The influence of hepatitis B virus (HBV) or hepatitis C virus (HCV) infections on the pregnancy course.

OBJECTIVES: The incidence of HBV infections among the pregnant in Europe falls within the range of 1-7%, whereas it is 1.7-4.3% for HCV. The aim was to assess the course of pregnancy among women infected with HBV or HCV, and the condition of neonates in the fifth minute after the birth. MATERIAL AND METHODS: The study included 157 pregnant individuals infected with HBV, 53 infected with HCV, and 330 healthy pregnant women. None of the women infected with HBV and HCV as well as from the control group were infected with HIV, and none of them took intoxicants. RESULTS: Weight of neonates delivered by healthy women was higher as compared with children born by women infected with HBV or HCV (3.517 vs 3.347 and 3.366). The Apgar score of neonates delivered by women with HBV and HCV infections was lower as compared with the children born by healthy women (9.4 vs 9.3 vs 9.7; p < 0.05). Premature births occurred more often in HBV and HCV-infected women than in the control group (14.6% and 24.5% vs 6.96%; p < 0.05). Miscarriages were significantly more common among the patients with HCV infections as compared with the patients who were healthy (9.4% vs 1.8%; p < 0.05). In comparison with the healthy individuals, this group of patients experienced pruritus (10.5% vs 4.2%; p < 0.05), oedemas (9.4% vs 2.4%; p < 0.05), and hypertension (9.4% vs 1.5%; p < 0.05) more often. An increase in HBV loads was observed between the 6th and 28th-32nd week of pregnancy among the infected with HBV, and then, a decrease was observed in the 6th months after the delivery. CONCLUSIONS: The women infected with HBV without HBsAg (-) and the infected with HCV are subject to common incidence of premature births. Women infected with HCV often experience oedemas, hypertension, and pruritus.

Antiviral therapy of chronic HBV infection in pregnancy.

We describe a 27-year-old hepatitis B virus (HBV)-infected pregnant woman, with a history of miscarriage a year ago. The patient has been HBsAg and HBeAg positive for 20 years but has never been treated for HBV infection, because of stable elevated alanine aminotransferase (ALT) activity and high viral load. Treatment with tenofovir disoproxil was introduced in the 10th week of pregnancy and HBV DNA became undetectable. The clinical course of pregnancy was normal and the patient gave birth by caesarean section to a healthy child. At birth the newborn was HBsAg negative, after 3 months of follow-up is healthy, and evaluation of HBV status will be scheduled shortly. The decision to treat HBV infection during pregnancy should be individualized.