Erzurum'da Hepatit B’li Annelerin Bebeklerine Verilen Pasif-Aktif İmmunoprofilaksinin Sonuçları, Türkiye

Yıl 2019, Cilt: 17 Sayı: 1, 110 - 120, 01.04.2019

Handan Alay , Melek Şahiner Berrin Göktuğ Kadıoğlu Ragıp Afşin Alay

Öz

GİRİŞ ve AMAÇ: Hepatit B virüsü (HBV) ile
infekte annelerden doğan bebekler pasif-aktif immünoprofilaksiye rağmen infekte
olabilirler. Bu çalışmada HBV’nin bulaşmasında maternal vireminin rolünü ve HBV
ile infekte annelerden doğan bebeklerin pasif-aktif immunoprofilaksi
sonuçlarını değerlendirmeyi amaçladık.

 

YÖNTEM ve GEREÇLER: Bu çalışmaya bir Kadın
Hastalıkları ve Doğum hastanesinde 2014 ve 2016 yılları arasında HBV ile
infekte anneler ve pasif-aktif immünoprofilaksi uygulanan bebekleri dahil
edildi. Hastaların sosyodemografik verileri, hepatit belirteçleri, viral
yükleri ve çocukların hepatit belirteçleri değerlendirildi.

 

BULGULAR: 2014-2016 yılları arasında 26925
gebe kadın HBsAg için tarandı. 328 HBsAg pozitif gebe kadının 271’i
hastanemizde doğum yaptı. Sadece 53 anne ve bebeğine ulaşabildik. HBsAg pozitif
53 anneden 2(% 3,72)’si HBeAg pozitif, 51(% 96,23) anne ise AntiHBe pozitifti.
Beş annede(% 9,43) viral yük ≥2000 IU / ml idi. 28(% 52,83) annenin viral
yüklerine ulaşılamadı. Maternal HBeAg durumu ve viral yük ile infant antikor
yanıtı arasında istatistiksel olarak anlamlı ilişki vardı (p <0,05). Doğum
ağırlığı, gestasyonel yaş ve HBIG yapılma zamanı ile infant antikor yanıtı
arasında istatistiksel olarak anlamlı bir ilişki yoktu (p> 0,05).

 TARTIŞMA
ve SONUÇ: HBV
ile infekte annelerin bebeklerinde pasif-aktif immunoprofilaksi, perinatal
bulaşmanın önlenmesinde oldukça etkilidir. HBsAg taraması tüm gebelere
hamilelikleri sırasında yapılmalıdır. Hamileliklerinde HBsAg pozitif olarak
saptanan annelerin bebeklerine doğumdan 6-12 saat içinde pasif-aktif
immunoprofilaksi verilmelidir. Sonrasında mutlaka immünizasyon sonuçları
değerlendirilmelidir. Ebeveynlere taburculuk sırasında bilgi verilmesi,
toplumun farkındalığını artıracak ve hepatit B'nin ortadan kaldırılmasına
katkıda bulunacaktır.

Anahtar Kelimeler

HBsAg pozitif anneler, çocuklar, pasif-aktif immünoprofilaksi

Outcomes of Passive-Active Immunoprophylaxis Administered to Infants of Mothers Infected with Hepatitis B Virus in Erzurum, Turkey

Öz

OBJECTIVES:  Infants
born to mothers with hepatitis B virus (HBV) may be infected despite receiving
passive-active immunoprophylaxis. The purpose of this study was to assess the role of maternal viremia in the transmission of HBV
and the passive-active immunoprophylaxis outcomes of infants born to women infected
by HBV.

METHODS:
HBV-infected mothers and infants up to 12 months of
age receiving passive-active immunoprophylaxis at the Erzurum Nenehatun
Obstetrics and Gynecology Hospital, Turkey, between 2014 and 2016 were included
in the study. Socio-demographic data for the patients, and hepatitis markers,
viral loads and hepatitis markers of children were evaluated.

RESULTS:
A total of 26,925
pregnant women were screened for HBsAg between 2014 and 2016. Three hundred
twenty-eight HBsAg-positive pregnant women, of whom 271 delivered at our
hospital, and 53 mother-infant pairs were included in the study. Of the 53
HBsAg-positive mothers, HBeAg status was positive in 2 (3.72%) and antiHBe
status was positive in 51 (96.23%). Viral load was ≥2000IU/ml in 5 mothers
(9.43%). The viral loads of 28 mothers (52.83%) were unavailable. Statistically
significant associations were determined between maternal HBeAg status,
maternal viral load and antibody response (p<0.05). No statistically
significant associations were observed between birth weight, gestational age,
timing of HBIG and antibody response (p>0.05).

CONCLUSIONS: Passive-active immunoprophylaxis in
babies of HBV-infected mothers was highly efficacious in preventing perinatal
transmission. Antepartum HBsAg markers must be examined in all pregnancies, and
passive-active immunoprophylaxis should be given in the first 6-12 h of life to
infants of mothers who are HBsAg-positive during pregnancy. Immunization
results should be evaluated subsequently. Healthy generations can be produced by treating HBsAg-positivity with
high maternal viremia by means of passive-active immunoprophylaxis, thus
reducing the economic impact of diseases and care, and improving quality of
life. Giving information to parents during discharge training will increase
community awareness and contribute to the eradication of hepatitis B.

Anahtar Kelimeler

HBsAg-positive mothers, children, passive-active immunoprophylaxis

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