REVISAN LA INFECCION POR EL VIRUS DE LA HEPATITIS C EN EL EMBARAZO





REVISAN LA INFECCION POR EL VIRUS DE LA HEPATITIS C EN EL EMBARAZO

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La infección ocasionada por el virus de la hepatitis C (VHC) en las mujeres embarazadas y su potencial transmisión vertical representan un problema de salud pública. No existen datos suficientes para sugerir un aumento de la cantidad de anomalías congénitas y complicaciones obstétricas o un bajo peso al nacer entre los hijos de las mujeres infectadas por el VHC. Actualmente no se recomienda la detección sistemática de rutina.
kumar9.jpg Autor:
Ashok Kumar
Columnista Experto de SIIC
Artículos publicados por Ashok Kumar
Recepción del artículo
26 de Septiembre, 2006
Aprobación
16 de Noviembre, 2006
Primera edición
24 de Abril, 2007
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La infección cuasado por el virus de la hepatitis C (VHC) frecuentemente es asintomática. No obstante, puede provocar morbilidad y mortalidad a largo plazo debido a la aparición de hepatitis crónica activa, cirrosis, carcinoma hepatocelular e insuficiencia hepática. Se informó que la prevalencia de seropositividad contra el VHC entre las mujeres embarazadas es del 1% al 5% y que la variación internacional es baja. Además, se halló una prevalencia más elevada entre las usuarias de drogas intravenosas. Los factores de riesgo de la infección se conocen adecuadamente y el modo más eficiente de transmisión es la exposición percutánea directa. La transmisión vertical puede suceder, especialmente en las madres con una viremia elevada y dosajes positivos del virus de la inmunodeficiencia humana (VIH). Ante la falta de recursos, el antecedente de procedimientos quirúrgicos puede ser el factor más importante para la transmisión del VHC. No se observaron efectos adversos sobre los resultados del embarazo en términos de edad gestacional, puntaje de Apgar y peso al nacer en comparación con los controles. Tampoco se considera que el embarazo ocasione un empeoramiento de la enfermedad hepática en las mujeres portadoras del VHC. De acuerdo con los datos actualmente disponibles, la detección sistemática prenatal de rutina del VHC no debería llevarse a cabo. Tampoco se recomienda la cesárea ni evitar la lactancia materna para prevenir la transmisión del VHC de las madres infectadas a sus hijos.

Palabras clave
virus de la hepatitis C, embarazo, consecuencias obstétricas, detección sistemática


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Abstract
Hepatitis C virus (HCV) infection is most often asymptomatic but it has a potential for long term morbidity and mortality in terms of chronic active hepatitis, cirrhosis, hepatocellular carcinoma and liver failure. The prevalence of anti HCV seropositivity in pregnant women is reported to be between 1-5% with relatively little international variation. The prevalence is found to be higher in intravenous- drug users. Risk factors for infection are well described, with direct percutaneous exposure the most efficient mode of transmission. Vertical transmission may occur, particularly in highly viraemic and anti-human immunodeficiency (HIV) positive mothers. Past history of surgical procedures may be the most important factor for transmission of hepatitis C virus infection in the resource poor settings. No adverse effect on pregnancy outcome was observed in terms of gestational age, Apgar score and baby weight when compared with the controls. Pregnancy is also not considered to cause deterioration of liver disease in women who have hepatitis C. Based on the current evidence, routine antenatal screening for HCV should not be introduced and neither elective caesarean section nor avoidance of breastfeeding should be recommended to HCV infected women to prevent mother-to-child transmission.

Key words
hepatitis C virus, pregnancy, obstetric outcome, screening


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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Infectología
Relacionadas: Atención Primaria, Bioquímica, Diagnóstico por Laboratorio, Epidemiología, Medicina Familiar, Medicina Interna, Obstetricia y Ginecología, Pediatría, Salud Pública



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Enviar correspondencia a:
Ashok Kumar, Department of Obstetrics and Gynaecolgy, Maulana Azad Medical College, Lok Nayak Hospital, 110002, Nueva Delhi, India
Bibliografía del artículo
1. Wasley AD, Alter MJ. Epidemiology of hepatitis C. Semin Liver Dis 20:1-16, 2000.
2. Centers for Disease Control and Prevention, Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related disease. MMWR Morb Mortal Wkly Rep 47:1-39, 1998.
3. Alter MJ, Margolis HS, Krawczynski K, Judson FN, Mares A, Alexander J, et al. The natural history of the community acquired hepatitis C in United States. The Sentinel Counties Chronic Non-A, Non-B Hepatitis Study Team. N Engl J Med 327:1899-905, 1992.
4. Puoti M, Zonaro A, Ravaggi A, Marian MG, Castelnuovo F, Cariani E, et al . Hepatitis C virus RNA and antibody response in the clinical course of acute hepatitis C virus infection. Hepatology 16:877-81, 1992.
5. Hino K, Sainokami S, Shimoda K, Niwa H, Iino S. Clinical course of acute hepatitis C and changes in HCV markers. Dig Dis Sci 39:19-27, 1994.
6. Rodger AJ, Roberts S, Lanigan A, Bowden S, Brown T, Crofts N. Assessment of long term outcomes of community acquired hepatitis C infection in a cohort with sera stored from 1971-1975. Hepatology 32:582-7, 2000.
7. Seef LB, Hollinger FB, Alter HJ, Wright WC, Cain CM, Buskell ZJ, Ishak KG, et al . Long term mortality and morbidity of transfusion associated non-A, non-B and type C hepatitis: a National Heart, Lung and Blood Institute collaborative study. Hepatology 33:455-63, 2001.
8. Walsh KE. Clinical outcomes after hepatitis C infection from contaminated anti D immune globulin. Irish Hepatology Research Group. N Engl J Med 340:1228-33, 1999.
9. Thomas DL, Astemborski J, Rai RM, Anania FA, Schaeffer M, Galai N, et al. The natural history of hepatitis C virus infection: host, viral and environmental factors. JAMA 284:450-6, 2000.
10. Gerlach JT, Diepolder HM, Zachoval R, Gruener NH, Jung MC, Ulsenheimer A, et al. Acute hepatitis C: high rate of both spontaneous and treatment-induced viral clearance. Gastroenterology 125:80-8, 2003.
11. Jackel E, Comberg M, Wedmeyer H, Santantoio T, Mayer J, Zankel M, Pastore G, et al . Treatment of acute hepatitis C with interferon alfa 2b. N Engl J Med 345:1452-7, 2001.
12. Vogt M, Lay T, Frosner G, Klingler C, Sendl AF, Zeller A, et al. Prevalence and clinical outcome of hepatitis C infection in children who underwent cardiac surgery before the implementation of blood donor screening. N Engl J Med 341:8866-70, 1999.
13. Thorpe LE, Ouellet LJ, Hershow R, Bailey SL, Williams IT, Williamson J, et al. Risk of hepatitis C virus infection among young adult injection drug users who share injection equipment. Am J Epidemiol 155:645-53, 2002.
14. Freeman AJ, Dore GJ, Low MG, Thorpe M, Van Overhede J, Lloyd AR, et al. Estimating progression to cirrhosis in chronic hepatitis C virus infection. Hepatology 34:809-16, 2001.
15. El-Serag HB. Hepatocellular carinoma and hepatitis C in United States. Hepatology 36:S74-S83, 2002.
16. Gordon SC, Bayati N, Silverman AL. Clinical outcome of hepatitis C as a function of mode of transmission. Hepatology 28:562-7, 1998.
17. Chiba T, Matsuzaki Y, Abei M, Shoda J, Aikawa T, Tanaka N, et al. Multivariate analysis of risk factors for hepatocellular carcinoma in patients with hepatitis C virus-related liver cirrhosis. J Gastroenterol 31:552-8, 1996.
18. Sherman KE, Rouster SD, Chung RT, Rajicic N. Hepatitis C virus prevalence among patients infected with human immunodeficiency virus: a cross sectional analysis of the US Adult AIDS Clinical Trial Group. Clin Infect Dis 34:831-7, 2002.
19. Hellard M, Hocking J, Crofts N. The prevalence of hepatitis C among inmates in Victorian correctional facilities. In: 14th Australasian Society for HIV Medicine Conference 23-26 October 2002;Sydney, Australia.
20. Bjoro K et al. Hepatitis C infection in patients with primary hypogammaglobulinemia after treatment with contaminated immune globulin. N Engl J Med 1994;331:1607-1611, 1994.
21. Alter MJ, Hadler SC, Judson FN, et al. Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C virus infection. JAMA 264:2231-2235, 1990.
22. Alter MJ, Coleman PJ, Alexander WJ, et al. Importance of heterosexual activity in the transmission of hepatitis B and non-A, non-B hepatitis. JAMA 262:1201-1205, 1989.
23. Dienstag JL. Sexual and perinatal transmission of hepatitis C. Hepatology 26:66S-70S, 1997.
24. Meisel H, Reip A, Faltus B, et al. Transmission of hepatitis C virus to children and husbands by women infected with contaminated anti-D immunoglobulin. Lancet 345:1209-1211, 1995.
25. ACOG Educational Bulletin. Viral hepatitis in pregnancy. Number 248, July 1998. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 63:195-202, 1998.
26. Jaffery T, Tariq N, Ayub R, Yawar A. Frequency of hepatitis C in pregnancy and pregnancy outcome. J Coll Physicians Surg Pak 15(11):716-9, 2005.
27. Arthur RR, Hassan NF, Abdallah MY et al. Hepatitis C antibody prevalence in blood donors in different governorates in Egypt. Trans R Soc Trop Med Hyg 91:271-274, 1997.
28. Hellard M, Aitken C, Mackintosh A, Ridge A, Bowden S. An investigation of infection control practices and knowledge of hepatitis C among body piercing practitioners. Am J Infect Control 31(4):215-20, 2003.
29. Kumar A, Sharma KA, Gupta RK, Kar P, Murthy NS. Hepatitis C virus infection during pregnancy in North India. Intl J Gynaecol Obstet 88(1):55-6, 2005.
30. Ward C, Tudor-Williams G, Cotzias T, et al. Prevalence of hepatitis C among pregnant women attending an inner London obstetric department: uptake and acceptability of named antenatal testing. Gut 47:277-280, 2000.
31. Alter MJ. Epidemiology of hepatitis C in the west. Semin Liver Dis 15:5-14, 1995.
32. Silverman NS, Jenkin BK, Wu C, McGillen P, Knee G. Hepatitis C virus in pregnancy: Seroprevalence and risk factors for infection. Am J Obstet Gynecol 169:583-587, 1993.
33. Uehara S, Abe Y, Saito T, et al. The incidence of vertical transmission of hepatitis C virus. Tohoku J Exp Med 171:195-202, 1993.
34. Reinus JF, Leikin EL, Alter HJ, et al. Failure to detect vertical transmission of hepatitis C virus. Ann Intern Med 117:881-886, 1992.
35. Conte D, Fraquelli M, Prati D, et al. Prevalence and clinical course of chronic hepatitis C virus (HCV) infection and rate of vertical transmission in a cohort of 15,250 pregnant women. Hepatology 31:751-755, 2000.
36. Langlet P, Lasser L, Sidi B. Hepatitis C in women planning a pregnancy: current opinions. Rev Med Brux 26(6):487-91, 2005.
37. Kumar A et al. Hepatitis C virus infection during pregnancy and its effect on the course and outcome of pregnancy. Indian council of medical research: Adhoc research project. 2003-2006.
38. Hieber JP, Dalton D, Shorey J, Combes B. Hepatitis and pregnancy. J Pediatr 91:545-9, 1977.
39. Floreani A, Paternoster D, Zappala F, Cusinato R, Bombi G, Grella P, Chiaramonte M. Hepatitis C virus infection in pregnancy. Br J Obstet Gynaecol 103:325-9, 1996.
40. Jabeen T, Cannon B, et al. Pregnancy and pregnancy outcome in hepatitis C type 1b. QJM 93(9):597-601, 2000.
41. National Institutes of Health Consensus Development Conference statement: management of hepatitis C: June 10-12, 2002. Hepatology 36(Suppl):S3-S20, 2002.
42. American College of Obstetricians and Gynecologists, Viral hepatitis in pregnancy: ACOG Educational Bulletin 248. Intl J Gynaecol Obstet 63:195-202, 1998.
43. Plunkett BA, Grobman WA. Routine hepatitis C virus screening in pregnancy: A cost-effectiveness analysis Am J Obstet Gynecol 192:1153-1161, 2005.
44. Pembreya L, Newella ML, Tovob PA. EPHN Collaborators. The management of HCV infected pregnant women and their children European paediatric HCV network. J Hepatol 43(3):515-25, 2005.
45. Hepatitis C virus infection. American Academy of Pediatrics. Committee on Infectious Diseases. Pediatrics 101(3 Pt 1):481-5, 1998.
46. American College of Obstetricians and Gynecologists, Viral hepatitis in pregnancy: ACOG Educational Bulletin 248. Intl J Gynaecol Obstet 63:195-202, 1998.

 
 
 
 
 
 
 
 
 
 
 
 
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