Erzurum'da hepatit B’li annelerin bebeklerine verilen pasif-aktif immunoprofilaksinin sonuçları, Türkiye
Loading...
Date
2019
Authors
Alay, Handan
Şahiner, Melek
Kadıoğlu, Berrin Göktuğ
Alay, Ragıp Afşin
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
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.
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.
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.
Description
Keywords
HBsAg pozitif anneler, Çocuklar, Pasif-aktif immünoprofilaksi, HBsAg-positive mothers, Children, Passive-active immunoprophylaxis
Citation
Alay, H. vd. (2019). "Erzurum'da hepatit B’li annelerin bebeklerine verilen pasif-aktif immunoprofilaksinin sonuçları, Türkiye". Güncel Pediatri, 17(1), 110-120.