Aniszewska Małgorzata, Kowalik-Mikołajewska Barbara, Pokorska-Lis Maria, Kalinowska Monika, Marczyńskai Magdalena
Klinika Chorob Zakaźnych Wieku Dzieciecego, Warszawski Uniwersytet Medyczny ul. Wolska 37, Warszawa.
Przegl Lek. 2010;67(1):9-12.
To estimate the management of HCV infected women and their children.
Part I/: Blood samples were collected from 544 pregnant women and tested for anti-HCV. Part II/: Data of risk factors of HCV infection, reasons of HCV diagnostics were assessed in 281 mothers infected with HCV, not infected with HIV. 317 children born to HCV infected mothers were observed from birth until age 2.5-10 years (testing of HCV-RNA, ALT). 26 (8.%) of them were infected with HCV.
Part I/: 22.02% of tested pregnant women were anti-HCV(+). Part II/: Presence of risk factors for HCV infection in anamnesis was the reason of HCV diagnostics in 34% of women. None of HCV-RNA(-) women transmitted HCV to their child. The rate of HCV infection in infants born to HCV-RNA(+) mothers was 14.1% and was higher in case of natural delivery (19.2%) compared to cesarean section (7.5%). Intrapartum percutaneus exposure to maternal blood increased transmission rates. All children born via elective cesarean section (in 38 Hbd) were HCV-RNA(-). None of infected children had clinical symptoms of hepatitis, however, one of them had mild changes in liver histopathology.
Antenatal screening of anti-HCV is not necessary, however, every woman with risk factors for HCV infection in anamnesis should be tested. Women infected with HCV ought to be treated before pregnancy in order to decrease HCV replication. The protective role of elective cesarean section requires further investigation. A number of children with chronic HCV infection should be considered for early treatment.
评估丙型肝炎病毒（HCV）感染女性及其子女的管理情况。
第一部分：收集544名孕妇的血样并检测抗HCV。第二部分：在281名感染HCV但未感染HIV的母亲中评估HCV感染的危险因素数据、HCV诊断原因。观察317名HCV感染母亲所生子女从出生到2.5至10岁的情况（检测HCV-RNA、丙氨酸转氨酶）。其中26名（8%）感染了HCV。
第一部分：22.02%的受检孕妇抗HCV呈阳性。第二部分：既往史中有HCV感染危险因素是34%女性HCV诊断的原因。HCV-RNA阴性的女性均未将HCV传播给其子女。HCV-RNA阳性母亲所生婴儿的HCV感染率为14.1%，自然分娩时（19.2%）高于剖宫产时（7.5%）。分娩时经皮暴露于母体血液会增加传播率。所有经择期剖宫产出生的儿童（共38例）HCV-RNA均为阴性。所有感染儿童均无肝炎临床症状，然而，其中一名儿童肝脏组织病理学有轻度改变。
产前抗HCV筛查并非必要，但既往史中有HCV感染危险因素的每位女性都应接受检测。感染HCV的女性应在孕前接受治疗以减少HCV复制。择期剖宫产的保护作用需要进一步研究。应对一些慢性HCV感染儿童考虑早期治疗。
