Influence of pregnancy in chronic hepatitis C virus infection

BACKGROUND: There is scarce information about the influence of pregnancy in patients with chronic hepatitis C virus infection is little know. PATIENTS AND METHODS: 6.556 pregnant women were screened for anti-HCV (ELIS A II). We determine ALT, MCV-RNA by PCR (Amplicor Roche) and HCV viraemia ( Amplicor-HCV-Monitor Roche) in the third trimester of pregnancy and after 6 months of delivery. HBsAg, anti-HIV and MCV serotype (Murex 1-3) were also determined. Statistical analysis: Fisher test, paired-t and U Mann Whitney . RESULTS: Anti-HCV was positive in 59 out of 6.556 (0,9%). Mean (SD) age: 27 (9) years (range, 18-40). Drug users: 34 (57%), post-transfusion: 10 (18%) and unknown: 15 (25%). HIV positive 11 (19%). Serotype 1, 30 (51%), setoty pe 3, 7 (20%), and nontypeable, 22 (37%). We studied HCV-RNA before and aft er delivery in 35 women. 8 out of 35 (23%) had HCV-RNA negative in both ana lysis. ALT was normal in 88% of women during pregnancy and in 42% after del ivery. ALT levels in pregnancy were 32.6 (39.5) and in postpartum 64.5 (53. 4) U/l (p < 0.005). 6 women were RNA-VHC negative during pregnancy and posi tive in postpartum. MCV viraemia during pregnancy and postpartum was 503 (1 ,203) and 1,014 (1,907) thousand copies/ml (p < 0.05). No relation was foun d among ALT or MCV viraemia with risk factors, serotype or coinfection with HIV. CONCLUSIONS: The prevalence of anti-MCV in pregnant women is 0.9%. ALT is u sually normal in pregnancy. A quarter of women were HCV-RNA negative in pre gnancy and positive after delivery. The viraemia was lower in pregnancy tha n after delivery, which is consistent with the fact of the low mother-to-in fant MCV transmission rate.