Hepatitis C virus load during pregnancy and puerperium

Objective To assess whether pregnancy and delivery influence serum levels o f hepatitis C virus (HCV) in carrier mothers. Design A prospective study. Setting University department of obstetrics and gynaecology. Participants Ten pregnant HCV carriers (group A) and 8 nonpregnant HCV carr iers (group B). Methods Serum samples were collected for group A at first and third trimest ers, delivery, postpartum 1, 3, 6, 9 and 12 months, and at every three mont hs for 1 year for group B. Main outcome measures Each serum sample was tested for serum alanine aminot ransferase (ALT), anti-HCV titre and HCV-cDNA concentration by a competitiv e polymerase chain reaction (PCR) with a sensitivity of 250 copies/ml serum . Results In group A, the HCV levels remained unremarkably changed during pre gnancy and delivery. However, all women had decreased HCV levels 1 and 3 mo nths after delivery. Two women had undetectable serum HCV level postpartum and thereafter. Serum ALT values in 3 women were sporadically elevated, but did not correlate with decreased serum HCV levels. Anti-HCV titres remaine d unchanged during the study period. In two women from group B, the serum H CV levels were undetectable during follow up. Other 6 women showed fluctuat ions in the serum HCV levels but all were above 250 copies/ml. Serum ALT va lues were normal and anti-HCV titres remained stationary in all 8 nonpregna nt carriers. Conclusion Serum HCV levels are decreased 1 and 3 months after delivery. Th is fact might suggest that puerperium is an optimal time for antiviral ther apy in HCV carrier mothers.