Lombay Béla, Gasztonyi Beáta, Szalay Ferenc
Szent Ferenc Kórház, Belgyógyászat, Miskolc.
Orv Hetil. 2008 Jun 1;149(22):1017-21. doi: 10.1556/OH.2008.28394.
It is difficult to define the optimal timing of antiviral treatment in women infected with viral hepatitis C, who have child-bearing potential. Antiviral treatment is strictly contraindicated during pregnancy and the breast-feeding period. Data are conflicting about the question of treatment with modern drugs (peginterferon and ribavirin) before or after pregnancy. The risk of vertical transmission from mother to child is estimated about 5%. The mother's viraemia seems to be the main transmission factor. There is a worse prognosis in nulliparous and postmenopausal women in the natural history of viral hepatitis C. Poor outcome in gestational age, maturity and Apgar score were not associated with hepatitis C virus infection. Combined treatment has frequent gynecological and other side effects. The timing of antiviral therapy in women in child-bearing period is recommended individually.
对于有生育潜力的丙型病毒性肝炎感染女性,很难确定抗病毒治疗的最佳时机。孕期和哺乳期严格禁止抗病毒治疗。关于在怀孕前或怀孕后使用现代药物(聚乙二醇干扰素和利巴韦林)进行治疗的问题,数据存在冲突。母婴垂直传播的风险估计约为5%。母亲的病毒血症似乎是主要传播因素。在丙型病毒性肝炎的自然病程中,未生育和绝经后女性的预后较差。胎龄、成熟度和阿氏评分不佳与丙型肝炎病毒感染无关。联合治疗常有妇科及其他副作用。建议对育龄期女性的抗病毒治疗时机进行个体化评估。