or above in the liver biopsy and the liver enzymes were at least twice as high as the normal values. Group 2 was the control group and consisted of 22 inactive carriers who were HBsAg (+) and HBV DNA (-) with normal liver enzymes. The patients’ β-2 MG levels (AIDA autoimmune diagnostic assays, Ref 10801) were analysed with the microELISA method using the serums that were stored at -70oC. The β-2 MG tests of the patients in Group 1 were essayed both before the treatment and 2 months into the treatment.
RESULTS: The ages of the patients in the case of group varied between 17 and 59 (mean age: 38), while the age of the control group were between 21 and 57 (mean age: 44). No statistically significant difference has been observed in terms of the age and sex of the treatment and the control groups (p=0.177, p=0.181, respectively). There was a statistically significant difference between the starting β-2 MG values of case of group and the starting β-2 MG values of control group (p=0.0001). The β-2 MG levels in Group 1 were observed to be significantly lower in the 2nd month of the treatment.
DISCUSSION AND CONCLUSION: The β-2 MG values have been thought to be auxiliary parameters both in the follow up of the treatment success and to make the decision to initiate the treatment. More comprehensive studies are required to clarify this issue.
Kroni̇k Hepati̇t B Tedavi̇si̇nde Prognosti̇k Faktör Olarak Beta-2 Mi̇kroglobulin
Seda Sibel Günbay1, Özcan Deveci2, Canan Ağalar3, Tuna Demirdal4, Neşe Demirtürk4, Sedat Kaygusuz5, Dilek Kılıç51Dept. of Infectious diseases and Clinical Microbiology Erzurum Educ. and Research Hosp. Turkiye2Dept. of Infec. diseases and Clinical Micb. Faculty of Medicine, Unv. of Dicle, Diyarbakir, Turkiye
3Dept. of Infec. diseases and Clinical Micb. İstanbul, Fatih S. Mehmet Educ. and Resr. Hosp. Turkiye
4Dept. of Infec. diseases and Clinical Micb. Faculty of Med. Unv. of Afyon Kocatepe Afyon, Turkiye
5Dept. of Infec. diseases and Clinical Micb. Faculty of Med. Unv. of Kırıkkale, Kırıkkale, Turkiye
6Dept. of Family Medicine, Faculty of Medicine, University of Dicle, Diyarbakir, Turkiye
GİRİŞ ve AMAÇ: Kronik Hepatit B(KHB) hastalarında Beta- 2 mikroglobulin (β-2 MG) seviyesi, inaktif taşıyıcılarına göre yüksek gözlemlenmiştir. β-2 MG seviyesi KHB’larında interferon tedavisi ile arttığı izlenmiştir. Bu çalışmanın amacı interferon tedavisi alan hastalarda tedavi öncesi ve sonrası β-2 MG seviyeleri arasındaki ilişkiyi araştırmaktır.
YÖNTEM ve GEREÇLER: Bu Çalışma Kırıkkale Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji bölümü tarafından yürütüldü. Çalışmada hastalar iki gruba ayrıldı. Grup 1 daha önce tedavi almış veya ilk kez tedavi alan hastalardan oluştu(Bu hastalar HBsAg (+), HBV DNA (+), knodell skoru 4<, KCFT normal veya yüksek olan hastalar). Grup 2 kontrol grubu olarak belirlendi. Bu hastalar inaktif hepatit B taşıyıcısı olan hastalardan oluşuyordu(HBsAg (+), HBV DNA(-), KCFT normal) β-2 MG seviyeleri (AIDA autoimmune diagnostic assays, Ref 10801) cihazı ile microELİSA metodu kullanılarak değerlendirildi. Grup 1 hastalarında hem tedavi öncesi hem de tedaviden 2 ay sonra β-2 MG testi yapıldı.
BULGULAR: Grup 1’deki hastaların yaşları 17-59 arasında idi(Ortalama: 38). Grup2’de ise yaşlar 21-57 arasında iken ortalama yaş 44’idi. Her iki grup arasında ortalama yaş ve cinsiyet açısından anlamlı bir fark yoktu.( p=0.177, p=0.181, sırasıyla). Grup 1 hasta grubunda β-2 MG seviyeleri kontrol grubuna yüksek saptandı(p=0.0001). Ayrıca Grup 1 hasta grubunda tedavinin ikinci ayında β-2 MG sevileri anlamlı bir şekilde düşük saptandı.
TARTIŞMA ve SONUÇ: β-2 MG değerleri Kronik hepatit B tedavisine başlamada ve tedavinin başarısını takipte bir parametre olabileceği düşünüldü. Bu konuda geniş kapsamlı çalışmalara ihtiyaç bulunmaktadır.
Manuscript Language: English