卡拉奇中低收入社会经济阶层孕妇群体中的丙型肝炎病毒垂直传播。

Vertical transmission of hepatitis C virus in low to middle socio-economic pregnant population of Karachi.

机构信息

Sarwar Zuberi Liver Centre, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, Sindh, Pakistan,

出版信息

Hepatol Int. 2011 Jun;5(2):677-80. doi: 10.1007/s12072-010-9229-8. Epub 2010 Dec 31.

DOI:10.1007/s12072-010-9229-8

PMID:21484109

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3090561/

Abstract

PURPOSE

To determine the rate of vertical transmission (transmission from mother to child) of hepatitis C virus in low to middle socio-economic pregnant women.

METHODS

This study was conducted at Sarwar Zuberi Liver Centre (SZLC) in collaboration with the department of Gynaecology and Obstetrics, Civil Hospital Karachi (CHK) and Abbasi Shaheed Hospital (ASH) for a period of 4 years from September 2005 to December 2009. Total 18,000 women seeking antenatal care were screened for hepatitis C antibodies (Anti-HCV) using 4th generation ELISA technique. Positive 1,043 women were further offered HCV ribonucleic acid (RNA) by polymerase chain reaction (PCR). Six hundred and forty women agreed to have PCR done, and 510 PCR positive women were finally included in the study, followed till delivery and treated if required. Newborns of 510 PCR positive mothers were advised HCV-RNA by PCR from 3 to 12 months of age and Anti-HCV at 18 up to 24 months and followed up to 3 years.

RESULTS

1,043/18,000 (5.79%) mothers were Anti-HCV positive, of which PCR results of 640 mothers are available where 510/640 (79.7%) were PCR positive, 357/510 (70%) delivered by spontaneous vaginal delivery (SVD), 33 (6.4%) by forceps delivery, 70 (13.7%) had elective, and 50 (9.8%) had emergency caesarian section. Premature rupture of membranes (PROM) was present in 81 mothers. Data of 510 babies from 3 months to 3 years of age was available of which only 215 had their laboratory tests done (HCV-RNA-PCR in 86 and Anti-HCV in 129). Mean birth weight (kg), height (cm) and OFC (cm) were 2.74 ± 0.43, 52.4 ± 7.5, and 35 ± 4. Apgar score median at 1 and 5 min was 7 (range 2-10), 8 (range 4-10), respectively. Low birth weight was present in 49 (9.6%), 37 (7.2%) had history of Neonatal Intensive Care Unit (NICU) admission. PCR of none of the 86 babies done at 3-12 months was positive. Five babies out of 129 were Anti-HCV positive at 18 months of age. Of this, 3/5 was HCV-RNA-PCR positive. Rate of vertical transmission of HCV was 1.39.

CONCLUSION

In spite of the high hepatitis C positivity in pregnant population, the rate of vertical transmission to the neonate is low.

摘要

目的

确定中低收入社会经济背景下的孕妇中丙型肝炎病毒（HCV）垂直传播（从母亲到婴儿）的比率。

方法

本研究于 2005 年 9 月至 2009 年 12 月在萨瓦尔·祖贝利肝脏中心（SZLC）与卡拉奇民事医院（CHK）和阿巴西·谢赫德医院（ASH）妇产科合作进行，共对 18000 名接受产前护理的妇女进行了丙型肝炎抗体（抗-HCV）的第四代 ELISA 检测。1043 名阳性妇女进一步通过聚合酶链反应（PCR）检测丙型肝炎病毒核糖核酸（RNA）。640 名妇女同意进行 PCR 检测，510 名 PCR 阳性妇女最终纳入研究，随访至分娩，并在需要时进行治疗。510 名 PCR 阳性母亲的新生儿在 3 至 12 个月时通过 PCR 检测 HCV-RNA，在 18 至 24 个月时通过抗-HCV 检测，并随访至 3 岁。

结果

18000 名母亲中有 1043 名（5.79%）抗-HCV 阳性，其中 640 名母亲的 PCR 结果可用，其中 510 名（79.7%）PCR 阳性，510 名中有 357 名（70%）经自然阴道分娩（SVD）分娩，33 名（6.4%）经产钳分娩，70 名（13.7%）行选择性剖宫产，50 名（9.8%）行紧急剖宫产。81 名母亲存在胎膜早破（PROM）。510 名婴儿在 3 至 3 岁时的实验室检测数据可用，其中仅 215 名进行了检测（86 名进行 HCV-RNA-PCR，129 名进行抗-HCV）。平均出生体重（kg）、身高（cm）和头围（cm）分别为 2.74±0.43、52.4±7.5 和 35±4。1 分钟和 5 分钟时的阿普加评分中位数分别为 7（范围 2-10）和 8（范围 4-10）。49 名（9.6%）新生儿出生体重低，37 名（7.2%）有新生儿重症监护病房（NICU）入住史。86 名婴儿在 3-12 个月时进行的 PCR 检测均为阴性。129 名婴儿中有 5 名在 18 个月时抗-HCV 阳性。其中 3 名 HCV-RNA-PCR 阳性。HCV 的垂直传播率为 1.39%。