Dergi Ara >>
Yıl:2008; Cilt: 9; Sayı: 4>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2008;9(4):208-216
Madde kullanım bozukluğu olan ergenlerde HBV: Yaygınlık, riskler, aşılama
Z Yüncü, BK Başay, B Özbaran, C Aydın, M Tamar
EGEBAM (Ege Üniv. Çocuk Ergen Alkol ve Madde Bağ. Araş. ve Uyg. Merkezi), İzmir
Giriş: Hepatit B virüsü (HBV) bulaşmasında madde kullanımı ve cinselliğin aynı düzeyde etkiye sahip olduğu
bildirilmektedir. Ülkemizde ergenlik döneminde madde kullanımı giderek yaygınlaşmaktadır. Bu çalışmada,
ergenlik döneminde madde kullananlar arasında HBV sıklığını ve risk etkenlerini saptamayı amaçladık. Yöntem:
Bu çalışmada 2004 Ocak ayından 2007 Kasım ayına kadar Ege Üniversitesi Çocuk Ergen Alkol Madde
Bağımlılığı Araştırma ve Uygulama Merkezi’nde (EGEBAM) yatarak tedavi gören hastaların dosya kayıtları
tarandı. Bu dönemde 206 olgunun yatarak tedavi gördüğü saptandı. Serolojik sonuçları bulunan 188 olgu,
sosyodemografik (s=188), klinik (s=188) ve risk etkenleri (s=41) açısından sorgulandı. İstatistiksel değerlendirme
için SPSS 13.0 paket programı kullanıldı. Sınıfsal değişkenlerin karşılaştırılmasında ki-kare testi, risk etkenlerini
değerlendirmek için lojistik regresyon analizi yapıldı, istatistiksel anlamlılık p<0.05 olarak kabul edildi. Bulgular:
Bu çalışmaya katılan 188 olgunun tümü erkek olup yaş ortalaması 16.4±1.4’tür. Olguların %69.1’inin (s=130)
esrar, %56.4’ünün (s=106) uçucu, %46.8’inin (s=88) ekstazi, %42.6’sının (s=80) alkol kullandığı saptanmıştır.
Olguların %23.9’u (s=45) virüsle karşılaşmıştır. Virüsle bağışıklama yolu ile karşılaşma oranı %14.9’dur (s=28).
Hastalık olarak karşılaşma oranı %9 (s=17) olarak bulunmuştur. Anne eğitim düzeyi (p=0.005), baba eğitim
düzeyi (p=0.010) ve anne-babaların gelir düzeyi (p<0.001) yüksek olanlarda, bu değerlendirme araçları açısından
daha düşük olanlara göre anti-HBc (+) olma oranı daha düşük bulunmuştur. Kardeş sayısı üç ve üçten az
olanlarda, dört ve dörtten çok olanlara göre anti-HBc (+) olma sıklığı daha düşük bulunmuştur (p=0.010). Aşılama
oranı gelir düzeyi yüksek olanlarda düşük olanlara göre daha yüksek bulunmuştur (p=0.033). Tartışma:
Ülkemizde ergenlik döneminde madde kullanımı olanlarda HBV ile karşılaşma sıklığı yurtdışındaki olgulara göre
daha düşüktür. Ancak bu sonuçlar değerlendirirken HBV görülme sıklığının yaşla beraber arttığı ve yurtdışında
benzer yaş dönemindeki olgularda damar içi madde kullanımının daha sık olduğu bilgileri değerlendirilmelidir.
Hepatitis B virus among adolescents with substance use disorder: Prevalence, risks, vaccinization
Objective: Drug abuse and sexual intercourse have been reported to have equal level of effects on hepatitis B
virus (HBV) contamination. Drug abuse prevalence increases in adolescence period in Turkey. The aim of presentstudy was to determine the prevalence of HBV infection and risk factors among adolescent drug users, an
important health problem in our country. Methods: In the study, the medical records of the patients who were
hospitalized between October 2004 and November 2007 at the inpatient service of Ege University Child and
Adolescent Addiction Investigation and Practice Center (EGEBAM) were evaluated. From a total of 206 patients
hospitalized within this period, 188 patients whose serological results were available, were reviewed in terms of
socio-demographic features (n=188), clinical properties (n=188) and risk factors (n=41). For the comparison of
categorical variables chi-square test and for the risk assessment logistic regression analysis was used. Results:
All of the 188 subjects recruited in the study were male and the mean age of the sample was 16.4±1.4 [year]s.
69.1% (n=130) of the subjects were using cannabis, 56.4% (n=106) were using inhalants, 46.8% (n=88) were
using ecstasy, and 42.6% (n=80) were using alcohol. Forty-five patients (23.9%) had been exposed with the virus.
Among these subjects, 14.9% (n=28) of them have been exposed to the virus via immunization while 9% of the
cases have been exposed to the virus via viral infection. Anti-HBc positivity was negatively correlated with
education status of the mother (p=0.005) and the father (p=0.010) and economic levels of parents (p<0.001). The
number of cases with Anti-HBc positivity was found to be smaller among the patients with three or less siblings
compared to the ones with 4 or more siblings. Immunization via vaccination was higher among patients with
higher income (p=0.033). Discussion: The prevalence of HBV infection among adolescents with substance use
disorders in our country is quite lower than other countries which might be a result of lower intravenous drug
users in this age group in this country. As the prevalence of HBV infection increases with age, utmost care should
be provided to avoid the spread of infection in this age group.

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