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Viral load in HCV RNA-positive pregnant women

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  • claudine intexas
    NATAP - www.natap.org Viral load in HCV RNA-positive pregnant women Paternoster DM, Santarossa C, Grella P, Palu G, Baldo V, Boccagni P, Floreani A. Department
    Message 1 of 1 , Sep 18, 2002
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      NATAP - www.natap.org

      Viral load in HCV RNA-positive pregnant women

      Paternoster DM, Santarossa C, Grella P, Palu G, Baldo V, Boccagni P,
      Floreani A.
      Department of Obstetrics and Gynecology, Institute of Hygiene,
      University of Padua, Italy.
      Am J Gastroenterol 2001 Sep;96(9):2751-4

      OBJECTIVES: The risk of hepatitis C virus (HCV) infection in the
      newborn is estimated to be around 5%, but becomes very high in the
      case of coinfection with HIV. One of the main factors associated with
      the vertical transmission of HCV is the viral load. Our objective was
      to investigate the behavior of HCV viral load during pregnancy in
      relation to HIV coinfection, liver enzymes, and vertical
      transmission.

      METHODS: Three thousand seven hundred forty-eight women seen
      consecutively in their first trimester of pregnancy were screened for
      HCV infection. Sixty-five were found to be anti-HCV+/HCV RNA+ and
      were followed up with clinical and serological assessment (i.e.,
      transaminases and quantitative polymerase chain reaction [PCR] for
      viral load) in their second and third trimesters and 6 months after
      delivery. All were anti-HIV and hepatitis B surface antigen negative.
      HCV RNA was 12.0+/-19.9 x 10(6) copies/ml in the first trimester and
      10.9+/-13.3 x 10(6) in the second, but increased to 19.5+/-25.1 x
      10(6) in the third trimester. Six months after delivery the viral
      load returned to the baseline levels; the changes in viral load did
      not reach any statistical significance, however. Transaminases tended
      toward a reduction from the baseline during the second and third
      trimesters, and then an increase in both AST and ALT was recorded 6
      months after delivery. However, when the group whose AST/ALT were
      found abnormal at the first test was considered, no significant
      changes were recorded during the follow-up. The overall rate of
      vertical transmission was 4.6

      CONCLUSIONS: With HCV+ mothers monitoring transaminases during
      pregnancy is unnecessary, and testing liver enzymes at the beginning
      of pregnancy is sufficient. Qualitative PCR should be done once
      during the pregnancy, but any staging of the liver disease should be
      taken after delivery. Quantitative PCR testing is expensive and
      pointless. Any decision for elective cesarean section in HCV RNA+
      mothers should be confirmed by other studies.


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