Perinatal Hepatitis B Virüs Bulaşı

Hepatit B virüs (HBV) taşıyıcılığı prevelansının yüksek olduğu ülkelerde bulaşın en önemli şekli perinatal anneden çocuğa bulaştır. Perinatal bulaş intrauterin bulaş, doğum sırasında bulaş ve postpartum bulaş olmak üzere üç şekilde gerçekleşebilir ve yüksek oranda enfeksiyonun kronikleşmesi ile sonuçlanmaktadır. Bu nedenlerden HBV enfeksiyonunun perinatal bulaşının önlenmesi önemlidir. Doğumda uygulanan hepatit B immunglobulini (HBIG) ve ilk doz HBV aşılaması sonucunda özellikle doğum sırasında bulaş ve postpartum bulaş engellenebilirken intrauterin bulaşa etki yoktur. Doğum sonrası doğru bir şekilde uygulanan HBIG ve aşıya rağmen devam eden perinatal bulaş rezidüel riski nedeniyle, diğer stratejiler (antiviral profilaksi, anneye HBIG uygulanması, doğum şekli vb.) ile ilgili birçok çalışma yapılmaktadır.

Anahtar Kelimeler:

Gebelik, Hepatit B virüsü, perinatal bulaş, antiviral profilaksi

Perinatal Transmission of Hepatitis B Virus

Perinatal transmission of hepatitis B virus (HBV) is the predominant mode of transmission in countries with a high prevalence of hepatitis B surface antigen carriage. Perinatal transmission can occur via three modalities: intrauterine transmission; transmission during delivery; and postpartum transmission and perinatal transmission results in a high frequency of chronic infection. Therefore, it is important to prevent perinatal transmission. At-birth prophylaxis with hepatitis B immunoglobulin (HBIG) and the first dose of the HBV vaccine can prevent transmission during delivery or in the postpartum period, but it has no effect on the intrauterine route of transmission. Due to the residual risk of perinatal transmission despite correct use of birth prophylaxis with HBIG and vaccine, other strategies (namely, antiviral drugs, HBIG to the mother, and mode of delivery) have been tested in several studies.

Keywords:

Pregnancy, hepatitis B virus, perinatal transmission, antiviral prophylaxis,

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Correspondence Address / Yazışma Adresi Murat Afyon
GATA Haydarpaşa Eğitim Hastanesi İstanbul, Turkey
e-mail: muratafyon2002@yahoo.com
Geliş tarihi/ Received: 04.12.2015
Kabul tarihi/Accepted: 08.01.2016