İzmir Ege Doğumevi ve Kadın Hastalıkları Eğitim ve Araştırma Hastanesine başvuran gebe kadınlarda HBV, HCV ve HAV seroprevalansları: 2010-2011

Öz

Amaç: Bu çalışmada; İzmir Ege Doğumevi ve Kadın Hastalıkları Eğitim ve Araştırma Hastanesi’ne başvuran gebe kadınlarda hepatit B yüzey antijeni HBsAg , hepatit B yüzey antikoru anti-HBs , hepatit B core antikoru anti-HBcIgG , hepatit C antikoru anti-HCV ve hepatit A virüs antikoru anti-HAV IgG seroprevalanslarının araştırılması amaçlanmıştır.Yöntem: Bu çalışma; tanımlayıcı bir çalışma olarak planlanmıştır. Bu amaçla; İzmir Ege Doğumevi ve Kadın Hastalıkları Eğitim ve Araştırma Hastanesi Gebe Polikliniği’ne 01 Aralık 2010 - 30 Eylül 2011 tarihleri arasında başvuran ve Kan Alma Merkezi’ne yönlendirilen 2003 adet gebe kadın çalışma kapsamına alınmıştır. Çalışmaya katılmayı kabul edenlerden aydınlatılmış yazılı “Onam Formu” alınmıştır. Gebe kadınlara yaş, meslek, eğitim, aşılanma durumu ve risk faktörlerini içeren anket uygulanmıştır. Gebe kadınlara anket uygulandıktan pregnant women were evaluated in terms of HBsAg, antiHBs, anti-HBcIgG, anti-HCV and anti-HAV IgG antibodies. Blood samples were evaluated by ELISA technique.Results: The mean age of 2003 pregnant women participated in the study was detected as 27±3 1844 years. In terms of occupational distribution, 89.70% were housewives, 5.4% were workers, 3.6% were freelancers, 1.1% were officers and 0.2% were students. As risk factors, being an intrafamilial transmitted hepatitis carrier was 3.6%, having had c-section was 9.4%, having had other operations 4.3%. Four percent of pregnant women had history of hepatitis B vaccinetion. It was detected to HBsAg positivity in 1.14%, anti-HBs posivity in 17% past and recovered infection or vaccination , both antiHBcIgG and anti-HBs positivity in 13.4%, anti-HBs positivity in 3.6%, anti-HCV positivity in 0.7% and anti-HAV IgG positivity in 88.2% .Conclusion: Based on the rate of salt antiHBs 3.6% , the low rate of HBsAg positivity was not associated with efficient vaccination. Low HBsAg positivity suggests that pregnant women who participated in our study were aware of prevention of hepatitis andits transmission paths. It has been contemplated that other hepatitis seroprevalence studies that will be carried out will contribute health policies in terms of public health. düşüklüğü, çalışmamıza katılan gebelerde hepatit bulaş yolları ve korunma yolları hakkında farkındalık olduğunu düşündürmüştür. Yapılacak diğer hepatit seroprevalans açısından sağlık politikalarına yardımcı olacağı düşünülmektedir.pozitiflik düşüklük etkin çalışmalarının toplum sağlığı

Anahtar Kelimeler

• gebelik, prevalans, hepatit B, hepatit C, hepatit A

HBV, HCV AND HAV seroprevalence ın pregnant women admıtted to Izmır Aegean Obstetrıcs and Gynecology Traınıng and Research Hospıtal: 2010-2011

Öz

Objective: In this study, it was aimed to investigate seroprevalence of hepatitis B surface antigen HBsAg , hepatitis B surface antibody anti-HBs , hepatitis B core antibody anti-HBcIgG , hepatitis C surface antibody anti-HCV and hepatitis A virus antibody anti-HAV IgG in pregnant women admitted to Izmir Aegean Obstetrics and Gynecology Training and Research Hospital.Methods: This study was planned as a descriptive study. 2003 pregnant women, who admitted to pregnancy clinic of Izmir Aegean Maternity and Gynaecology Training and Research Hospital and were directed to blood drawing centre between December 01, 2010 and September 30, 2011 were included in the study. A written consent form was obtained from whom accepted to participate in the study. A questionnarie which is included age, occupation, education, vaccination status and risk factors were applied to the pregnant women. After in the questionnaire, the blood samples which were taken from pregnant women were evaluated in terms of HBsAg, antiHBs, anti-HBcIgG, anti-HCV and anti-HAV IgG antibodies. Blood samples were evaluated by ELISA technique.Results: The mean age of 2003 pregnant women participated in the study was detected as 27±3 1844 years. In terms of occupational distribution, 89.70% were housewives, 5.4% were workers, 3.6% were freelancers, 1.1% were officers and 0.2% were students. As risk factors, being an intrafamilial transmitted hepatitis carrier was 3.6%, having had c-section was 9.4%, having had other operations 4.3%. Four percent of pregnant women had history of hepatitis B vaccinetion. It was detected to HBsAg positivity in 1.14%, anti-HBs posivity in 17% past and recovered infection or vaccination , both antiHBcIgG and anti-HBs positivity in 13.4%, anti-HBs positivity in 3.6%, anti-HCV positivity in 0.7% and anti-HAV IgG positivity in 88.2% .Conclusion: Based on the rate of salt antiHBs 3.6% , the low rate of HBsAg positivity was not associated with efficient vaccination. Low HBsAg positivity suggests that pregnant women who participated in our study were aware of prevention of hepatitis andits transmission paths. It has been contemplated that other hepatitis seroprevalence studies that will be carried out will contribute health policies in terms of public health

Anahtar Kelimeler

• pregnancy, prevalence, hepatitis B, hepatitis C, hepatitis A

Kaynakça

1. Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat, 2004; 11: 97-107.
2. Kumar A. Hepatitis B virus infection and pregnancy: a practical approach. Indian J Gastroenterol, 2012; 31: 43-54. Jonas MM. Hepatitis B and pregnancy: an underestimated issue. Liver Int, 2009; 29: 133-9.
3. Örmeci N. Hepatit C virüsü. In: Tabak F, Tosun S, eds. Viral Hepatit. 1. Baskı. İstanbul: Medikal Yayıncılık, 2013: 317.
4. Akhan SÇ. Gebelik ve Kronik Hepatitler. In: Tabak F, Balık İ, eds. Viral Hepatit. 1. Baskı. İstanbul: İstanbul Medikal Yayıncılık, 2009: 190-1.
5. Elinav E, Ben-Dov IZ, Shapira Y, Daudi N, Adler R, Shouval D, et al. Acute hepatitis A infection in pregnancy is associated with high rates of gestational complications and preterm labor. Gastrenterology, 2006; 130:1129-34.
6. Günal Ö, Barut HŞ, Erkorkmaz Ü, Göral A. Gaziosmanpaşa Üniversitesi Hastanesi’ne başvuran HBsAg pozitif hastalarda risk faktörlerinin analizi. Viral Hepatit Derg, 2008; 13: 111-14.
7. Pan CQ, Duan ZP, Bhamidimarri KR, Zou HB, Liang XF, Li J, et al. An algorithm for risk assessment and intervention of mother to child transmission of hepatitis B virus. Clin Gastroenterol Hepatol, 2012; 10: 452-9.
8. Tran TT. Hepatitis B and pregnancy. Curr Hepat Rep, 2009; 8: 91-5.

9. Petrova M, Kamburov V. Breastfeeding and chronic HBV infection: clinical and social implications. World J Gastroenterol, 2010; 16: 5042-6.
10. Borgia G, Carleo MA, Gaeta GB, Gentile I. Hepatitis B in pregnancy. World J Gastroenterol, 2012; 18: 4677-83.
11. Giles ML, Visvanathan K, Lewin SR, Sasadeusz J. Chronic hepatitis B infection and pregnancy. Obstet Gynecol Surv, 2012; 67: 37-44.
12. Franco E, Bagnato B, Marino MG, Meleleo C, Serino L, Zaratti L. Hepatitis B: Epidemiology and prevention in developing countries. World J Hepatol, 2012; 4: 74-80.
13. Başaran BB, Güler C, Eryılmaz Z, Yentür GK, Pulgat E. TC Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı 2011. Sağlık Araştırmaları Genel Müdürlüğü, Yayın No: 8852011. Ankara, 2012.
14. Nguyen TD, Dang AD, Van Damme P, Nguyen CV, Duong HT, Goossens H, et al. Coverage of the expanded program on immunization in Vietnam: Results from 2 cluster surveys and routine reports. Hum Vaccin Immunother, 2015; 11: 1526-33.
15. Langiano E, Lanni L, Ferrara M, Atrei P, Martellucci G, De Vito E. Preventable infectious diseases using vaccination in developmental age in the province of Frosinone, Italy. J Prev Med Hyg, 2007; 48: 97- 102.
16. Tosun S. Viral hepatitlerin ülkemizde ki değişen epidemiyolojisi. ANKEM, 2013; 27: 128-34.
17. Gül A, Türkdoğan MK, Zeteroğlu Ş. Bir grup gebede hepatit B ve hepatit C prevelansı. Perinatol Derg, 1998; 6: 67-9.
18. Kölgeliler S, Güler D, Demiraslan H. Adıyaman’da gebe kadınlarda HBsAg ve anti-HCV sıklığı. Dicle Tıp Derg, 2009; 36: 191-4.
19. Yegane Tosun S, Erensoy S, Özacar T, Yücebilgin S, Altınay B. Gebelerin ve bebeklerin hepatit virus infeksiyonları yönünden araştırılması ve izlenmesi. Turk Mikrobiyol Cem Derg, 2003; 33: 153-9.
20. Madendağ Y, Çöl Madendağ D, Çelen Ş, Ünlü S, Danşman N. Hastanemize başvuran tüm obstetrik ve jinekolojik hastalarda hepatit B, hepatit C ve HIV seroprevalansı. Türkiye Klinikleri J Gynecol Obst, 2007; 17: 442-6.
21. Köksaldı MV, Evirgen Ö, Aksakal M, İnci M, Önlen Y, Ocak S. Hatay Doğum ve Çocuk Bakımevi Hastanesi’ne başvuran kadınlarda hepatit B ve hepatit C seropozitifliği. Viral Hepatit Derg, 2010; 16: 53-6.
22. Atılgan R, Kavak SB, Çelik A. Gebelerde hepatit B ve hepatit C seropozitiflik oranları. Türkiye Klinikleri J Gynecol Obst, 2009; 19: 34-7.
23. Çiçek AÇ, İnakçı İH, Duygu F. Şanlıurfa ilinde kadın hastalıkları ve doğum hastanesine başvuran kadınlarda hepatit B ve hepatit C seroprevalansı: Üç-yıllık değerlendirme. Viral Hepatit Derg, 2012; 18: 15-8.
24. Araz NC, Dikensoy E. Seoprevalence of hepatitis B among pregnant women in southern Turkey. J Pak Med Assoc, 2011; 61: 176-7.
25. Furuncuoglu Y, Bolukbas FF, Bolukbas C, Torun P, Ozturk R. Changes in prevalence of HBV infection in pregnant womwn in Turkey between 1995 and 2015: A 20-year evaluation. Postgrad Med J, 2016. doi: 10.1136/postgradmedj-2015-133876.
26. Zahran KM, Badary MS, Aqban MN, Abdel Aziz NH. Pattern of hepatitis virus infection among pregnant women and their newborns at the Women’s Health Center of Assiut University, Upper Egypt. Int J Gynaecol Obstet, 2010; 111: 171-4.
27. Taseer IU, Ishaq F, Hussain L, Safdar S, Mirbahar AM, Faiz SA. Frequency of anti-HCV, HBsAg and related risk factors in pregnant women at Nishtar Hospital, Multan. J Ayub Med Coll Abbottabad, 2010; 22: 13-6.
28. Todd CS, Ahmadzai M, Atiqzai F, Miller S, Smith JM, Ghazanfar SA, et. al. Seroprevalence and correlates of HIV, syphilis, and hepatitis B and C virus among intrapartum patients in Kabul, Afghanistan. BMC Infect Dis, 2008; 8: 119.
29. Elsheikh RM, Daak AA, Elsheikh MA, Karsany MS, Adam I. Hepatitis B virus and hepatitis C virus in pregnant Sudanese women. Virol J, 2007; 13: 104.
30. Molla S, Munshea A, Nibret E. Seroprevalence of hepatitis B surface antigen and anti HCV antibody and its associated risk factors among pregnant women attending maternity ward of Felege Hiwot Referral Hospital, northwest Ethiopia: a cross- sectional study. Virol J, 2015; 12: 204.
31. Tsankova GS, Kostadinova T, Todorova TT. Seoprevalence of hepatitis B among pregnant women in Varna Region, Bulgaria. J Med Virol, 2016. doi: 10.1002/jmv.24543.
32. Tosun YS, Özacar T, Zeytinoğlu A, Tavmergen E, Bilgiç A. İnfertilite olgularında hepatit A, hepatit B ve hepatit C seroprevalansı. MN Klinik Bilimler & Doktor, 2003; 9: 215-9.
33. Arshad M, El-Kamary SS, Jhaveri R. Hepatitis C virus infection during pregnancy and the new born period are they opportunities for treatment? J Viral Hepat, 2011; 18: 229-36.
34. Pembrey L, Newell ML, Tovo PA, EPHN Collaborators. The management of HCV infected pregnant women and their children European paediatric HCV network. J Hepatol, 2005; 43: 515- 25.
35. Çakmak B, Karataş A. Kocaeli bölgesinde yaşayan gebe kadınlarda hepatit B ve C seropozitiflik oranları. Selçuk Tıp Derg, 2012; 28: 80-2.
36. Çetinkol Y, Altunçekiç YA. Ünye Hastanesine başvuran hastalarda hepatit A seroprevalansı. Kocatepe Tıp Derg, 2011; 12: 18-22.
37. Arabacı F, Oldacay M. Çanakkale yöresinde çeşitli yaş gruplarında hepatit A seroprevalansı ve akut hepatitli olgularda hepatit A sıklığı. Çocuk Enf Derg, 2009; 3: 58-61.