GEBELİKTE KRONİK HEPATİT B YÖNETİMİ Management of Chronic Hepatitis B in Pregnancy

Year 2016, Volume: 6 Issue: 2, 48 - 52, 19.12.2016

Mehmet Ali Narin Suat Dede Raziye Narin

Abstract

Gebelikte kronik hepatit B (KHB) enfeksiyonu global bir problem olarak karşımıza çıkmaktadır. Dünyadaki

yaklaşık 350 milyon KHB taşıyıcının %50’ si enfeksiyonu perinatal dönemde edinmektedir.

KHB ile enfekte gebe kadınlar genel nüfustan farklıdır ve hepatit B virüs (HBV) enfeksiyonunun

anne ve çocuğa etkisi, gebeliğin HBV replikasyonuna etkileri, gebelik sürecinde annenin antiviral

tedavi alıp almayacağı, tedavinin anne ve çocuğa etkileri, yenidoğanın nasıl immünize edileceği ve

bunun hastalığa etkileri gibi pek çok özel poblem söz konusudur. HB e Ag pozitif annelerden doğan

ve immünprofilaksi yapılmayan infantlarda vertikal geçiş oranı %40-90 düzeyindedir. KHB enfeksiyonlu,

doğurganlık çağındaki kadınlar bulaş için önemli bir kaynak durumundadırlar; bu nedenle

gebelikte KHB yönetimi perinatal geçişi azaltmak açısından önemli bir süreçtir. Bu derleme perinatal

geçişin önlenmesi ve gebelikte tedavisini de içeren KHB yönetimi ile ilgili optimal yaklaşımı

özetlemektedir.

ABSTRACT

Chronic hepatitis B (CHB) virus infection in pregnancy is an important global health problem. Over

50% of the 350 million chronic hepatitis B carriers acquire their infection perinatally. Pregnant

women infected with CHB are different from the general population, and their special

problems need to be considered: such as the effect of hepatitis B virus (HBV) infection on the

mother and fetus, the effect of pregnancy on replication of the HBV, whether mothers should take

HBV antiviral therapy during pregnancy, the effect of these treatments on the mother and

fetus, how to carry out immunization of neonates, whether it can induce hepatitis activity

after delivery and other serious issues. Without immunoprophylaxis, infants born to HBeAgpositive

mothers have a 40–90% risk of vertical transmission. Women of childbearing age with

chronic HBV infection remain an important source of HBV transmission. Thus, the management

of chronic HBV infection during pregnancy is an important opportunity to interrupt the perinatal

transmission of HBV. This review will provide an optimal approach to a number of issues of HBV

management in pregnancy, including the prevention of perinatal transmission and the treatment

of chronic hepatitis B in pregnancy.

Keywords

Kronik hepatit B; Gebelik; Anneden çocuğa bulaş; Antiviral tedavi

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