Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Rutin Aşılama Programına Dâhil Olan Çocuklarda Hepatit B Serolojisinin Retrospektif Olarak Değerlendirilmesi
Retrospective Evaluation of Hepatitis B Serology in Children Included in a Routine Vaccination Program
Tuğba KULA ATİKa, Ersin GÜMÜŞb, Alev ÇETİN DURANa
aBalıkesir Atatürk Şehir Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı, Balıkesir, Türkiye
bBalıkesir Atatürk Şehir Hastanesi, Çocuk Gastroenteroloji Bölümü, Balıkesir, Türkiye
Turkiye Klinikleri J Pediatr. 2022;31(2):93-100
doi: 10.5336/pediatr.2021-85990
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışma ile Türkiye'de rutin hepatit B virüsü (HBV) aşılama programının başlamasından itibaren doğan çocuklarda HBV seroepidemiyolojisini değerlendirmek amaçlandı. Gereç ve Yöntemler: Hastanemiz çocuk hastalıkları polikliniklerine Ocak 2017-Aralık 2019 tarihleri arasında başvuran çocukların anti-HBs, HBsAg, anti-HBc immünglobulin G ve HBV-DNA sonuçları retrospektif olarak incelendi. Bulgular: Çalışmamızda, 1.867 çocuğun anti-HBs değerine ulaşıldı ve doğal bağışıklık oranının %0,2, kronik HBsAg taşıyıcılığı oranının ise %0,3 olduğu saptandı. Hastalığı geçirerek bağışıklık kazanan ve kronik HBsAg taşıyıcılığı olanlar dışında kalan toplam 1.857 çocuğun %69,4'ünün anti-HBs değeri reaktif, %30,6'sının ise nonreaktif olduğu belirlendi. Anti-HBs değeri reaktif ve nonreaktif olan gruplar arasında cinsiyet, yaş ve anti-HBs değeri açısından istatistiksel olarak anlamlı fark saptandı (p<0,001). Anti-HBs seviyesi ve anti-HBs reaktivite oranı açısından yaş grupları arasında istatistiksel olarak anlamlı farklılık olup (p<0,001), bu parametrelerin en yüksek saptandığı yaş grubu 0-5 yaş grubu idi. Sonuç: Yüksek aşılama oranlarına ulaşılan rutin HBV aşılama programının uygulandığı dönemde doğan çocukların önemli bir kısmında, zaman içinde anti-HBs seviyelerinde düşüş olmakta ve en düşük seviyelere ergenlik döneminde ulaşılmaktadır. Buna rağmen doğal bağışıklık kazanan ya da kronik taşıyıcı olan hasta sayısı çok azdır. Bu durum, aşılamanın anti-HBs titreleri düşse dahi uzun vadede HBV enfeksiyonuna karşı koruma sağladığını göstermektedir.

Anahtar Kelimeler: Anti-HBs; aşılama; hepatit B; hepatit B aşısı; seroprevalans
ABSTRACT
 Objective: The aim of the present study was to evaluate the seropositivity rate of anti-HBs antibodies in children who have been born since the implementation of the routine hepatitis B virus (HBV) vaccination program in Turkey. Material and Methods: The anti-HBs, HBsAg, anti-HBc immunoglobulin G and HBV-DNA results of the patients who applied to the pediatrics outpatient clinics of our hospital between January 2017 and December 2019 were retrospectively analyzed. Results: In our study, the anti-HBs value of 1,867 children were reached. The rate of innate immunity was found to be 0.2%, and the rate of chronic HBsAg carrier status was 0.3%. Following exclusion of patients who have been chronically infected or have recovered from the disease, it was determined that 69.4% of the 1,857 children were seropositive and 30.6% were seronegative for anti-HBs. A statistically significant difference was found between seropositive and seronegative groups in terms of gender, age, and serum anti-HBs level (p<0.001). There was a statistically significant difference between the age groups regarding anti-HBs level and anti-HBs seropositivity rate (p<0.001) both of which were higher in 0-5 years age group. Conclusion: Significant number of the children who have been born since the implementation of the routine HBV vaccination program with a high vaccination rate, had a decrease in anti-HBs levels over time, with the lowest levels being reached in adolescence. Despite the decrease in anti-HBs seropositivitiy rate, the number of patients who acquire natural immunity or have chronic infection was low. This can be interpreted as that vaccination protects against HBV infection in long-term, even if the anti-HBs titers decrease.

Keywords: Anti-HBs; vaccination; hepatitis B; hepatitis B vaccine; seroprevalence
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