Yak\u0131n Do\u011fu \u00dcniversitesi Hastanesi \u0130nfeksiyon Hastal\u0131klar\u0131 ve Klinik Mikrobiyoloji Anabilim Dal\u0131 Uzman\u0131 Do\u00e7. Dr. H. Kaya S\u00fcer, \u00fclkemizde d\u00fc\u015f\u00fck oranda g\u00f6r\u00fclmesine ra\u011fmen anne adaylar\u0131n\u0131n hamilelik d\u00f6neminde mutlaka Hepatit C enfeksiyonu taramas\u0131 yapt\u0131rmas\u0131 gerekti\u011fini belirtti.<\/p>\n
Yak\u0131n Do\u011fu \u00dcniversitesi Hastanesi \u0130nfeksiyon Hastal\u0131klar\u0131 ve Klinik Mikrobiyoloji Anabilim Dal\u0131 Uzman\u0131 Do\u00e7. Dr. H. Kaya S\u00fcer, anne adaylar\u0131na hamilelik d\u00f6neminde dikkat edilmesi gereken konular hakk\u0131nda uyar\u0131larda bulundu. Anneden bebe\u011fe ge\u00e7me \u00f6zelli\u011fine sahip olan Hepatit C vir\u00fcs\u00fcn\u00fcn (HCV) Flaviviridae ailesi olan Hepasivirus cinsinde yer ald\u0131\u011f\u0131n\u0131 s\u00f6yleyen Do\u00e7. Dr. Kaya S\u00fcer, Hepatit C vir\u00fcs\u00fcn\u00fcn anneden \u00e7ocu\u011fa s\u0131kl\u0131kla vajinal do\u011fum esnas\u0131nda bula\u015ft\u0131\u011f\u0131n\u0131 belirtti. Vajinal do\u011fum esnas\u0131nda vir\u00fcs\u00fcn bula\u015fmas\u0131 ile bebekte saptanan vir\u00fcs varl\u0131\u011f\u0131n\u0131n y\u00fczde 20-55 oran\u0131nda kendili\u011finden temizlendi\u011fini s\u00f6yleyen S\u00fcer, \u201cHCV\u2019nin bir ba\u015fka bula\u015fma yolu olan maternal bula\u015fan yani anne karn\u0131nda veya do\u011fum sonras\u0131nda vir\u00fcs ge\u00e7i\u015f s\u0131kl\u0131\u011f\u0131n\u0131n y\u00fczde 2-20 aral\u0131\u011f\u0131nda de\u011fi\u015fti\u011fi bildirilmektedir. Anne aday\u0131n\u0131n kan\u0131nda 100.000 IU\/ml d\u00fczeyinde viral y\u00fck var ise bebe\u011fe bula\u015fma oran\u0131 y\u00fcksektir. Yap\u0131lan ara\u015ft\u0131rmalarda bu d\u00fczeyin alt\u0131nda viral y\u00fck\u00fc olan anne adaylar\u0131n\u0131n da bebe\u011fe hastal\u0131\u011f\u0131n\u0131 ge\u00e7irdi\u011fi baz\u0131 olgularda g\u00f6sterilmi\u015ftir\u201d diye konu\u015ftu.<\/p>\n
\u201cGebelik planlamas\u0131 olan kad\u0131nlar, gebelik \u00f6ncesi HCV taramas\u0131 yapt\u0131rmal\u0131\u201d<\/p>\n
Gebelik s\u0131ras\u0131nda saptanan kronik Hepatit C olgular\u0131nda tedavi a\u00e7\u0131s\u0131ndan rehberler incelenirse se\u00e7ilecek tedavi metodu olmad\u0131\u011f\u0131n\u0131n g\u00f6r\u00fcld\u00fc\u011f\u00fcn\u00fc s\u00f6yleyen S\u00fcer, \u201cBu nedenle t\u00fcm rehberlerin de gebelik planlamas\u0131 olan kad\u0131nlara gebelik \u00f6ncesi HCV taramas\u0131 yapt\u0131rmas\u0131 \u00f6nerilmesi gerekli. Ancak HCV\u2019nin yayg\u0131nl\u0131k oran\u0131n\u0131n d\u00fc\u015f\u00fck oldu\u011fu \u00fclkelerde maliyet etkin bulunmad\u0131\u011f\u0131ndan bu taraman\u0131n yap\u0131lmas\u0131 \u00f6nerilmiyor. Tarama s\u0131ras\u0131nda pozitiflik saptanan adaylara, tedaviye gebelik \u00f6ncesi ba\u015flanmas\u0131 ve tedavi bitimine kadar gebe kal\u0131nmamas\u0131 \u00f6neriliyor. Hamile kad\u0131nlar\u0131n belirli risk fakt\u00f6rlerini g\u00f6z \u00f6n\u00fcnde bulundurmas\u0131 ve mutlaka Hepatit C taramas\u0131 yapt\u0131rmas\u0131 gerekiyor” dedi.<\/p>\n
Risk fakt\u00f6rleri<\/p>\n
Hastal\u0131\u011f\u0131n risk fakt\u00f6rleri hakk\u0131nda da a\u00e7\u0131klamalarda bulunan Do\u00e7. Dr. Kaya S\u00fcer, damar i\u00e7i ve burunla kullan\u0131labilen madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131, uzun s\u00fcreli diyaliz tedavisi, hijyenik olmayan ortamlarda yap\u0131lan d\u00f6vme, piercing, enjeksiyon, HCV pozitif bir don\u00f6rden kan al\u0131nmas\u0131, hapishane \u00f6yk\u00fcs\u00fc, HIV riski, nedeni bilinmeyen kronik karaci\u011fer hastal\u0131\u011f\u0131 gibi durumlar\u0131n Hepatit C hastal\u0131\u011f\u0131n\u0131n risk fakt\u00f6rleri oldu\u011funu belirtti.<\/p>\n
\u201c\u00dclkemizde Hepatit C g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 d\u00fc\u015f\u00fck\u201d<\/p>\n
Risk grubu d\u0131\u015f\u0131nda kalan anne adaylar\u0131 a\u00e7\u0131s\u0131ndan bak\u0131ld\u0131\u011f\u0131nda ise hamile kad\u0131nlar aras\u0131nda HCV g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131n\u0131n artt\u0131\u011f\u0131n\u0131 s\u00f6yleyen Do\u00e7. Dr. Kaya S\u00fcer, bu nedenle risk profili ne olursa olsun t\u00fcm gebelere HCV taramas\u0131 yapt\u0131rmalar\u0131n\u0131n \u00f6nerildi\u011fini belirtti. \u00dclkemizde Hepatit C enfeksiyonu g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131n\u0131n yap\u0131lan ara\u015ft\u0131rmalarda d\u00fc\u015f\u00fck bulundu\u011funu ifade eden Do\u00e7. Dr. S\u00fcer, \u201cRisk grubu d\u0131\u015f\u0131nda kalan gruplara da tarama yap\u0131lmas\u0131 konusunda g\u00f6r\u00fc\u015f farkl\u0131l\u0131klar\u0131 olmakla beraber enfeksiyon hastal\u0131klar\u0131 uzman\u0131 olarak tarama yap\u0131lmas\u0131 gerekti\u011fini \u00f6nermekteyim\u201d dedi.<\/p>\n
Hepatit C tedavisindeki \u00f6nemli geli\u015fmeler<\/p>\n
D\u00fcnyada ve T\u00fcrkiye\u2019de kullan\u0131lmaya ba\u015flanm\u0131\u015f olan direkt etkili antiviraller genel ba\u015fl\u0131\u011f\u0131 alt\u0131nda yer alan ila\u00e7lar ile kronik Hepatit C tedavisinde \u00f6nemli geli\u015fmelerin g\u00f6r\u00fcld\u00fc\u011f\u00fcn\u00fc s\u00f6yleyen Do\u00e7. Dr. Kaya S\u00fcer, s\u00f6zlerine \u015f\u00f6yle devam etti:<\/p>\n
\u201cHindistan\u2019da Hepatit C pozitif gebe kad\u0131nlara hastal\u0131\u011f\u0131n bebek a\u00e7\u0131s\u0131ndan riskleri ve tedavi sonu\u00e7lar\u0131 ile bilgilendirme yap\u0131lm\u0131\u015f ve hastalar\u0131n onay\u0131 al\u0131nd\u0131ktan sonra yap\u0131lan bir pilot \u00e7al\u0131\u015fmada gebeli\u011fin 23-24. haftas\u0131nda ba\u015flanan Ledipasvir+Sofosbuvir kombinasyonu 12 hafta boyunca verilmi\u015ftir. Bu olgularda tedavinin etkinli\u011fi, tedavi s\u0131ras\u0131nda, do\u011fum s\u0131ras\u0131nda ve do\u011fum sonras\u0131nda tekrarlanan HCV viral y\u00fckleri ile de\u011ferlendirilmi\u015ftir. Ara\u015ft\u0131rmac\u0131lar t\u00fcm hastalar\u0131n tedaviye h\u0131zl\u0131 yan\u0131t verdiklerini ve tedaviden 12 hafta sonra kal\u0131c\u0131 viroloik yan\u0131t olu\u015ftu\u011funu bildirmi\u015flerdir. Do\u011fumu ger\u00e7ekle\u015fen bebeklerin takibinde ise hi\u00e7bir bebekte Hepatit C hastal\u0131\u011f\u0131 olmad\u0131\u011f\u0131 g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Ancak gebelerde bu tedavi \u015fekli hen\u00fcz FDA onay\u0131 almam\u0131\u015f olup, \u00f6n\u00fcm\u00fczdeki y\u0131llarda ara\u015ft\u0131rmalar\u0131n artmas\u0131 ile beraber muhtemelen onay alacak ve kronik Hepatit C\u2019li gebelerde tedavi uygulanmaya ba\u015flayacakt\u0131r.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
YAKIN DO\u011eU \u00dcN\u0130VERS\u0130TES\u0130 HASTANES\u0130 \u0130NFEKS\u0130YON HASTALIKLARI VE KL\u0130N\u0130K M\u0130KROB\u0130YOLOJ\u0130 ANAB\u0130L\u0130M DALI UZMANI DO\u00c7. DR. H. KAYA S\u00dcER, \u00dcLKEM\u0130ZDE D\u00dc\u015e\u00dcK ORANDA G\u00d6R\u00dcLMES\u0130NE RA\u011eMEN ANNE ADAYLARININ HAM\u0130LEL\u0130K D\u00d6NEM\u0130NDE MUTLAKA HEPAT\u0130T C ENFEKS\u0130YONU TARAMASI YAPTIRMASI GEREKT\u0130\u011e\u0130N\u0130 BEL\u0130RTT\u0130.<\/p>\n","protected":false},"author":1,"featured_media":250740,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[1],"tags":[2717,4963,2603,4590],"class_list":["post-250739","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-doneminde","tag-hamilelik","tag-hepatit","tag-taramasi"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.tvturk.com\/wp-content\/uploads\/2020\/01\/hamilelik-doneminde-hepatit-c-taramasi_25aaed2.jpg?fit=875%2C1000","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/paKIfm-13eb","_links":{"self":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/250739","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/comments?post=250739"}],"version-history":[{"count":0,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/250739\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media\/250740"}],"wp:attachment":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media?parent=250739"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/categories?post=250739"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/tags?post=250739"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}