Features of chronic hepatitis C course in pregnant women

Abstract

Aim. To study features of the course of chronic hepatitis C virus infection in pregnant women and its effect on pregnancy.

Methods. The study included 111 pregnant women: 67 with chronic hepatitis C and 44 healthy women. The mean age was 28 years. The number of pregnancies among examined women ranged from 1 to 8. All pregnant women had no concomitant therapeutic pathology and various addictions (alcohol, nicotine, drugs). The viral load in pregnant women with chronic hepatitis C ranged from 3.18×102 to 2.4×107 IU/mL.

Results. Alanine aminotransferase and bilirubin levels in the group of chronic hepatitis C and in healthy pregnant women did not exceed the normal range and were not statistically different from each other. In repeated pregnancies viral load of hepatitis C virus was lower, compared with the first pregnancy: median [25%; 75%] = 5.202 [4.079; 6.364] and 6.658 [5.708; 7.380], respectively (p106 IU/mL). At the same time threatened miscarriage, intrauterine hypoxia and preeclampsia were registered more often.

Conclusion. In the first pregnancy the viral load is higher than in repeated pregnancies; pregnancy in women with chronic hepatitis C without concomitant diseases does not cause activation of the inflammatory process in the liver; in pregnant women with chronic hepatitis C, especially at higher viral loads, medical history remarkable for obstetric diseases are more likely detected.

Keywords

chronic hepatitis C / pregnancy / viral load / aggravated obstetric and gynecological history

References

[1] Государственный доклад «О санитарно-эпидемиологической обстановке в Российской Федерации в 2014 году». Федеральный центр гигиены и эпидемиологии Роспотребнадзора. М. 2015; 456 с.

[2] Государственный доклад «О состоянии санитарно-эпидемиологического благополучия населения в Российской Федерации в 2014 году». Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека. М. 2015; 206 с.

[3] Гурская Т.Ю., Гогова Л.М. Клинические особенности течения хронического гепатита С у беременных. Рос. ж. гастроэнтерол., гепатол., колопроктол. 2006; 16 (6): 30-34.

[4] Ершова О.Н., Шахгильдян И.В., Кузин С.Н. Естественные пути передачи вируса гепатита С - современные взгляды на проблему. Детские инфекции. 2006; (1): 16-18.

[5] Игнатова Т.М. Хронический гепатит и беременность. Клин. гепатол. 2008; (1): 3-9.

[6] Приказ Министерства здравоохранения РФ от 1 ноября 2012 г. №572н «Об утверждении Порядка оказания медицинской помощи по профилю ”акушерство и гинекология (за исключением использования вспомогательных репродуктивных технологий)”» (с изменениями и дополнениями). М., 2016.

[7] Airoldi J., Berghella V.P. Hepatitis C and pregnancy. Obstet. Gynec. Surv. 2006; 61 (10): 666-672. http://dx.doi.org/10.1097/01.ogx.0000238671.13495.33

[8] Anwar T., Salekeen M.S., Khan F. Nausheen S. Comparison of outcomes among pregnant women with hepatitis C versus without hepatitis C. Pak. J. Surg. 2010; 26 (4): 304-307.

[9] Conte D., Fraguelli M., Prati D. et al. Prevalence and clinical course of chronic hepatitis C virus (HCV) infection and rate of HCV vertical transmission in a cohort of 15,250 pregnant women. Hepatology. 2000; 31: 751-755. http://dx.doi.org/10.1002/hep.510310328

[10] Gervais A., Bacq Y., Bernuan J. et al. Decrease of serum ALT andincrease in serum HCV RNA during pragnancy in women with chronic hepatitis C. J. Hepatol. 2000; 32: 293-299. http://dx.doi.org/10.1016/S0168-8278(00)80075-6

[11] Paternoster D.M., Santarossa C., Grella P. et al. Viral load in HCV RNA-positive pregnant women. Am. J. Gastroenterol. 2001; 96 (9): 2751-2754. http://dx.doi.org/10.1111/j.1572-0241.2001.04135.x

[12] Pergam S.A., Wang C.C., Gardella C.M. et al. Pregnancy complications associated with hepatitis C: Data from a 2003-2005 Washington State Bith Coort. Am. J. Obstet. Gynecol. 2008; 199 (1): 38.е1-38.е9.

[13] Reddick K.L.B., Jhaveri R., Gandhi M., et al. Pregnancy outcomes associated with viral hepatitis. J. Viral Hepatology. 2011; 18: 394-398. http://dx.doi.org/10.1111/j.1365-2893.2011.01436.x

[14] Versace A., Bezzio S., Tovo P.A. Mother-to-child hepatitis C virus transmission. Hot Topics in Viral Hepatitis. 2008; 11: 7-11.

RIGHTS & PERMISSIONS

Filipovich O.M., Kuznetzov N.I.