Bir ilçedeki gebelerde TORCH seroprevalansının araştırılması

Year 2022, Volume: 19 Issue: 3, 1373 - 1379, 30.09.2022

Fatih Kılıç , Burak Ersak , Adem Yalçınkaya

https://doi.org/10.38136/jgon.1021475

Cited By: 1

Abstract

Amaç: Bir ilçedeki gebelerde ilk trimesterde toksoplazma, rubella, CMV, sifiliz, HIV ve hepatit B&C seroprevalansının belirlenmesini ve gebelik takibinde bu enfeksiyonların taranmasının gerekli olup olmadığını tartışmayı amaçladık.
Gereçler ve Yöntem: Çalışmaya bir ilçedeki mevcut olan tek kadın hastalıkları ve doğum polikliniğine bir yıl içinde başvuran 259 gebe dahil edilmiştir. Gebelerden ilk trimesterde alınan venöz kanda; rubella IgM&IgG, toksoplazma IgM&IgG, CMV IgM&IgG, HBsAg, anti-HCV, anti-HIV ve sifiliz (VDRL-RPR) serolojileri değerlendirilmiştir.
Bulgular: Hastaların seroloji sonuçlarında rubella IgG 255 (%98.5), CMV IgG 254 (%98.1), toksoplazma IgG 58(%22.4) hastada pozitif olarak bulundu. Bir hastada toksoplazma IgM ve IgG pozitif saptandı. Rubella IgM, CMV IgM, anti-HCV ve anti-HIV hiçbir hastada pozitif saptanmadı. Hastaların 2’sinde (%0.8) HBsAg, başka 2 (%0.8) hastada da VDRL-RPR pozitif saptandı. İki hastada HBV DNA testi ile Hepatit B hastalığı, bir hastada TPHA testi ile sifiliz hastalığı doğrulandı.
Sonuç: Bölgemizde rubella enfeksiyonunun aşılama programı sayesinde, CMV enfeksiyonun da gebelik öncesi dönemde geçirilerek bağışıklıklarının yüksek olması gebelikte taranmalarının uygun olmadığını göstermektedir. Bölgemizdeki toksoplazma için tespit edilen yüksek seronegatiflik oranları gebelik takibinde ilk muayenede toksoplazma yönünden bağışıklık durumunun belirlenmesinin yararlı olacağını göstermektedir. Hepatit B için gerekli taramalar yapıldıktan sonra mümkünse prekonsepsiyonel dönemde aşılama önerilmelidir. Hepatit C, HIV ve sifiliz taramasının maliyeti ve bölgemizdeki düşük prevelansı göz önüne alındığında riskli grupların taranması daha uygun gözükmektedir. Ancak ülkemiz Sağlık Bakanlığı, Birleşmiş Milletlerin belirlediği hedefler doğrultusunda tüm gebelerin özellikle HIV ve sifiliz açısından taranmasını önermektedir.

Keywords

Gebelik, HIV, seroprevalans, TORCH, VDRL

Investigation of TORCH seroprevalence among pregnant women in a district

Abstract

Aim: The aim of this study to evaluate the seroprevalence of toxoplasmosis, rubella, CMV, syphilis, HIV and hepatitis B&C infections among pregnant women at the first trimester in a district and to discuss whether it is necessary to screen for these infections during routine pregnancy follow -up.
Materials and Method: This study included 259 pregnant women who applied to the single Obstetrics and Gynecology outpatient clinic in a district within one year. Rubella IgM&IgG, toxoplasma IgM&IgG, CMV IgM&IgG, HBsAg, anti-HCV, anti-HIV and syphilis (VDRL-RPR) serologies were examined from the venous blood sample taken in the first trimester of pregnancy.
Results: Rubella IgG antibodies detected in 255 (98.5%) patients, CMV IgG antibodies in 254 (98.1%) patients, toxoplasma IgG antibodies in 58 (22.4%) patients. Only one patient was positive for Anti-Toxoplasma IgM and IgG antibodies. None of the patients were positive for Rubella IgM, CMV IgM, anti-HCV and anti-HIV antibodies. HBsAg positivity was detected in 2 (0.8%) patients and VDRL-RPR positivity in other 2 patients. Positive results for Hepatitis B disease was confirmed by HBV DNA test in two patients and syphilis disease was confirmed by TPHA test in one patient.
Conclusion: Due to the protective effects of rubella vaccination and acquired immunity in the pre-pregnancy period of CMV infection, screening for these infections during pregnancy may not be appropriate. The high seronegativity rates determined for toxoplasmosis in our region indicate that it will be useful to screen for toxoplasmosis in the first antenatal visit. If possible, in the preconceptional period, vaccination should be recommended after the routine screening for hepatitis B infection done. Considering the cost of the screening for hepatitis C, HIV and syphilis infections and low prevalence in our region, screening of high-risk groups seems more convenient. However, the Ministry of Health recommends that all pregnant women be screened for HIV and syphilis infections in line with the goals set by the United Nations.

Keywords

Pregnancy, HIV, seroprevalence, TORCH, VDRL

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