Esra KOÇOĞLU, Tekin TAŞ, Melahat Emine DÖNMEZ, Tülay ÖZLÜ, Fırat Zafer MENGELOĞLU

Üçüncü basamak bir hastanedeki gebe ve/veya jinekolojik hastalıklı kadınlarda HBsAg, anti-HCV ve anti-HIV sıklığı

Amaç: Hepatit B virüsü (HBV), Hepatit C virüsü (HCV)ve insan immün yetmezlik virüsü (HIV) enfekte vücut sıvılarıyla sağlık çalışanlarına ve enfekte anneden bebeğe bulaşabilen virüslerdir. Çalışmamızda Bolu ilinde birüniversite hastanesine başvuran gebe ve/veya jinekolojik hastalıklı kadınlarda; hepatit B yüzey antijenleri (HBsAg), hepatit C antikorları (anti-HCV) ve HIV antikorlarının (an- ti-HIV) sıklığını belirlemeyi amaçladık.Yöntemler: Ocak 2006-Haziran 2012 tarihleri arasında Kadın Hastalıkları ve Doğum polikliniklerine başvuran gebe ve/veya jinekolojik hastalıklı kadınlara ait HBsAg, anti-HCV ve anti-HIV sonuçları retrospektif olarak tarandı. Tüm belirteçler hastanemiz mikrobiyoloji laboratuvarında makro ELISA yöntemi kullanılarak (Axsyme ve Architect i2000SR sistemleri, Abbott Diagnostics, Chicago, IL, ABD) çalışıldı. Bulgular: HBsAg, anti-HCV ve anti-HIV pozitifliği gebe kadınlarda %1.8, %0.5 ve %0, jinekolojik hastalıklı kadınlarda ise bu oranlar %1.9, %1.1 ve %0 olarak saptandı. Sonuç: Hastanemizde tespit edilen sıklıklar gelişmiş ülkeler seviyesindedir. Özellikle HCV için sekonder korunma amacıyla uygulanabilecek etkin bir yöntem olmadığından, hastalarda müdahale öncesi HBsAg, anti-HCV ve anti-HIV pozitifliğinin bilinmesi hekim ve diğer sağlık çalışanları tarafından hastalık bulaşını önleyici tedbirlerin alınmasına imkân sağlayacaktır.

Frequency of HBsAg, anti-HCV, and anti-HIV in pregnant women and/or patients with gynecologic diseases in a tertiary hospital

Objective: Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are viruses that can be transmitted to the health care workers by infected body fluids and from mother to the baby before, during or after delivery. In the present study, we aimed to investigate the frequency of hepatitis B surface antigens (HBsAg), hepatitis C antibodies (anti-HCV), and HIV antibodies (anti-HIV) in pregnant women and/or patients with gynecologic diseases that admit to a university hospital in Bolu. Methods: HBsAg, anti-HCV, and anti-HIV results of the pregnant women and/or patients with gynecologic diseas- es that admitted to the obstetrics and gynecology clinics between January 2006 and June 2012 were retrospectively investigated. All markers were tested in the microbiology laboratory of our hospital by using macro ELISA method (Axsyme and Architect i2000SR systems, Abbott Diagnostics, Chicago, IL, USA). Results: The frequency of HBsAg, anti-HCV, and anti- HIV positivity were 1.8%, 0.5%, and 0% in pregnant women and 1.9%, 1.1%, and 0% in patients with gynecologic diseases, respectively. Conclusion: The frequencies detected in our hospital are at low levels as seen in developed countries. Since there is no effective method of prevention especially from HCV, awareness of this serologic result before high risk procedures will enable the doctors and the health care workers to take extensive measures to prevent the transmission of the disease.

PDF

___

1. Maynard JE. Hepatitis B: global importance and need for control. Vaccine 1990;8(Suppl 18-20):21-23.
2. Alter MJ, Hadler SC, Margolis HS, et al. The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies. JAMA 1990;263:1218-1222.
3. Ökten A. [The etiology of chronic hepatitis, cirrhosis and hepatocellular carcinoma in Turkey]. Güncel Gastroenterol 2003;7:187-191.
4. Shepard CW, Finelli L, Alter MJ. Global epidemiology of hepatitis C virus infection. Lancet Infect Dis 2005;5:558-5675.
5. Turhan NÖ, Kaygusuz İÇ, Pekel A. [Assisted Reproduction Techniques in HIV Positive Couples: Review]. Turkiye Klinikleri J Gynecol Obst 2007;17:117-125.
6. Arshad M, El-Kamary SS, Jhaveri R. Hepatitis C virus infection during pregnancy and the newborn period- are they opportunities for treatment? J Viral Hepat 2011;18:229-236.
7. U.S. Preventive Services Task Force. Screening for hepatitis B virus infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med 2009;150:869.
8. Lin K, Vickery J. Screening for hepatitis B virus infection in pregnant women: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med 2009;150:874.
9. Workowski KA, Berman S. Centers for Disease Control and Prevention (CDC).Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010;59:1-110.
10. Tekin A, Deveci Ö. [Seroprevalences of HBV, HCV and HIV among healthcare workers in a state hospital.]. Clin Exp Invest 2010;1:99-103.
11. Kuru Ü, Turan Ö, Ceylan Y, et al. [Incidence of HBsAg positivity in pregnancy]. Klimik Derg 1992;5:83-86.
12. Kadanalı A, Çelebi S, Aydos SK, Kadanalı S, Ayyıldız A. [Perinatal Transmission of Hepatit B virus in Erzurum]. AÜTD 1997;29:450-452.
13. Gül A, Türkdoğan MK, Zeteroğlu Ş. [The prevalance of Hepatit B and Hepatit C in a group of pregnant women]. Perinatoloji Dergisi 1998;6:67-69.
14. Biri A, Kılıç G, Bozdayı G, Tezcan S. Prevalence of Hepatitis B, Hepatitis C and Human Immunodeficiency Viruses during pregnancy. T Klin J Med Res 2001;19:100-103.
15. Sağsöz N, Apan T. [The rates of tetanus, Hepatitis B and Rubella seropositivity in pregnants]. T Klin J Gy- necol Obst 2002;2:52-55.
16. Karaca Ç, Karaca N, Usta T, et al. [The frequencies of Hepatitis B, C, D virus infection in the pregnant population and the rate of perinatal transmission of Hepatitis C virus]. Akademik Gastroenteroloji Dergisi 2003;2:122-124.
17. Yılmazer M, Altındiş M, Cevrioğlu S, et al. [Toxo- plasma, Cytomegalovirus, Rubella, Hepatitis B and Hepatitis C Seropositivity Rates in Pregnant Women Who Live in Afyon Region]. Kocatepe Tıp Dergisi 2004;5:49-53.
18. Tekay F, Özbek E. [Hepatitis B, Hepatitis C and Hu- man Immunodeficiency Virus seropositivities in wom- en admitted to Şanlıurfa Gynecology And Obstetrics Hospital]. Mikrobiyol Bült 2006;40:369-373.
19. Madendağ Y, Madendağ İÇ, Çelen S, et al. [Sero- prevalence of Hepatitis B, Hepatitis C and HIV at whole obstetric and gynecologic patients who applied our hospital]. Turkiye Klinikleri J Gynecol Obst 2007;17:442-446.
20. Atılgan R, Kavak SB, Çelik A. [The ratio of Hepatitis B and Hepatitis C seropositivity in pregnants]. Turkiye Klinikleri J Gynecol Obst 2009;19:34-37.
21. Uyar Y, Cabar C, Balci A. Seroprevalence of Hepatitis B Virus among pregnant women in northern Turkey. Hepatitis Monthly 2009;9:146-149.
22. Dundar Ö, Çelik S, Tütüncü L, et al. [The prevalence of Hepatitis B, Hepatitis C, HIV, toxoplasmosis and ru- bella among pregnant women delivered in our clinic between 2000 and 2005]. Zeynep Kamil Tıp Bülteni 2009;40:1-9.
23. Kölgelier S, Güler D, Demiraslan H. [The prevalence of HBsAg and Anti-HCV in pregnant women in Adıyaman]. Dicle Tıp Derg 2009;36:191-194.
24. Api O, Bektaş M, Akıl A, Api M, Batırel A, Bayer F, et al. [Hepatitis B Virus seroprevalance in the pregnant population admitting to an Education and Research Hospital in Istanbul]. TJOD Derg 2009;6:103-110.
25. Karlıdağ GE. [HBsAg Seroprevalance in pregnant women admitted to a Hospital in Centrum of Elazig]. FÜ Sağ Bil Tıp Derg 2011;25:111-113.
26. Coşkun Eİ, Dinçgez B, Koyucu RG, et al. The incidence of HBSAg, Anti-HBS and Anti-HCV in pregnant women. Perinatal Journal 2011;19:71-75.
27. Araz NC, Dikensoy E. Seroprevalence of hepatitis B among pregnant women in Southern Turkey. J Pak Med Assoc 2011;61:176-177.
28. Çiçek AÇ, Duygu F, İnakçı İH. [Hepatitis B and Hepatitis C Seropositivities in Women Admitted To Gynecology and Obstetrics Hospital in Şanlıurfa City: A 3-Year Evaluation]. Viral Hepatit Dergisi 2012;18:15-18.
29. Asan A, Akbulut A, Saçar S, Turgut H. [Evaluation of seroprevalence of HBsAg and Anti-HCV in the patients admitted to the Tunceli State Hospital]. Viral Hepatit Dergisi 2011;17:52-56.
30. Tosun SY. [Hepatitis B vaccination in our country]. Sted 2002;11:140-142.
31. Barut Ş, Barut S, Eğri M. Healthcare related risk fac- tors account for the majority of HCV transmissions in Middle Black Sea Region of Turkey: A Case-Control Study. Turkiye Klinikleri J Med Sci 2011;31:142-147.
32. Jamieson DJ, Read JS, Kourtis AP, Durant TM, Lampe MA, Dominguez KL. Cesarean delivery for HIV-infected women: recommendations and controversies. Am J Obstet Gynecol 2007;197(3 Suppl):96-100.
33. American Academy of Pediatrics Committee on Pediatric AIDS. HIV testing and prophylaxis to prevent mother-to-child transmission in the United States. Pediatrics 2008;122:1127-1134.