Hepatit B Yüzey Antijeni Pozitif Annelerin Bebeklerinde Bağışıklama Sonrası Hepatit B Serolojisinin Değerlendirilmesi

Yıl 2021, Cilt: 21 Sayı: 2, 99 - 104, 20.09.2021

Emine Tekin , Müferet Ergüven Öznur Yılmaz Gondal

Öz

Amaç: Hepatit B yüzey antijeni (HBsAg) pozitif annelerden doğan bebek- lerin bağışıklama sonrası hepatit B serolojilerini değerlendirmek, antiHBs titresinin anne yaşı, doğum şekli, bebeğin kilosu, gestasyon haftası, anne sütü alımı ve sigara maruziyeti ile ilişkisini araştırmaktır. Gereç ve Yöntem: Sağlık Bakanlığı Göztepe Eğitim Araştırma Hastanesi Kadın Doğum Kliniği’ne başvuran HBsAg antijeni pozitif olan annelerden doğan bebekler çalışmaya kabul edildi. Tüm bebeklere ilk 24 saat içinde, rekombinan hepatit B İmmünoglobulin (HBIG) ve rekombinan hepatit B aşısı kas içi yapıldı. Bebekler 0, 1, 6 ay şemasına göre aşılandı, 9-12 aylık olduklarında serum HBsAg ve anti-HBs düzeylerine bakıldı. Anne yaşı, doğum şekli ve kilosu, gestasyon haftası, anne sütü alımı ve sigara maru- ziyeti sorgulanarak hazırlanmış forma kaydedildi. Bulgular: Çalışmaya 50 bebek alındı. Olguların 26’sı (%52) kız, 24’ü (%48) erkek idi. Üç doz aşılamadan sonra bir bebekte HBsAg pozitif bulundu. Bu bebeğin annesinin Hepatit B e antijeni (HBeAg) de pozitifti. Altı bebek haricinde koruyucu düzeyde anti-HBs pozitifliği (%88) saptandı. Gestasyon yaşı <37 hafta olan (preterm) bebeklerde anti-HBs titresi anlamlı olarak düşük bulundu. (p=0,014) .Erkek bebeklerde, normal vajinal yolla doğan- larda, doğum kilosu >2500 gram olanlarda, 6 aydan az anne sütü alanlar- da, sigara maruziyeti olmayanlarda anti-HBs düzeyleri ortalamaları daha yüksekti, ancak bu fark istatistiksel olarak anlamlı değildi. Anne yaşı ile ilişki saptanamadı. Sonuç: Tüm gebelerde Hepatit B serolojisi taranmalı, HBsAg pozitif olan- lara gerekli danışmanlık verilmeli, bebekler etkin bir şekilde bağışıklan- malı, aşı yanıtları yetersiz olduğu için prematürelere 4 doz aşılama yapıl- malı ve aşı yanıtı kontrol edilmelidir. Hepatit B’den korunmada en önemli yöntem aşılamadır.

Anahtar Kelimeler

Anti-HBs, aşı, hepatit B, immün bağışıklama, perinatal geçiş

Teşekkür

Hastalarımıza çalışmaya verdikleri destekten dolayı teşekkür ediyoruz.

Determining Hepatitis B Serology After Immune Prophylaxis in Babies of Hepatitis B Surface Antigen Positive Mothers

Öz

Objective: This study aims to evaluate the post-immunization hepatitis B serology of babies born to hepatitis B surface antigen (HBsAg) positive mothers, and to investigate the relationship of antiHBs titer with maternal age, delivery type and baby’s weight, week of gestation, breast milk intake and cigarette exposure. Material and Method: Babies born from HBsAg positive mothers admitted to the Ministry of Health Göztepe Training and Research Hospital Gynecology Clinic were included. Recombinant hepatitis B Immunoglobulin (HBIG) and vaccine were administered intramuscularly to all babies within the first 24 hours. Babies were vaccinated according to the 0, 1, 6 month scheme, and their serum HBsAg and anti-HBs levels were measured when they were 9-12 months old. Maternal age, delivery type, birth weight, gestational week, breast milk intake and smoking exposure were questioned and recorded. Results: Fifty babies were included, 26 (52%) of them were girls and 24 (48%) were boys. HBsAg was found positive in one baby whose mother was also positive for Hepatitis B e antigen (HBeAg). Except for six babies, protective anti-HBs positivity (88%) was detected. Anti-HBs titers were found to be significantly lower in babies with a gestational age of <37 weeks (preterm) (p=0.014). The mean anti-HBs levels were higher in male babies, born by normal vaginal delivery, birth weight> 2500 grams, breastfed less than 6 months, and not exposed to smoking, but this difference was not statistically significant. No relationship was found with maternal age. Conclusion: Hepatitis B serology should be screened in all pregnant women, necessary counseling should be given to those who are positive for HBsAg, babies should be immunized effectively, 4 doses of vaccination should be given to premature babies and the vaccine response should be checked. Vaccination is the most important method of protection against hepatitis B.

Anahtar Kelimeler

Anti-HBs, Hepatitis B, immunoprophylaxis, perinatal transmission, vaccine

Kaynakça

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