Esra KAYA KILIÇ, Şerife ALTUN DEMİRCAN, Çiğdem ATAMAN HATİPOĞLU, Kader ARSLAN, Cemal BULUT, Salih CESUR, Sami KIRIKLI

Bir eğitim ve araştırma hastanesinde takip edilen Hepatit B ile enfekte gebelerin değerlendirilmesi

Amaç: Kronik hepatit B önemli bir sağlık sorunudur. İmmünoprofilaksiye rağmen, anneden çocuğa hepatit B virüs (HBV) bulaşı yüksek oranda viremi olan annelerin % 1-10' unda görülür. Gebelerin bu nedenle HBsAg pozitifliği yönünden taranması ve takibi önerilir. Bu çalışmada kliniğimizde izlenen hepatit B ile enfekte gebe kadınların yönetimi ve tedavisi değerlendirildi.Gereç ve Yöntemler: Çalışmaya 85 HBV ile enfekte gebe dahil edildi. Gebeler, gebelik süresince ve doğum sonrasında periyodik olarak takip edildi. Üç aylık aralıklarla hastaların HBV-DNA ve karaciğer fonksiyon testleri değerlendirildi.Bulgular: Hastaların yaş ortalaması 29,04±5,6 (17-38) yaş, başvuru sırasındaki gebelik haftası ortalaması 17,39±9,3 (5-38) idi. Hastaların 14’ ü (%16,4) gebelik sırasında yapılan taramalarla HbsAg pozitif olduğunu öğrendi. Gebelerin 25’inde (%29,4) Anti-HAV IgG pozitifti. Onüç hastaya (%15,3) antiviral tedavi başlandı. Onüç (%15,3) hastaya tedavi başlandı, tedavi başlanan hastaların 12’ si (%92,3) tenofovir disoproksil fumarat alırken, bir hasta telbivudin almaktaydı. Hiçbir hastada tedaviye bağlı yan etki gözlenmedi. Bebeklerin doğum sonrası takiplerinde antiviral tedavi ile ilişkili problemler izlenmedi. Takibi yapılabilen 25 (%29,4) bebeğin hiçbirinde HbsAg pozitifliği saptanmadı.Sonuç: Hepatit B bulaşında önemli bir yol olan vertikal bulaşların engellenmesi için, gebelik taramalarının ve gebelerin yakın takibinin yapılması gerekmektedir.

Evaluation of hepatitis b ınfected pregnants followed at a research and training hospital

Aim: Chronic hepatitis B is an important health problem. Despite immunoprophylaxis, hepatitis B virus (HBV) transmission from mother to child is seen in 1-10% of mothers with high rates of viremia. Therefore, screening and follow-up of pregnant women is recommended for HBsAg positivity. Material and Methods: In this study, the management and treatment of hepatitis B infected pregnant women were evaluated in our clinic. 85 HBV infected pregnant women were included in the study. The pregnant women were followed periodically during pregnancy and after delivery. HBV-DNA and liver function tests were evaluated at three-month intervals. Results: The mean age of the patients was 29.04 ± 5.6 years (range, 17-38 years), and the mean gestational age at admission was 17.39 ± 9.3 (5-38). 14 of the patients (16.4%) learned that HbsAg was positive by screening during pregnancy. Anti- HAV IgG was positive in 25 (29.4%) of the pregnant women. Thirteen patients (15.3%) underwent antiviral therapy. Thirteen (15.3%) patients were started on treatment and 12 (92.3%) patients received tenofovir disoproxil fumarate and one patient was receiving telbivudine. No side effect was observed in any patient. There were no problems about infants, associated with antiviral treatment in the postpartum period. There were no HbsAg positivity in 25 (29.4%) infants. Conclusion: In order to prevent vertical transmission, which is an important pathway in the transmission of hepatitis B, it is necessary to follow up pregnancy screenings and pregnant women closely.

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