Hillemanns P, Langenegger P, Langer B C, Knitza R, Hasbargen U, Hepp H
Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum Grosshadern.
Z Geburtshilfe Neonatol. 1998 May-Jun;202(3):127-30.
Hepatitis C shows an increasing distribution in countries of western Europe. The aim of our study was to assess the prevalence of antibodies to hepatitis C (anti-HCV) in pregnancy, to evaluate the risk factors for anti-HCV positive women and the course of hepatitis C during pregnancy. 3712 pregnant patients of the university hospital Grosshadern, Munich, were analyzed for anti-HCV, anti-HIV and hepatitis B surface antigen. Anti-HCV seropositive women were further tested with western blot and polymerase chain reaction for HCV-RNA. Thirty-five (0.94%) of the 3712 pregnant women were found anti-HCV positive. 20% of them had present or previous injection drug abuse, hereof one patient had an associated seropositivity for HIV. Parenteral transmission through blood transfusion was likely in 11%. However, no parenteral exposure was recognized in 57% of the anti-HCV positive patients. The presence of serum HCV-RNA was detected in 16 (57%) of the 28 patients tested. In 17% (6/35) of the anti-HCV positive pregnancies elevated liver enzymes were noted, which did not show any significant change during the course of pregnancy. In conclusion, the prevalence of hepatitis C in pregnancy is relatively high with nearly 1%-comparable to chronic hepatitis B infection. Selected pregnancy screening based on perceived high-risk groups alone fail to detect about 60% of HCV antibody-positive women. Pregnancy did not influence the course of hepatitis C.
丙型肝炎在西欧国家的分布呈上升趋势。我们研究的目的是评估孕期丙型肝炎抗体（抗-HCV）的流行情况，评估抗-HCV阳性女性的危险因素以及孕期丙型肝炎的病程。对慕尼黑格罗斯哈登大学医院的3712名孕妇进行了抗-HCV、抗-HIV和乙肝表面抗原检测。抗-HCV血清学阳性的女性进一步通过免疫印迹法和聚合酶链反应检测HCV-RNA。3712名孕妇中有35名（0.94%）抗-HCV阳性。其中20%有当前或既往注射吸毒史，其中1例患者HIV血清学也呈阳性。11%的感染可能是通过输血的非肠道传播。然而，57%的抗-HCV阳性患者未发现有非肠道暴露史。在接受检测的28例患者中，有16例（57%）检测到血清HCV-RNA。17%（6/35）的抗-HCV阳性孕妇出现肝酶升高，在孕期过程中未显示出任何显著变化。总之，孕期丙型肝炎的患病率相对较高，接近1%，与慢性乙型肝炎感染相当。仅基于高危人群进行的选择性孕期筛查未能检测出约60%的HCV抗体阳性女性。妊娠并未影响丙型肝炎的病程。
