Hepatitis C Transmission and Pregnancy

Decrease in serum ALT and increase in serum HCV RNA during pregnancy in women
with chronic hepatitis C

Gervais A, Bacq Y, Bernuau J, Martinot M, Auperin A, Boyer N, Kilani A,
Erlinger S, Valla D, Marcellin P

Service d'Hepatologie, INSERM U481 and Centre de Recherche Claude Bernard sur
les Hepatites Virales, Hopital Beaujon, Clichy, France.

J Hepatol 2000 Feb;32(2):293-9

The natural history of chronic hepatitis C infection during pregnancy has not been clearly established, and thus our aim was to assess serum alanine aminotransferase levels and serum HCV RNA levels during pregnancy.

Twenty-six pregnant women with chronic hepatitis C were studied. Serum alanine aminotransferase was assessed within the 3 months before, monthly during and within the 3 months after pregnancy. In 12 women, serum HCV RNA levels were quantified by the branched DNA assay. Twenty-six age-matched non-pregnant women with chronic hepatitis C were followed up for 1 year, and used as a comparison group.

During pregnancy, serum alanine aminotransferase levels decreased in the second and third trimesters. The third trimester levels were significantly lower than serum alanine aminotransferase levels before pregnancy (p=0.0001). Seventy-seven percent of the pregnant women with increased pre-pregnancy levels had normalization of serum alanine aminotransferase levels. In the second or third trimesters, serum HCV RNA levels increased. The third trimester serum HCV RNA levels were significantly higher than levels before pregnancy (p=0.01). No significant change in serum alanine aminotransferase or HCV RNA levels was observed in the control group.

In pregnant women with chronic hepatitis C, serum alanine aminotransferase levels decrease, and serum HCV RNA levels increase during the second and third trimesters.

Mother-to-infant transmission of hepatitis C virus
Zanetti AR, Tanzi E, Newell ML

Institute of Virology, University of Milan, Italy. alessandro.zanetti@unimi.it

J Hepatol 1999;31 Suppl 1:96-100

The rate of mother-to-infant transmission of hepatitis C virus (HCV) is approximately 5%, but is higher when the mother is co-infected with HIV. Vertical transmission is restricted to infants whose mothers are viraemic. The risk of transmission increases with increasing maternal viral load but a specific cut-off value predicting infection cannot be defined. There is no specific HCV genotype which is preferentially transmitted. The mode of delivery (caesarean versus vaginal) does not appear to influence the rate of transmission, but firm evidence is lacking. There is no evidence to suggest an increased risk of HCV transmission through breast feeding. Pregnancy is not contra-indicated in HCV-infected women. Without drugs to treat established infections in mothers and infants and interventions to prevent vertical transmission, routine HCV screening is not recommended in pregnant women.