Decrease in serum ALT and increase in serum HCV RNA during pregnancy in women with chronic hepatitis C
Section snippets
Patients and Methods
Between 1992 and 1997, 26 women with a monofetal pregnancy and chronic hepatitis C were followed in two liver units (21 in Hôpital Beaujon, Clichy, and 5 in Hôpital Trousseau, Tours). All patients were anti-HCV positive (ELISA and RIBA, Ortho Diagnostic Systems, Roissy, France) and were serum HCV RNA positive (Amplicor, Roche, Neuilly sur Seine, France). Thirteen of the 26 women had histologically proven hepatitis on liver biopsy performed within 2 months to 2 years before the onset of
Results
The clinical characteristics of the pregnant and the non-pregnant women were similar: median age 33 years (range: 24 to 44 years) in pregnant women versus 34 years (range: 24 to 42 years) in non-pregnant women; duration of infection was 10 years in both groups (Table 1). Pregnancies reached a mean term of 39 weeks (33 to 42 weeks). Serum HCV RNA was not detectable by PCR in any children 1 year after birth.
Discussion
This study evaluated the changes in serum ALT and serum HCV RNA levels during pregnancy in women with chronic hepatitis C. There was a frequent decrease, and even normalization, of serum ALT levels during the second and the third trimesters of pregnancy (77% of the pregnancies studied). As serum ALT decreased, the viral load increased during pregnancy, and this phenomenon reached a peak in the third trimester of pregnancy. Within the 3 months after delivery, serum ALT levels increased again and
Acknowledgements
We thank Dr Marie-Claude Bréchot (Laboratoire de Biochimie, Hôpital Trousseau, Tours, France) and Véronique Lebreton (INSERM U481, Hôpital Beaujon Clichy, France) for their technical assistance.
Grant support: this study was supported by a grant from the Association Recherche et Partage.
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