Epidemiology and prevalence of seropositivity for hepatitis C virus in pregnant women in Granada.

OBJECTIVES

To study personal and familial antecedents of risk and prevalence of infection by HCV in pregnant women in the south area of Granada.

PATIENTS AND METHODS

We included in the study 3003 pregnant women of the south area of Granada during the period from January 1993 to December 1995. Anti-HCV was detected in the third trimester of pregnancy by second and third generation ELISA, and positive results were confirmed by RIBA 3. We also determined HCV-RNA and genotype. Finally, we analyzed ALT levels in 1171 (39%) pregnant women. We carried out an epidemiological survey of all pregnant women, which included the following personal antecedents: transfusion, intravenous drug use, liver diseases, risk profession and sexually transmitted diseases. We studied the same antecedents in the parents, husbands and other relatives.

RESULTS

Prevalence of anti-HCV was 0.63% (19 cases) with ELISA and 0.53% with RIBA. HCV-RNA was positive in 14 (74%) genotype 1b (57%) being the most frequent. ALT was increased in 52 (4.4%) pregnant women, 7 (13.5%) of whom were anti-HCV positive, versus 12 women (1%) in the normal ALT group (p < 0.001). In the epidemiological study we observed statistically significant differences in: a) housing characteristics [2125 (71%) anti-HCV negative pregnant women living in occupant-owned housing versus 7 (36%) in anti-HCV-positive group, p < 0.001]; b) personal antecedents of transfusion, chronic or acute hepatitis, or intravenous drug use (p < 0.001) (these factors were confirmed in the multivariable analysis), and c) familial antecedents of the husband (p < 0.05).

CONCLUSIONS

In this study we demonstrated that 0.53% of the pregnant women were infected by HCV; most of them were HCV-RNA positive and was genotype 1b was the most frequent. The risk factors most frequently associated with infection were antecedents of transfusion, intravenous drug use and acute or chronic hepatitis.