Up to 80% of patients infected with the hepatitis C virus (HCV) develop chronic hepatitis, making hepatitis C the most common cause
of chronic hepatitis HCV infection is acquired most commonly by exposure to infected blood. Pregnant women with chronic hepatitis
C are generally asymptomatic during pregnancy, although they are at increased risk for gestational diabetes, cholestasis, and
preterm delivery Patients with chronic HCV infection are also at .risk for cirrhosis. Acute viral hepatitis can be life threatening,
especially in a patient with pre-existing chronic viral hepatitis Therefore, all patients with chronic HCV should be immunized against
hepatitis A and B if they are not already immune. The inactivated (killed) hepatitis A and B vaccines are both safe to administer
during pregnancy
(Choice A) Breastfeeding does not increase the risk of HCV transmission to the neonate. The American College of Obstetricians and
Gynecologists and the American Academy of Pediatrics support routine breastfeeding by HGV-infected mothers. Breastfeeding
should be suspended only if the nipple area is actively bleeding
(Choice B) A combination of interferon-a and ribavirin is used tow the treatment of nonpregnant patients with chronic hepatitis C and
compensated liver disease. However, ribavirin is highly teratogenic, and there is insufficient data to determine the safety of interferona during pregnancy
(Choice D) The incidence of vertical transmission of HCV is -2%-5%. Factors which increase the overall risk of vertical transmission
are HIV co-infection and a high HCV viral load. A cesarean delivery does not decrease the risk of vertical transmission, likely because
most vertical transmission occurs in the late third trimester prior to delivery
(Choice E) Risk factors for sexual transmission include practices that increase risk for microtrauma and blood exposure (eg, men
who have sex with men, multiple partners, HIV co-infection). However, barrier precautions are not necessary for monogamous
serodiscordant couples as the risk for sexually-transmitted HCV infection is <0.1 % in this population.
Educational objective:
The incidence of vertical transmission of HCV infection is -2%-5%. All patients with chronic hepatitis C infection, including pregnant
women, shou_ld be immunized against hepatitis A and B if they are not already immune
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