Hepatitis C virus infection in pregnancy

Floreani, Annarosa; Paternoster, Delia Maria; Zappalà, F; Cusinato, Riccardo; Bombi, G. Giorgio; Grella, P.; Chiaramonte, M.

doi:10.1111/j.1471-0528.1996.tb09736.x

Cited by 88 publications

(30 citation statements)

References 28 publications

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“…[15][16][17] The rate of spontaneous abortion was approximately the same as in the normal population. There was no increase in typical obstetric complications such as gestational diabetes and hypertension.…”

Section: Issues Relating To Pregnancy and Chronic Hepatitis Cmentioning

confidence: 67%

Maternal-infant transmission of hepatitis C virus infection

2002

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Mother-to-infant transmission of hepatitis C virus (HCV) is comparatively uncommon. The prevalence of antibody to HCV (anti-HCV) in pregnant women is 0.1% to 2.4%, although in some endemic areas it is much higher. The proportion of women with anti-HCV who have active infection with viremia is 60% to 70%. Transmission of HCV occurs only when serum HCV RNA is detectable and may be related to higher levels (above 10 6 copies per mL). M aternal and child health issues relating to hepatitis C virus (HCV) infection have recently assumed greater importance than ever before. From the pediatric perspective, the availability of effective screening methods for HCV has virtually eliminated new cases of transfusion-associated hepatitis C in children. Consequently, childhood acquisition of HCV infection through maternal-infant transmission has become the most important mode of spread. 1 Vertical, or more precisely, mother-to-infant hepatitis C will likely be the major type of childhood chronic hepatitis C within the next 6 to 8 years. It has been difficult to determine the rate of mother-to-infant transmission, partly because reports of mother-to-infant transmission of HCV have been based on small numbers of patients, with differing disease definitions, followed with different study designs and using different virological assays. These reports tended to be heterogeneous and conflicting. Moreover, factors that promote mother-to-infant transmission and the outcome of chronic HCV infection acquired by this route still require clarification. Likewise, for women of child-bearing age who acquired chronic hepatitis C in childhood or in early adulthood, there are important issues relating to pregnancy itself, such as its effect on the disease course of chronic hepatitis C. Prevalence of Hepatitis C Among Pregnant WomenNumerous studies have examined the prevalence of hepatitis C among pregnant women (Table 1). The studies vary considerably in terms of the size of the study, geographic variables, and adequacy of laboratory testing. In general, the prevalence of detectable antibody to HCV (anti-HCV) is approximately 1% overall (range, 0.1% to 2.4%), based on the studies that included at least 3,000 subjects. The mean Abbreviations: HCV, hepatitis C virus; anti-HCV, antibody to HCV; ALT, alanine aminotransferase; HIV, human immunodeficiency virus.

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Section: Issues Relating To Pregnancy and Chronic Hepatitis Cmentioning

confidence: 67%

Maternal-infant transmission of hepatitis C virus infection

2002

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“…33 This observation is in agreement with reports that the maternal/placental unit manufactures interferon, possibly decreasing hepatic inflammation during pregnancy. 34 The risk for vertical transmission and maternal or fetal outcome in patients who previously underwent OLT has not been systematically reported.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy after liver transplantation

et al. 2000

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The first known posttransplantation pregnancy was in 1958 in a renal transplant recipient who had received a kidney from her identical twin sister. The first known posttransplantation pregnancy in a liver transplant recipient was in 1978. Information available from female kidney transplant recipients helped in the decision making involved in the management of this case, as well as those that followed. Over the last 20 years, issues specific to liver transplantation and pregnancy have been identified. Similar to the kidney transplant recipient population, when prepregnancy recipient graft function is stable and adequate, pregnancy appears to be well tolerated. Also similar to kidney transplant recipients, there has been no evidence of a specific malformation pattern among the children, and although prematurity and low birth weight occur, overall newborn outcomes have been favorable. Pregnancy in the setting of recurrent liver disease, such as recurrent hepatitis C, poses a potential problem among liver transplant recipients, as well as the possible adverse effects of immunosuppression on maternal kidney function. Also of significance, peripartum graft deterioration has more severe consequences in this transplant recipient population. Therefore, pregnancy must be considered carefully in this transplant recipient group. Since 1991, the National Transplantation Pregnancy Registry (NTPR) has studied the safety of pregnancy outcomes in solid-organ transplant recipients. The purpose of this review is to catalog studies in the literature, as well as to present current data from the registry with management guidelines. (Liver Transpl 2000;6:671-685.)

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“…The limited data that are available come to varying conclusions. While maternal HCV was not associated with obstetric complications in a number of studies [23,38,39], one reported that women with HCV viremia had an increased risk of premature rupture of membranes [40]. Two studies demonstrated an increased risk of gestational diabetes in pregnant women with HCV [41,42].…”

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confidence: 99%

“…A study in HIV-positive women demonstrated higher rates of low birth weight children (<2500 g) born to those coinfected with HCV [42], and another demonstrated higher rates of neonatal intensive care unit admission and need for assisted ventilation [41]. Apgar scores on the other hand, appear to be similar regardless of maternal HCV status [20,23,38,41]. Owing to their narrow scope and retrospective nature, conclusions that can be drawn from these studies are limited.…”

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“…Pregnancy is an opportunity to identify women with HCV, many of whom may not have otherwise sought, nor had access, to primary care. Since few are aware of their serologic status [23], early diagnosis could be the most important reason in support of universal testing for HCV. Those identified as HCV-positive could benefit from opportunities for evaluation and treatment, alcohol abstinence and access to primary care and monitoring.…”

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confidence: 99%

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