Hepatitis C in pregnancy

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Abstract
Any significant chronic liver disease may render both women and men subfertile through a combination of pathogenic mechanisms. Most female patients with chronic HCV, however, will not develop end stage chronic liver disease during their fertile period. A recent study from Ireland followed up a group of 36 rhesus negative women infected with HCV type 1b following postnatal exposure to contaminated anti-D immunoglobulin.4 Over 20 years, despite the presence of biochemical abnormalities in 55% and liver fibrosis in 42%, there were a total of 100 pregnancies, with no difference in the incidence of spontaneous miscarriages, premature deliveries, and obstetric interventions compared with controls. None of the 53 HCV RNA positive women in a large Italian study,5 from whom biopsy specimens were taken either before or after pregnancy, was cirrhotic. Mild fibrosis was found in most of the patients, and bridging fibrosis was more commonly the result of HCV genotype 3a infection.5