Gonca KESKİNDEMİRCİ, Esra DEVECİOĞLU KARAPINAR, Tijen EREN, Gonca YILMAZ, Selim BADUR, Gülbin GÖKÇAY

YAŞAMIN İLK ALTI AYINDA ANNE VE BEBEKLERİNDE HEPATİT A SEROLOJİSİ

Amaç: Hepatit A enfeksiyonu epidemiyolojisi yaşam koşullarına göre farklılık gösteren bir sorundur. Bu nedenle hastalığın değişen epidemiyolojisini değerlendirmek koruyucu hekimlik uygulamaları açısından önemlidir. Çalışmanın amacı anne ve bebek çiftlerinde hepatit A antikoru seropozitifliğinin belirlenmesi ve bunu etkileyen faktörlerin değerlendirilmesidir. Gereç ve Yöntem: Çalışmada 209 anne-bebek çiftinin verileri değerlendirilmiştir. Kan örnekleri annelerden doğumdan 1 ay sonra ve bebeklerinden ise 1. ve 6. aylarda alınmıştır. Hepatit A IgG antikor düzeyleri ELİSA yöntemi ile belirlenmiştir. Ailelerin sosyo-ekonomik ve demografik özelliklerine yönelik bilgiler yüz yüze uygulanan bir anket yolu ile toplanmıştır. Bulgular: Annelerde 1. ayda hepatit A seropozitifliği %67, bebeklerde 1. ayda %66,1, 6. ayda %68,9 olarak saptanmıştır. Ebeveynlerin eğitim süresinin, ailenin aylık gelirinin, gravida ve paritenin hepatit A seropozitiflik düzeyine istatistiksel açıdan ileri düzeyde anlamlı etkisi olduğu saptanmıştr. Eğitim düzeyi, aylık gelir arttıkça seropozitiflik oranı düşmekte; gravida ve parite artıkça yükselmektedir. Sonuç: Süt çocuklarında hepatit A seropozitiflik düzeyinin sosyo-ekonomik faktörlerden etkilendiği düşünülmüştür.

Anahtar Kelimeler:

Hepatit A, maternal antikorlar, süt çocukları

HEPATITIS A SEROLOGY IN MOTHERS AND THEIR BABIES IN THE FIRST SIX MONTHS OF LIFE

Objective: Epidemiology of hepatitis A infection differs according to living conditions. Therefore, evaluating the changing epidemiology of the disease is important for preventive medicine. The aim of the study was to determine the seropositivity of hepatitis A antibody in mothers and their babies and to evaluate the factors affecting it. Materials and Methods: The data of 209 mother-infant pairs were evaluated. Blood samples were collected from mothers one month after birth and at 1 and 6 months of age from their babies. Hepatitis A IgG antibody levels were determined by ELISA method. The socio-economic and demographic characteristics of the families were collected by a questionnaire. Results: The seropositivity of the hepatitis A antibody was 67% in mothers at one month after birth, 66.1% and 68.9% in their babies at 1 and 6 months of age respectively. Parental education, family monthly income, gravity and parity were found to have a statistically significant effect on hepatitis A seropositivity. As the level of education and monthly income increased, hepatitis A seropositivity decreased. On the other hand as parity and gravida increased, seropositivity increased as well. Conclusion: Hepatitis A seropositivity in infants is thought to be affected by socio-economic factors.

Keywords:

Hepatitis A, maternal antibodies, infants,

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1. Niewiesk S. Maternal antibodies: clinical significance, mechanism of interference with immune responses, and possible vaccination strategies. Front Immunol 2014;5:1-15.
2. Maertens K, De Schutter S, Braeckman T, Baerts L, Van Damme P, De Meester I, et al. Breastfeeding after maternal immunisation during pregnancy: providing immunological protection to the newborn: a review. Vaccine 2014;32:178692.
3. Koroglu M, Jacobsen KH, Demiray T, Ozbek A, Erkorkmaz U, Altindis M. Socioeconomic indicators are strong predictors of hepatitis A seroprevalence rates in the Middle East and North Africa. J Infect Public Health 2017;10(5):513-7.
4. Jacobsen KH and Koopman JS. The effects of socioeconomic developmenton worldwide hepatitis A virüs seroprevalence patterns. Int J Epidemiol 2005;34:600-9.
5. Demiray T, Köroğlu M, Jacobsen KH, Özbek A, Terzi HA, Altındiş M. Hepatitis A virus epidemiology in Turkey as universal childhood vaccination begins: seroprevalence and endemicity by region. Turk J Pediatr 2016;58:480-91.
6. Ceyhan M, Yıldırım I, Kurt N, Uysal G, Dikici B, Ecevit C, et al. Differences in hepatitis A seroprevalence among geographical regions in Turkey: a need for regional vaccination recommendations. J Viral Hepat 2008;15:69-72.
7. Begde F, Orhon FS, Gerceker D, Ulukol B, Topcu S, Baskan S. Determining the persistence of maternally acquired antibodies to hepatitis A and varicella zoster during the first 2 years of life in Turkey. Eur J Pediatr 2015;174:883-90.
8. Germinaro C, Lopalco PL, Chicanna M, Da villa G. From hepatitis B to hepatitis A prevention: the Puglia (Italy) experience . Vaccine 2000;18:83-5.
9. Gür E.Hepatit A Aşısı. Gökçay G, Beyazova U (Ed). İlk Beş Yaşta Çocuk Sağlığı İzlemi. Nobel Tıp Kitapevi. İstanbul, 1. Baskı, 2017 p: 493-6.
10. Averhoff FM, Khudyakov Y, Nelson NP. Hepatitis A Vaccine In: Plotkin SA, Orenstein WA, Offit PA, Edwards KM (ed). Plotkin’s Vaccines. 2018, Elsevier, Philadelphia.
11. Linder N, Karetnyi Y, Gidony Y, Dagan R, Ohel G, Levin E, et al. Decline of hepatitis A antibodies during the first 7 months of life in full-term and preterm infants. Infection 1999;27(2):128-31.
12. Fix AD, Martin OS, Gallicchio L, Vial PA, Lagos R Age-specific prevalence of antibodies to hepatitis A in Santiago, Chile: risk factors and shift in age of infection among children and young adults. Am J Trop Med Hyg 2002;66:628-32.
13. Pirinçcioğlu AG, Adıgüzel S, Özekinci T. Seropositivity of Hepatitis A in Children Aged 7-14 Years in Diyarbakir Province Center. Med Sci Monit 2018;24:936-43.
14. Kanra G, Tezcan S, Badur S; Turkish National Study Team. Hepatitis A seroprevalence in a random sample of the Turkish population by simultaneous EPI cluster and comparison with surveys in Turkey. Turk J Pediatr 2002;44:204-10.
15. Erdoğan MS, Otkun M, Tatman-Otkun M, Akata F, Türe M. The epidemiology of hepatitis a virus infection in children, in Edirne, Turkey. Eur J Epidemiol 2004;19:267-73.
16. Simister NE. Placental transport of immunoglobulin G. Vaccine 2003;24(24):3365-9.
17. Fouda GG, Martinez DR, Swamy GK, and Permar SR. The Impact of IgG transplacental transfer on early life immunity. Immunohorizons 2018;2:14-25.