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 >
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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
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