.: ORİJİNAL ARAŞTIRMA
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
Turkiye Klinikleri J Pediatr. 2022;31(2):93-100
doi: 10.5336/pediatr.2021-85990
Makale Dili: TR
Tam Metin
Ücretsiz Erişim
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
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
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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