Altınbas Sibel, Holmes Jacinta A, Altınbas Akif
Sibel Altinbas, MD, Department of Obstetrics and Gynecology, Kastamonu Medical Faculty, Hacettepe University, Ankara, Turkey.
Jacinta A. Holmes, MD, PhD, Department of Gastroenterology, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Gastroenterol Nurs. 2020 Jan/Feb;43(1):12-21. doi: 10.1097/SGA.0000000000000404.
Parenteral transmission is the major route of hepatitis C virus transmission in adults; however, vertical transmission is most common in children. There are several factors that have been shown to be associated with vertical transmission of hepatitis C virus, including hepatitis C virus RNA, human immunodeficiency virus coinfection, and peripheral blood mononuclear cell infection. As there is no effective vaccine to prevent hepatitis C virus infection, and there are no human data describing the safety of the new direct acting antiviral agents in pregnancy, the only preventive strategy for vertical transmission is to treat the hepatitis C virus infection before becoming pregnant. Direct acting antiviral agents are interferon-free, and many are also ribavirin-free. Based on animal studies, sofosbuvir plus ledipasvir may be the best safety profile during pregnancy for now; however, it is too early to recommend treating hepatitis C virus-infected pregnant women with these direct acting antiviral agents currently.
肠道外传播是丙型肝炎病毒在成人中传播的主要途径；然而，垂直传播在儿童中最为常见。有几个因素已被证明与丙型肝炎病毒的垂直传播有关，包括丙型肝炎病毒RNA、人类免疫缺陷病毒合并感染以及外周血单个核细胞感染。由于尚无有效的疫苗来预防丙型肝炎病毒感染，且尚无关于新型直接作用抗病毒药物在孕期安全性的人体数据，垂直传播的唯一预防策略是在怀孕前治疗丙型肝炎病毒感染。直接作用抗病毒药物不含干扰素，许多也不含利巴韦林。根据动物研究，目前索磷布韦加来迪帕司韦在孕期可能具有最佳的安全性；然而，目前推荐用这些直接作用抗病毒药物治疗丙型肝炎病毒感染的孕妇还为时过早。
