Age specific prevalence of hepatitis B and hepatitis C among pregnant women in the northwestern region of Turkey

Abstract

Sir: Hepatitis B (HBV) and C virus (HCV) infections are major public health problems around the globe and an estimated 170 to 400 million people are infected [1, 2]. Preventive measures like screening of all blood and blood components routinely for hepatitis B surface antigen (HBsAg) and antibody to HCV (anti-HCV) and use of disposable syringes resulted in a decrease in the incidence of parenteral transmission [3]; however, vertical transmission of these infections is still an important issue [4]. HBV seroprevalence among pregnant women worldwide is approximately 5 % (range 0.6 % to >20 %) [5]. On the contrary, the seroprevalence of HCVamong pregnant women worldwide is between 1 % and 8 % [6]. Despite the decreasing prevalence of HBsAg positivity in Turkey [4], it is still among the countries with moderate endemicity for HBV infection [3]. We aimed to investigate the seroprevalence of HBV and HCV infections among pregnant women in the northwestern region of Turkey and retrospectively analyzed the data of serological screening during prenatal care between January 2007 and December 2012. Serology was performed by microparticle enzyme immunoassay. SPSS 17® software was used to analyze the data. Continuous variables were described as mean (SD) and categorical data were expressed in n (percent). Statistically significant differences were defined as p <0.05. A total of 22,432 pregnant women were screened for HBsAg, antibody to hepatitis B surface antigen (anti-HBs) and anti-HCV. Population characteristics are presented in Table 1. The mean age of the study population was 27.5± 8.2 years. Ageand year-specific prevalences of HBsAg, antiHBs and anti-HCVare summarized in Table 2. The prevalence of HBsAg among all pregnant women included in the study was 2 %, and it ranged between 2.1 % in 2007 and 1.7 % in 2012. The highest prevalence was seen in the 41–45-year age group (3.8 %) and the lowest in the 16–24-year age group (1.2 %). The age-specific anti-HBs prevalence ranged from 48.6 % among pregnant women of 16–24 years old to 29.5 % among those that were 41–45 years old. The general prevalence of anti-HCV among pregnant women in our study was 0.09 %. The highest anti-HCV prevalence was seen in the 41– 45-year age group (0.54 %) and the lowest in the 16–24-year age group (0.05 %), similar to the prevalence of HBsAg. HBV carrier status among pregnant patients was lower in the more recent years falling to the range of low endemicity areas (<2 %). Anti-HCV prevalence within the 5-year time period was 0.09 % which was also similar to some of the previous reports from our country about incidence of HCV in pregnant women (0.1 %) [4]. There is a high probability of developing chronic infection if the HBV is acquired by the vertical route [7], and it is important to prevent vertical transmission. Mother-to-child transmission can be prevented by administering immunoprophylaxis to the baby after delivery. In Turkey, hepatitis B vaccine is administered to all infants at birth and at 1 and 6 months of age and infants born to HBsAgpositive mothers are given appropriate immunization and prophylaxis. While inadequate screening of blood and blood products and parenteral exposure continue to be major causes S. Simavli (*) Department of Obstetrics and Gynecology, Pamukkale University School of Medicine, Denizli, Turkey e-mail: serapsimavli@yahoo.com