Kołakowska Agnieszka, Godzik Paulina, Madaliński Kazimierz
Med Dosw Mikrobiol. 2014;66(3-4):215-22.
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 pregnan- cy 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.
全球孕妇中抗丙型肝炎病毒(HCV)抗体的流行率在0.1%至3.6%之间。在波兰,有一项关于孕妇HCV抗体流行率的研究发表。根据阿尼谢夫斯卡等人对544名女性进行的研究,抗HCV抗体的比例估计为2.02%。自2011年以来,国家公共卫生研究所 - 国家卫生研究院在瑞士 - 波兰合作项目中开展了“孕妇常规HCV检测初步项目”,该项目由卫生部共同资助,目的之一是估计孕妇群体中HCV感染的流行率。病毒从母亲传播给胎儿现在被认为是导致儿童和婴儿感染的最常见途径。根据现有数据,受感染母亲垂直传播的风险相对较低,在1.8%至5%之间。HCV传播可发生在产前以及分娩期间。尽管有许多关于病毒从母亲传播给孩子的研究,但其机制尚未完全了解。仅知道有利于这种感染途径的因素。垂直传播的主要危险因素是母体外周血中存在病毒RNA。其他危险因素包括:外周血单个核细胞(PBMC)中存在病毒RNA、合并感染HIV、感染HCV的女性在怀孕前一年和分娩期间谷丙转氨酶(ALT)显著升高、胎膜破裂与分娩之间的时间延长以及婴儿为女性。羊膜穿刺术和剖宫产作为HCV垂直传播危险因素的影响仍在讨论中。感染HCV的母亲进行母乳喂养是安全的,不会导致将感染传播给婴儿。由于治疗方案中使用的利巴韦林和干扰素在怀孕期间不能使用,在计划怀孕前进行HCV检测很重要。这为治愈感染并消除HCV垂直传播途径提供了机会。