Viral load in HCV RNA-positive pregnant women
Paternoster DM, Santarossa C, Grella P, Palu G, Baldo V, Boccagni P,
Floreani A. Department of Obstetrics and Gynecology, Institute of
Hygiene, University of Padua, Italy. Am J Gastroenterol 2001
Sep;96(9):2751-4

OBJECTIVES: The risk of hepatitis C virus (HCV) infection in the
newborn is estimated to be around 5%, but becomes very high in the
case of coinfection with HIV. One of the main factors associated
with the vertical transmission of HCV is the viral load. Our
objective was to investigate the behavior of HCV viral load during
pregnancy in relation to HIV coinfection, liver enzymes, and
vertical transmission. METHODS: Three thousand seven hundred
forty-eight women seen consecutively in their first trimester of
pregnancy were screened for HCV infection. Sixty-five were found to
be anti-HCV+/HCV RNA+ and were followed up with clinical and
serological assessment (i.e., transaminases and quantitative
polymerase chain reaction [PCR] for viral load) in their second and
third trimesters and 6 months after delivery. All were anti-HIV and
hepatitis B surface antigen negative. HCV RNA was 12.0+/-19.9 x
10(6) copies/ml in the first trimester and 10.9+/-13.3 x 10(6) in
the second, but increased to 19.5+/-25.1 x 10(6) in the third
trimester. Six months after delivery the viral load returned to the
baseline levels; the changes in viral load did not reach any
statistical significance, however. Transaminases tended toward a
reduction from the baseline during the second and third trimesters,
and then an increase in both AST and ALT was recorded 6 months after
delivery. However, when the group whose AST/ALT were found abnormal
at the first test was considered, no significant changes were
recorded during the follow-up. The overall rate of vertical
transmission was 4.6 CONCLUSIONS: With HCV+ mothers monitoring
transaminases during pregnancy is unnecessary, and testing liver
enzymes at the beginning of pregnancy is sufficient. Qualitative PCR
should be done once during the pregnancy, but any staging of the
liver disease should be taken after delivery. Quantitative PCR
testing is expensive and pointless. Any decision for elective
cesarean section in HCV RNA+ mothers should be confirmed by other
studies.
http://www.natap.org/

Hep C & Pregnancy: risks for transmission
Hep C & Pregnancy: risks for transmission
www.natap.org/2001/ddw/ddw_17pregnancy080101

This subject has not been well studied so we do not have clear
answers to many of these questions, but here are key published
studies providing helpful information. Studies find HIV increases
risk for HCV transmission by about 3-5 times. A high HCV viral load
in pregnant woman can increase risk. This articles discusses rates
of transmission found in studies conducted and various risk factors
and possible ways to reduce risk: c-section experiences. The extent
of maternal-fetal blood exchange at time of delivery may be the
major determinant of transmission as suggested by the duration of
membrane rupture

Mother-to-Infant Transmission of Hepatitis C Virus
http://www.natap.org/2001/sep/mother_to_infant091401.htm

This article is a comprehensive review of 77 found published
articles on this topic. Rates for transmission are very variable
from study to study but on average appear to be 5-7%. Risk for
tranmission may be a bit higher in IVDUs perhaps due to higher HCV
viral load. Studies suggest above (10 to the 5th) 100,000 or (10 to
the 6th) 1 million may be a level at which risk increases
significantly. Risk may increase as viral load increases. Although
its not clear breastfeeding could present a ris, this is discussed
in article.
http://www.natap.org/

i HAVE HEP C , AND MY OBGYN SAYS THAT IT DOESN'T POSE A RISK FACTOR WITH
THE BABIES, ALTHO WITH THE PREGNANCY THEY WILL TAKE THE BABIES C-SECTION.
JUST TO BE ON THE SAFE SIDE. BUT I WOULD HAVE TO HAVE A C-SECTION REGARDLESS BECAUSE OF MULTIABLE BIRTH. I DON'T DRINK, SO THAT LOWERS
MY RISKS WITH MY HEP C. MY LIVER AT THIS POINT IS FILTERING OUT NORMALLY.
SO THAT IS GOOD. I AM VERY CAREFULLY WATCHED WITH THIS PREGANCY THO, DUE
TO THE NATURE OF CARRYING 3.