Seroprevalance of Hepatitis C in Seroprevalance of Hepatitis C in Turkey (%) Turkey (%)

(Anti-HCV positivity in donors)(Anti-HCV positivity in donors)

• Adana (n:8310)Adana (n:8310)

• Antalya (n:16.410)Antalya (n:16.410)

• Bursa (n:16.512)Bursa (n:16.512)

• Erzurum (n:24.870)Erzurum (n:24.870)

• İstanbul (n:108.000)İstanbul (n:108.000)

• Trabzon (n:22.300)Trabzon (n:22.300)

• Ankara (n:14.372)Ankara (n:14.372)

Annual Anti-HCV Positivity rate Annual Anti-HCV Positivity rate at Istanbul–Çapa Red Crescent Blood Bankat Istanbul–Çapa Red Crescent Blood Bank

YearYear Total nbr of blood units Total nbr of blood units Seropositive Seropositive(%) (%)

19971997 73,959 73,959 0.40.4

19981998 62,786 62,786 0.60.6

19991999 55,953 55,953 0.40.4

20002000 51,460 51,460 0.40.4

20012001 51,037 51,037 0.40.4

Overall, 0.3% of 457,240 units from Red Crescent blood banks Overall, 0.3% of 457,240 units from Red Crescent blood banks

positive for Anti-HCV.positive for Anti-HCV.

Characteristics of seropositive casesCharacteristics of seropositive cases

No difference by sex or educational statusNo difference by sex or educational status

AgeAge 18-28 : 0,2% 18-28 : 0,2%

29-30 : 0,3%29-30 : 0,3%

40-50 : 0,4%40-50 : 0,4%

51-55 : 0,6%51-55 : 0,6%

First-time donorsFirst-time donors : 0,2 % : 0,2 %

SoldiersSoldiers : 2,4 %: 2,4 %

Professional donorsProfessional donors : 20 %: 20 %

Anti-HCV Seropositivity in different groups Anti-HCV Seropositivity in different groups (%)-I(%)-I

Haemodialysis patients (overall 41% positive in 2073 cases)Haemodialysis patients (overall 41% positive in 2073 cases)

nn %%

Ankara Ankara 418418 34,734,7

Bursa Bursa 110110 82,882,8

Adana Adana 180180 14,414,4

İstanbul İstanbul 150150 36,036,0

İzmir İzmir 8181 49,349,3

DiyarbakırDiyarbakır 5555 32,732,7

Kayseri Kayseri 7676 32,932,9

Sivas Sivas 6565 56,956,9

Trabzon Trabzon 8080 2020

Anti-HCV Seropositivity in different groups Anti-HCV Seropositivity in different groups (%)-II (%)-II

%%

Health personnel (n>3290)Health personnel (n>3290) 0,90,9

Sex workers (n> 800)Sex workers (n> 800) 4,84,8

PrisonersPrisoners 3,13,1

Diabetic patientsDiabetic patients 11,611,6

Hepatocellular carsinomaHepatocellular carsinoma 12,5-2912,5-29

Renal transplantationRenal transplantation 12,5-52,712,5-52,7

Cryptogenic cirrhosisCryptogenic cirrhosis 26,926,9

Talassemia patientsTalassemia patients 16,6-57,116,6-57,1

IV drug usersIV drug users 54,854,8

Diagnostic methods of HCV Diagnostic methods of HCV infections in Turkeyinfections in Turkey

• Screening : Anti-HCV ELİSA (3rd,4th generation kits)Screening : Anti-HCV ELİSA (3rd,4th generation kits)

• Monitorization of treatment (HCV –RNA viral load) ; Monitorization of treatment (HCV –RNA viral load) ; Cobas –Amplicor monitoring / b.DNA-BayerCobas –Amplicor monitoring / b.DNA-Bayer

• Treatment :INF + RibavirinTreatment :INF + Ribavirin

• Genotype distribution Genotype distribution :: >> 70 %: 1b 70 %: 1b

Liver cirrhosis in Turkey (%)Liver cirrhosis in Turkey (%)

Years Years

Aetiology Aetiology 1983-891983-89 1990-93 1994- 1990-93 1994-9797

((n=616) (n=436) (n=393)n=616) (n=436) (n=393)

ViralViral 42,9 42,9 56,7 56,7 59,559,5

Cryptogenic 41,2Cryptogenic 41,2 22,7 22,7 16,816,8

AlcoholicAlcoholic 8,9 12,6 10,9 8,9 12,6 10,9

Misc.Misc. 7 8 12,8 7 8 12,8

Viral Agents in Liver Cirrhosis (%)Viral Agents in Liver Cirrhosis (%)

1990-931990-93 1994-19971994-1997

HBVHBV 56,556,5 42,6 42,6

HCVHCV 25,225,2 34,534,5

HDVHDV 14,614,6 15,7 15,7

HBV + HCVHBV + HCV 3,7 3,7 1,2 1,2

Alcoholic + ViralAlcoholic + Viral __ 6 __ 6

Etiologic Distribution of the Etiologic Distribution of the Chronic Hepatitis (%)Chronic Hepatitis (%)

1991-1994 1994-19971991-1994 1994-1997 ( n: 296) (n: 527) ( n: 296) (n: 527)

Type B 56 46,5Type B 56 46,5Type C 23 Type C 23 35 35Cryptogenic C.H. Cryptogenic C.H. 9 9 8,9 8,9Type B+D 6,8 4,5Type B+D 6,8 4,5Type B+C 3 Type B+C 3 3 3Autoimmune 1,5 1,5Autoimmune 1,5 1,5Drug induced 0,7 0,2 Drug induced 0,7 0,2 B+C+D _ 0,4 B+C+D _ 0,4

SummarySummary

1.1. Hepatitis B still keeps the first place in the Hepatitis B still keeps the first place in the etiology of chronic hepatitis in Turkey.etiology of chronic hepatitis in Turkey.

2.2. The ratio of hepatitis B and D decreases among The ratio of hepatitis B and D decreases among the other causes of chronic hepatitis.the other causes of chronic hepatitis.

3.3. The ratio of hepatitis C increases as a cause of The ratio of hepatitis C increases as a cause of chronic hepatitis.chronic hepatitis.

4.4. The ratio of crytogenic and autoimmune The ratio of crytogenic and autoimmune hepatitis remain the same.hepatitis remain the same.