Outcomes of Passive-Active Immunoprophylaxis Administered to Infants of Mothers Infected with Hepatitis B Virus in Erzurum, Turkey/Erzurum'da HepatitB'li Annelerin Bebeklerine Verilen Pasif-Aktif Immunoprofilaksinin Sonuclari, Turkiye

• Published in: Güncel pediatri Vol. 17; no. 1; p. 110
• Main Authors: Alay, Handan, Sahiner, Melek, Kadioglu, Berrin Goktug, Alay, Ragip Afsin
• Format: Journal Article
• Language: Turkish
• Published: Galenos Yayinevi Tic. Ltd 01-04-2019
• Subjects: Care and treatment; Hepatitis B; Immunization; Infants (Newborn); Patient outcomes; Pediatric research; Perinatal infection; Prevention; Risk factors; Turkey
• ISSN: 1304-9054
• DOI: 10.4274/jcp.2019.0009

OBJECTIVES: Infants born to mothers with hepatitis B virus (HBV) may be infected despite receiving passive-active immunoprophylaxis. The purpose of this study was to assess the role of maternal viremia in the transmission of HBV and the passive-active immunoprophylaxis outcomes of infants born to women infected by HBV. METHODS: HBV-infected mothers and infants up to 12 months of age receiving passive-active immunoprophylaxis at the Erzurum Nenehatun Obstetrics and Gynecology Hospital, Turkey, between 2014 and 2016 were included in the study. Socio-demographic data for the patients, and hepatitis markers, viral loads and hepatitis markers of children were evaluated. RESULTS: A total of 26,925 pregnant women were screened for HBsAg between 2014 and 2016. Three hundred twenty-eight HBsAg-positive pregnant women, of whom 271 delivered at our hospital, and 53 mother-infant pairs were included in the study. Of the 53 HBsAg-positive mothers, HBeAg status was positive in 2 (3.72%) and antiHBe status was positive in 51 (96.23%). Viral load was [greater than or equal to] 2000IU/ml in 5 mothers (9.43%). The viral loads of 28 mothers (52.83%) were unavailable. Statistically significant associations were determined between maternal HBeAg status, maternal viral load and antibody response (p<0.05). No statistically significant associations were observed between birth weight, gestational age, timing of HBIG and antibody response (p>0.05). CONCLUSIONS: Passive-active immunoprophylaxis in babies of HBV-infected mothers was highly efficacious in preventing perinatal transmission. Antepartum HBsAg markers must be examined in all pregnancies, and passive-active immunoprophylaxis should be given in the first 6-12 h of life to infants of mothers who are HBsAg-positive during pregnancy. Immunization results should be evaluated subsequently. Healthy generations can be produced by treating HBsAg-positivity with high maternal viremia by means of passive-active immunoprophylaxis, thus reducing the economic impact of diseases and care, and improving quality of life. Giving information to parents during discharge training will increase community awareness and contribute to the eradication of hepatitis B. Key words: HBsAg-positive mothers, children, passive-active immunoprophylaxis GIRIS ve AMAC: Hepatit B virusu (HBV) ile infekte annelerden dogan bebekler pasif-aktif immunoprofilaksiye ragmen infekte olabilirler. Bu calismada HBV'nin bulasmasinda maternal vireminin rolunu ve HBV ile infekte annelerden dogan bebeklerin pasif-aktif immunoprofilaksi sonuclarini degerlendirmeyi amacladik. YONTEM ve GERECLER: Bu calismaya bir Kadin Hastaliklari ve Dogum hastanesinde 2014 ve 2016 yillari arasinda HBV ile infekte anneler ve pasif-aktif immunoprofilaksi uygulanan bebekleri dahil edildi. Hastalarin sosyodemografik verileri, hepatit belirtecleri, viral yukleri ve cocuklarin hepatit belirtecleri degerlendirildi. BULGULAR: 2014-2016 yillari arasinda 26925 gebe kadin HBsAg icin tarandi. 328 HBsAg pozitif gebe kadinin 271'i hastanemizde dogum yapti. Sadece 53 anne ve bebegine ulasabildik. HBsAg pozitif 53 anneden 2(% 3,72)'si HBeAg pozitif, 51(% 96,23) anne ise AntiHBe pozitifti. Bes annede(% 9,43) viral yuk [greater than or equal to] 2000 IU / ml idi. 28(% 52,83) annenin viral yuklerine ulasilamadi. Maternal HBeAg durumu ve viral yuk ile infant antikor yaniti arasinda istatistiksel olarak anlamli iliski vardi (p <0,05). Dogum agirligi, gestasyonel yas ve HBIG yapilma zamani ile infant antikor yaniti arasinda istatistiksel olarak anlamli bir iliski yoktu (p> 0,05). TARTISMA ve SONUC: HBV ile infekte annelerin bebeklerinde pasif-aktif immunoprofilaksi, perinatal bulasmanin onlenmesinde oldukca etkilidir. HBsAg taramasi tum gebelere hamilelikleri sirasinda yapilmalidir. Hamileliklerinde HBsAg pozitif olarak saptanan annelerin bebeklerine dogumdan 6-12 saat icinde pasif-aktif immunoprofilaksi verilmelidir. Sonrasinda mutlaka immunizasyon sonuclari degerlendirilmelidir. Ebeveynlere taburculuk sirasinda bilgi verilmesi, toplumun farkindaligini artiracak ve hepatit B'nin ortadan kaldirilmasina katkida bulunacaktir. Anahtar Kelimeler: HBsAg pozitif anneler, cocuklar, pasif-aktif immunoprofilaksi