{"id":30397,"date":"2025-06-28T17:14:33","date_gmt":"2025-06-28T14:14:33","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=30397"},"modified":"2025-06-29T12:34:58","modified_gmt":"2025-06-29T09:34:58","slug":"gebelikte-yalanci-anti-hiv-pozitifligi","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2025\/06\/28\/gebelikte-yalanci-anti-hiv-pozitifligi\/","title":{"rendered":"Gebelikte HIV Antijen\/Antikor ELISA Testinin Yalanc\u0131 Pozitifli\u011fi ve G\u00fcvenilirli\u011fi"},"content":{"rendered":"

G\u0130R\u0130\u015e<\/h2>\n

\u0130nsan imm\u00fcn yetmezlik virusu (HIV), Lentivirinae<\/i> alt ailesine ait zarfl\u0131 bir retrovirustur; ba\u011f\u0131\u015f\u0131kl\u0131k sistemini bask\u0131layarak f\u0131rsat\u00e7\u0131 infeksiyonlar\u0131n geli\u015fmesine yol a\u00e7ar ve kazan\u0131lm\u0131\u015f imm\u00fcn yetmezlik sendromu (Acquired Immunodeficiency Syndrome, AIDS) tablosuyla karakterize kronik bir hastal\u0131\u011fa neden olur (1). HIV ile infekte annelerden bebeklerine gebelik s\u00fcrecinde, do\u011fum s\u0131ras\u0131nda veya sonras\u0131nda emzirmeyle bula\u015fma olabilmektedir (2). Horizontal veya perinatal ge\u00e7i\u015f olarak da adland\u0131r\u0131lan anneden bebe\u011fe HIV bula\u015fmas\u0131, \u00e7ocuk \u00f6l\u00fcmlerinin \u00f6nemli nedenlerinden biridir ve d\u00fcnya genelinde yakla\u015f\u0131k iki milyon \u00e7ocu\u011fun HIV ile infekte oldu\u011fu tahmin edilmektedir (3). Gebelik s\u0131ras\u0131nda al\u0131nan antiretroviral tedavi (ART), HIV\u2019in horizontal bula\u015fmas\u0131n\u0131 \u00f6nleyebilmektedir; tedavi almayan gebelerden yenido\u011fanlara bula\u015fma oran\u0131 %15 ile %45 aras\u0131nda de\u011fi\u015fmektedir (4).<\/p>\n

T\u00fcrkiye\u2019de HIV prevalans\u0131 h\u00e2len d\u00fc\u015f\u00fck olmakla birlikte (%0.1\u20130.3) son be\u015f y\u0131ld\u0131r olgu say\u0131lar\u0131 h\u0131zla artmakta ve \u00f6zellikle gen\u00e7 n\u00fcfusta infeksiyon oranlar\u0131 y\u00fckselmektedir (5). \u00c7al\u0131\u015fmam\u0131z\u0131n ger\u00e7ekle\u015ftirildi\u011fi Diyarbak\u0131r ilinde, sa\u011fl\u0131kl\u0131 kan ba\u011f\u0131\u015f\u00e7\u0131lar\u0131nda yap\u0131lan seroprevalans \u00e7al\u0131\u015fmalar\u0131nda HIV seroprevalans oran\u0131 \u00fclke ortalamas\u0131ndan d\u00fc\u015f\u00fck seyretmekle birlikte y\u0131llar i\u00e7erisinde art\u0131\u015f g\u00f6stermektedir (6,7). T\u00fcrkiye\u2019de kad\u0131n pop\u00fclasyonunda HIV tan\u0131s\u0131 a\u00e7\u0131s\u0131ndan gebelik taramas\u0131 \u00f6nemli bir f\u0131rsat olarak de\u011ferlendirilmektedir; HIV ile infekte kad\u0131nlar\u0131n %17\u2019sinde gebelik taramas\u0131 ile tan\u0131 konuldu\u011fu bildirilmi\u015ftir (8).<\/p>\n

HIV infeksiyonunun laboratuvar tan\u0131s\u0131, serolojik tarama testleriyle yap\u0131lmaktad\u0131r. Y\u00fcksek duyarl\u0131l\u0131\u011f\u0131 nedeniyle hem HIV\u2019e \u00f6zg\u00fc antikorlar\u0131 hem de p24 antijenini e\u015fzamanl\u0131 saptayan 4. nesil HIV Ag\/Ab Combo kemil\u00fcminesans mikropartik\u00fcl imm\u00fcnoassay testi tarama amac\u0131yla tercih edilmektedir (9). Bununla birlikte HIV Ag\/Ab ELISA testlerinde HIV ile ili\u015fkili olmayan baz\u0131 proteinler HIV\u2019e \u00f6zg\u00fc antikorlar olarak tan\u0131mlanarak yalanc\u0131 pozitif sonu\u00e7lara yol a\u00e7abilmektedir. Baz\u0131 ara\u015ft\u0131rmac\u0131lar alloantikorlar\u0131n gebelik, transf\u00fczyon, transplantasyon ve otoimm\u00fcn hastal\u0131klarla ili\u015fkili olarak artan yalanc\u0131 pozitiflik oranlar\u0131ndan sorumlu olabilece\u011fini ileri s\u00fcrmektedir (10). Yalanc\u0131 pozitiflik, \u00f6zellikle HIV seroprevalans\u0131n\u0131n d\u00fc\u015f\u00fck oldu\u011fu toplumlarda \u00f6nemli bir endi\u015fe kayna\u011f\u0131d\u0131r; gebe kad\u0131nlar bu a\u00e7\u0131dan en y\u00fcksek risk grubunu olu\u015fturmaktad\u0131r (11).<\/p>\n

Bu \u00e7al\u0131\u015fmada, HIV infeksiyonu a\u00e7\u0131s\u0131ndan d\u00fc\u015f\u00fck endemik bir b\u00f6lgede ya\u015fayan gebelerde yalanc\u0131 pozitif HIV test oran\u0131n\u0131 belirlemeyi ve gereksiz antiretroviral profilaksiyi \u00f6nleyebilmek i\u00e7in uygun stratejiler geli\u015ftirmeyi ama\u00e7lad\u0131k.<\/p>\n

Y\u00d6NTEMLER<\/h2>\n

Retrospektif olarak ger\u00e7ekle\u015ftirilen \u00e7al\u0131\u015fmaya, 01 Ocak 2018 \u2013 31 Aral\u0131k 2022 tarihleri aras\u0131nda Sa\u011fl\u0131k Bilimleri \u00dcniversitesi (SB\u00dc) Gazi Ya\u015fargil E\u011fitim ve Ara\u015ft\u0131rma Hastanesi Kad\u0131n Hastal\u0131klar\u0131 ve Do\u011fum Klini\u011fi\u2019ne ba\u015fvuran ve ELISA HIV Ag\/Ab testi yap\u0131lan 18 ya\u015f ve \u00fczeri toplam 115 217 kad\u0131n dahil edildi.<\/p>\n

HIV-1\/2 Ag\/Ab testleri, \u00fcretici firma \u00f6nerilerine uygun olarak ve d\u00f6rd\u00fcnc\u00fc nesil HIV Ag\/Ab Combo kemil\u00fcminesans mikropartik\u00fcl imm\u00fcnoassay y\u00f6ntemi kullan\u0131larak (Architect i2000 SR; Abbott Laboratories, ABD) \u00e7al\u0131\u015f\u0131ld\u0131. En az iki \u00f6rnekte HIV Ag\/Ab S\/Co (signal-to-cutoff) de\u011feri \u22651 olan testler pozitif kabul edildi. Pozitif sonu\u00e7lar, T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 Ulusal AIDS Do\u011frulama Merkezi\u2019nde VIDAS HIV Duo Ultra (bioM\u00e9rieux, Fransa) HIV-1\/2 Ag\/Ab ve HIV-1\/2 antikor ay\u0131rt edici h\u0131zl\u0131 do\u011frulama testi (Geenius HIV-1\/2 Supplemental Assay; Bio-Rad Laboraties, ABD) kitleri kullan\u0131larak do\u011fruland\u0131. Viral y\u00fck \u00f6l\u00e7\u00fcm\u00fc i\u00e7in HIV-1 kantitatif ger\u00e7ek zamanl\u0131 polimeraz zincir reaksiyonu (RT-PCR) GeneXpert Dx otomatize sistemi (Cepheid AB, ABD) kullan\u0131ld\u0131.<\/p>\n

Hastane veri taban\u0131ndaki ayn\u0131 hastaya ait yaln\u0131zca bir HIV Ag\/Ab ELISA testi pozitifli\u011fi \u00e7al\u0131\u015fmaya dahil edilerek m\u00fckerrer hasta giri\u015fi \u00f6nlendi. Antiretroviral tedavi alm\u0131\u015f ve HIV RNA negatif saptanan hastalar \u00e7al\u0131\u015fma d\u0131\u015f\u0131 b\u0131rak\u0131ld\u0131.<\/p>\n

\u00c7al\u0131\u015fma Sa\u011fl\u0131k Bilimleri \u00dcniversitesi Gazi Ya\u015fargil E\u011fitim ve Ara\u015ft\u0131rma Hastanesi Klinik Ara\u015ft\u0131rmalar Etik Kurulu taraf\u0131ndan 30 Eyl\u00fcl 2022 tarih ve 195 karar numaras\u0131yla onayland\u0131.<\/p>\n

\u0130statistiksel Analizler<\/h3>\n

Verilerin analizi, SPSS (Statistical Package for the Social Sciences) versiyon 18.0 program\u0131 (IBM Corp., Armonk, NY, ABD) ile yap\u0131ld\u0131. Verilerin de\u011ferlendirilmesinde y\u00fczde (%), aritmetik ortalama, standart sapma gibi tan\u0131mlay\u0131c\u0131 istatistiksel y\u00f6ntemler kullan\u0131ld\u0131. De\u011fi\u015fkenler aras\u0131ndaki ili\u015fkiler \u03c7\u00b2 testi ve Fisher kesin testi ile de\u011ferlendirildi. \u0130statistiksel anlaml\u0131l\u0131k s\u0131n\u0131r\u0131 p<\/i><\/span><0.05 olarak kabul edildi.<\/p>\n

BULGULAR<\/h2>\n
\"\"<\/a>

Tablo 1.<\/strong> Akut Bruselloz ve KKKA Hastalar\u0131n\u0131n Ba\u015fvuru An\u0131nda Elde Edilen Biyokimyasal Parametrelerinin ROC Analizi<\/p><\/div>\n

HIV Ag\/Ab ELISA testi, gebelerde %0.18 (91\/49.560) ve gebe olmayan kad\u0131nlarda %0.02 (14\/65.657) oran\u0131nda pozitifti; 2 (%0.004) gebede ve 3 (%0.005) gebe olmayan kad\u0131nda ise do\u011frulama testleri ve HIV-RNA pozitif saptand\u0131. Gebe kad\u0131nlarda %0.18 (89\/49.560), gebe olmayan kad\u0131nlarda %0.02 (11\/65.657) oran\u0131nda yalanc\u0131 pozitif HIV testine rastland\u0131 ve aradaki fark, istatistiksel olarak anlaml\u0131 bulundu (p<\/i>=0.016) (Tablo 1). HIV Ag\/Ab ELISA testinin pozitif prediktif de\u011feri (PPD) gebeler i\u00e7in %2.2, gebe olmayanlar i\u00e7in ise %21.4 olarak tespit edildi.<\/p>\n

Do\u011frulama testleri ve HIV-RNA testi negatif olan, HIV Ag\/Ab ELISA reaktif 89 gebe kad\u0131n\u0131n ya\u015f ortalamas\u0131 28.7 \u00b1 6.6 (aral\u0131k 18\u201344) y\u0131l, HIV Ag\/Ab testi S\/Co titre ortalamas\u0131 ise 2.12 \u00b1 1.78 (aral\u0131k 1.00\u20139.44) idi. HIV RNA pozitif saptanan gebenin ya\u015f ortalamas\u0131 28.5 \u00b1 2.1 (aral\u0131k 27\u201330) y\u0131l, HIV Ag\/Ab testi S\/Co titre ortalamas\u0131 ise 624 \u00b1 320 (aral\u0131k 398\u2013852) olarak belirlendi.<\/p>\n

\"\"<\/a>

Tablo 2.<\/strong> \u00c7al\u0131\u015fmaya Al\u0131nan Kad\u0131nlarda HIV Ag\/Ab ELISA S\/Co Titre Ortalamalar\u0131<\/p><\/div>\n

Gebe olmayan, HIV Ag\/Ab ELISA reaktif testi, do\u011frulama testleri ve HIV-RNA testi negatif olan kad\u0131nlar\u0131n ya\u015f ortalamas\u0131 43.5 \u00b1 9.3 (aral\u0131k 29\u201364) y\u0131l olup anti-HIV testi S\/Co titre ortalamas\u0131 1.65 \u00b1 0.79 (aral\u0131k 1.02\u20132.99) idi. HIV RNA pozitif saptanan ve gebe olmayan \u00fc\u00e7 olguda ya\u015f ortalamas\u0131 38 \u00b1 2.0 (aral\u0131k 36\u201340) y\u0131l, HIV Ag\/Ab testi S\/Co titre ortalamas\u0131 387 \u00b1 229 (aral\u0131k 136\u2013586) olarak belirlendi (Tablo 2).<\/p>\n

\u0130RDELEME<\/h2>\n

Bu \u00e7al\u0131\u015fma, \u00fclkemizde gebelik s\u0131ras\u0131nda rutin olarak yap\u0131lan ELISA HIV tarama testlerinde y\u00fcksek oranda yalanc\u0131 pozitiflikle kar\u015f\u0131la\u015f\u0131labilece\u011fini g\u00f6stermektedir. Ayr\u0131ca, gebelerde referans laboratuvarda yap\u0131lan testlerle do\u011frulanan HIV kesin tan\u0131s\u0131 i\u00e7in y\u00fcksek HIV Ag\/Ab testi S\/Co titre ortalamas\u0131n\u0131n gerekli oldu\u011fu g\u00f6r\u00fclmektedir. Bununla birlikte, T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 HIV-AIDS Tan\u0131-Tedavi Rehberi\u2019ne g\u00f6re titre de\u011feri ister y\u00fcksek ister d\u00fc\u015f\u00fck olsun, HIV Ag\/Ab testi pozitif saptanan annelerde do\u011frulama veya viral y\u00fck sonucu \u00e7\u0131kana kadar bebe\u011fe m\u00fcmk\u00fcn olan en k\u0131sa s\u00fcrede mutlaka zidovudin (oral\/paranteral) ba\u015flanmas\u0131 ve emzirmenin kesilmesi \u00f6nerilmektedir (12).<\/p>\n

\u00c7al\u0131\u015fmam\u0131z\u0131n y\u00fcr\u00fct\u00fcld\u00fc\u011f\u00fc merkezde HIV Ag\/Ab testi pozitif \u00e7\u0131kan numunelerin referans laboratuvara g\u00f6nderilmesi nedeniyle ya\u015fanan gecikmeler (ortalama 3\u20135 g\u00fcn) yenido\u011fanlara gereksiz antiretroviral profilaksi ba\u015flanmas\u0131na yol a\u00e7maktad\u0131r. Ayr\u0131ca, gebelerde yalanc\u0131 pozitif HIV testleri damgalanma, annenin bebe\u011finden ayr\u0131lmas\u0131 ve emzirememe gibi istenmeyen sonu\u00e7lara neden olabilmektedir.<\/p>\n

ARCHITECT HIV Ag\/Ab testinde S\/Co de\u011ferinin 1\u201310 aral\u0131\u011f\u0131nda oldu\u011fu durumlarda yanl\u0131\u015f pozitiflik oran\u0131n\u0131n %100; S\/Co de\u011feri \u226530 oldu\u011funda ise yanl\u0131\u015f pozitiflik oran\u0131n\u0131n s\u0131f\u0131r oldu\u011fu ve S\/Co de\u011feri artt\u0131k\u00e7a yanl\u0131\u015f pozitiflik oran\u0131n\u0131n d\u00fc\u015ft\u00fc\u011f\u00fc yap\u0131lan \u00e7al\u0131\u015fmalarda g\u00f6sterilmi\u015ftir (13,14). Ayr\u0131ca, d\u00fc\u015f\u00fck HIV yayg\u0131nl\u0131\u011f\u0131na sahip pop\u00fclasyonlarda, HIV risk fakt\u00f6r\u00fc olmayan bireyler i\u00e7in do\u011fum eylemi gibi akut durumlarda RNA testlerine eri\u015fim m\u00fcmk\u00fcn olmad\u0131\u011f\u0131nda, ARCHITECT HIV Ag\/Ab testi S\/Co de\u011feri <5 olan ve do\u011frulama testi reaktif olmayan kombinasyonun, yalanc\u0131 pozitiflik i\u00e7in yeterli kan\u0131t sa\u011flayabilece\u011fine dair veriler bulunmaktad\u0131r (15).<\/p>\n

Gebelikteki yalanc\u0131 pozitif HIV testlerinin ara\u015ft\u0131r\u0131ld\u0131\u011f\u0131 \u0130stanbul\u2019da yap\u0131lan bir \u00e7al\u0131\u015fmada, gebe kad\u0131nlarda %0.25, gebe olmayan kad\u0131nlarda ise %0.10 oran\u0131nda yalanc\u0131 pozitifli\u011fe rastlanm\u0131\u015f ve aradaki fark istatistiksel olarak anlaml\u0131 bulunmu\u015ftur. \u00c7al\u0131\u015fmam\u0131za benzer \u015fekilde, \u00fclkemizde gebeli\u011fin yalanc\u0131 pozitif HIV testlerine yol a\u00e7an bir risk fakt\u00f6r\u00fc oldu\u011fu sonucuna var\u0131lm\u0131\u015ft\u0131r (16). Kuzey K\u0131br\u0131s T\u00fcrk Cumhuriyeti\u2019nde yak\u0131n zamanda yap\u0131lan retrospektif bir analiz \u00e7al\u0131\u015fmas\u0131nda da gebe kad\u0131nlarda (%0.3) yalanc\u0131 pozitiflik oran\u0131, gebe olmayanlara (%0.02) k\u0131yasla anlaml\u0131 olarak daha y\u00fcksek bulunmu\u015f; pozitif HIV ELISA test sonu\u00e7lar\u0131n\u0131n ART\u2019ye ba\u015flanmadan \u00f6nce molek\u00fcler y\u00f6ntemlerle do\u011frulanmas\u0131 gerekti\u011fi vurgulanm\u0131\u015ft\u0131r (17).<\/p>\n

Yalanc\u0131 HIV tarama testi pozitifliklerinin y\u00fcksek oranda g\u00f6r\u00fclmesi, gereksiz ART kullan\u0131m\u0131na ve istenmeyen yan etkilere neden olmaktad\u0131r. Bu sorunun \u00e7\u00f6z\u00fcm\u00fc i\u00e7in baz\u0131 \u00f6nerilerimiz bulunmaktad\u0131r. \u0130lk olarak, t\u00fcm gebelerde do\u011fum \u00f6ncesi takiplerde HIV Ag\/Ab ELISA testleri d\u00fczenli olarak \u00e7al\u0131\u015f\u0131lmal\u0131 ve sonu\u00e7lar kay\u0131t alt\u0131na al\u0131nmal\u0131d\u0131r. \u0130kinci olarak, y\u00fcksek n\u00fcfus ve do\u011furganl\u0131k oran\u0131na sahip illere yak\u0131n referans laboratuvarlar kurularak, do\u011frulama testlerinin sonu\u00e7 alma s\u00fcreleri k\u0131salt\u0131lmal\u0131d\u0131r. Son olarak, gebelerde ve yenido\u011fanlarda antiretroviral profilaksi karar\u0131n\u0131n verilmesinde HIV Ag\/Ab S\/Co titre de\u011ferinin dikkate al\u0131naca\u011f\u0131 farkl\u0131 bir algoritma olu\u015fturulmas\u0131 faydal\u0131 olabilir.<\/p>\n

Be\u015f y\u0131ll\u0131k d\u00f6nem i\u00e7in toplam hasta ba\u015fvuru say\u0131s\u0131na ait veri setine ula\u015f\u0131lamamas\u0131 nedeniyle HIV Ag\/Ab testi oran\u0131n\u0131n hesaplanamamas\u0131 \u00e7al\u0131\u015fmam\u0131z\u0131n en \u00f6nemli k\u0131s\u0131tl\u0131l\u0131\u011f\u0131d\u0131r. Bir di\u011fer \u00f6nemli k\u0131s\u0131tl\u0131l\u0131k ise verilerin retrospektif olarak hastane bilgi sisteminden al\u0131nmas\u0131 nedeniyle yalanc\u0131 HIV testi sonucunda bebeklerin ne kadar\u0131na profilaksi ba\u015fland\u0131\u011f\u0131 ve emzirmenin geciktirildi\u011fine dair verilere ula\u015f\u0131lamamas\u0131d\u0131r.<\/p>\n

Sonu\u00e7 olarak; gebelik s\u0131ras\u0131nda yalanc\u0131 pozitiflikle kar\u015f\u0131la\u015f\u0131labilece\u011finden, pozitif HIV Ag\/Ab ELISA sonu\u00e7lar\u0131n\u0131n ART\u2019ye ba\u015flanmadan \u00f6nce en k\u0131sa s\u00fcrede do\u011frulanmas\u0131 gerekmektedir. \u00dclkemizde 4. ku\u015fak HIV Ag\/Ab ELISA testleri kullan\u0131lmas\u0131na ra\u011fmen gebe kad\u0131nlarda, gebe \u00adolmayan kad\u0131nlara g\u00f6re daha fazla yalanc\u0131 HIV test pozitifli\u011fi g\u00f6r\u00fclmektedir. Ayr\u0131ca, ger\u00e7ek HIV pozitifli\u011fi saptanan gebelerde y\u00fcksek HIV Ag\/Ab S\/Co de\u011ferleri dikkati \u00e7ekmektedir.<\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e \u0130nsan imm\u00fcn yetmezlik virusu (HIV), Lentivirinae alt ailesine ait zarfl\u0131 bir retrovirustur; ba\u011f\u0131\u015f\u0131kl\u0131k sistemini bask\u0131layarak f\u0131rsat\u00e7\u0131 infeksiyonlar\u0131n geli\u015fmesine yol a\u00e7ar ve kazan\u0131lm\u0131\u015f imm\u00fcn yetmezlik sendromu (Acquired Immunodeficiency Syndrome, AIDS) tablosuyla karakterize kronik bir hastal\u0131\u011fa neden olur (1). HIV ile infekte annelerden bebeklerine gebelik s\u00fcrecinde, do\u011fum s\u0131ras\u0131nda veya sonras\u0131nda emzirmeyle bula\u015fma olabilmektedir (2). Horizontal veya […]<\/p>\n","protected":false},"author":4,"featured_media":30656,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[6108,5281,3875,6107,6109],"class_list":["post-30397","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ozgun-arastirma","tag-anti-hiv","tag-elisa-2","tag-gebelik","tag-hiv-ag-ab","tag-yalanci-pozitif"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/30397","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=30397"}],"version-history":[{"count":4,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/30397\/revisions"}],"predecessor-version":[{"id":30674,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/30397\/revisions\/30674"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media\/30656"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=30397"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=30397"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=30397"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}