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Medycyna Doświadczalna i Mikrobiologia 2014, 66(3): 215 - 222

ZAKAŻENIA WIRUSEM HCV U KOBIET W CIĄŻY
[HCV INECTION IN PREGNANCY]

A. Kołakowska, P. Godzik, K. Madaliński

Streszczenie

Zakażenia wirusem zapalenia wątroby typu C kobiet ciężarnych stanowią ważny problem zdrowotny. Najpoważniejszą konsekwencją zakażeń HCV, pod względem epidemiologicznym, jest możliwość wertykalnego przeniesienia wirusa z zakażonej matki na dziecko. Intensyfikacja badań przesiewowych wśród kobiet planujących ciążę jest istotnym działaniem umożliwiającym wyeliminowanie jednej z dróg szerzenia się zakażeń wirusem HCV w populacji.

Abstract

The prevalence of anti–HCV antibodies in pregnant women ranges from 0.1% to 3.6% worldwide. In Poland, one work was published on the prevalence of HCV antibodies in pregnant women. Based on studies conducted by Aniszewska et al. in 544 women, the percentage of anti–HCV antibodies was estimated at 2.02%. Since 2011, the NIPH–NIH performs “Preliminary programme of routine HCV testing among pregnant women” within the Swiss–Polish Cooperation Programme, co–financed by the Ministry of Health, with the aim to, i.a. estimate the prevalence of HCV infection in the population of pregnant women. The transmission of the virus from mother to fetus is now considered to be the most common route leading to infections in children and infants. According to available data, the risk of vertical transmission from infected mother is relatively low and ranges from 1.8% to 5%. Transmission of HCV can occur both in the prenatal period as well as during the labor. Irrespective of the numerous studies on the transmission of the virus from mother to child, its mechanism has not been completely understood. Exclusively the factors favoring this route of infection are known. The main risk factor for vertical transmission is the presence of viral RNA in maternal peripheral blood. Other risk factors include: the presence of viral RNA in PBMC, HIV coinfection, significant increase in ALT in a year preceding pregnancy and during labor in women infected with HCV, extended time between the rupture of membranes and delivery as well as female gender of the baby. The impact of amniocentesis
and cesarean delivery as risk factors for vertical transmission of HCV are still discussed. Breastfeeding by mothers infected with HCV is safe and does not lead to transmission of infection to the baby. As ribavirin and interferon, which are used in therapeutic regimens, cannot be administered during pregnancy, it is important to perform testing for HCV prior to a planned pregnancy. This gives the opportunity to cure the infection and eliminate the vertical route of HCV transmission.

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