الفهرس 
Hepatitis C VirusOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus (HCV) infection is a major worldwide public health problem. The World Health Organization (WHO) estimates that 3% of the world’s population are chronically infected with HCV and that it accounts for around 20% of cases of acute hepatitis and 70% of cases of chronic hepatitis. Africa is reported to have the highest HCV prevalence rate.
The prevalence of HCV infection among women of child-bearing age in the United States is approximately 1% and is increased among pregnant women with specific risk factors. The prevalence of HCV infection in pregnant women with intravenous drug use reaches 70-95%.
The overall risk of infection with respect to perinatal transmission has not been fully elucidated, but studies suggest that in utero, peri-and post-natal transmission via close contact, saliva, and breast milk/breastfeeding are all possible. Most studies report a rate of vertical transmission of about 5% among HCV-RNA positive pregnant women.
Vertical transmission of the hepatitis C virus from mother to neonate occurs in 3-10% of pregnancies complicated by maternal HCV infection and is the leading cause of pediatric chronic HCV infection.
Vertical transmission of HCV is more common where the mother is co-infected with HIV, probably as a result of increased immuno-suppression, leading to high-titre HCV viraemia. While acute illness is usually mild, a high proportion of those infected will progress to chronic liver disease. Acute maternal infections which lead to general illness with high temperature can stimulate uterine activity, and cause loss of pregnancy.
Most of studies have been conducted in the Northern Hemisphere. In Africa, the vertical transmission of HCV was mainly investigated in Egypt and Morocco with rates of transmission from HCV-RNA positive mothers ranging from 0% to 36%. In west-central African countries, where HIV, hepatitis B virus (HBV), and HCV infections are endemic, one study conducted in Tanzania among 980 pregnant women has reported a seroprevalence of 5%. In this study, only one child was found to be HCV-RNA positive at 18 months of age.
The potential importance of HCV infection in Egypt has been noticed due to the increased prevalence of HCV antibody seropositivity in normal children attending rural primary schools (12 per cent), with a significantly higher prevalence (38 per cent) in children with schistosomal hepatic fibrosis.
In Egypt, there is a little information about the course of HCV during pregnancy and its vertical transmission.
The current work is a cross sectional study performed at Ain Shams Maternity University Hospital in Cairo, Egypt, to assess the seroprevalence rate of hepatitis C virus (HCV) among the pregnant females and their neonates. A total number of 210 pregnant women in the third trimester attending for labor full term, free from hepatic disease, jaundice and have a living baby were randomly selected. All patients were subjected to full history taking and complete general and obstetrical examinations.
A venous blood samples were collected from each woman of 3-4 ml blood. Cord blood samples were obtained immediately after birth from babies of the included mothers.
The collected venous blood samples were centrifuged; the resultant serum were stored at -20 °C until assayed collectively
The stored serum were analyzed for hepatitis-C antibody by ACON laboratory technique. The result were taken in the form of positive versus Negative.
The HCV One Step Test Device (Serum/Plasma) is a qualitative, membrane based immunoassay for the detection of antibody to HCV in serum or plasma. The membrane is coated with recombinant HCV antigen on the test line region of the device. During testing, the serum or plasma specimen reacts with the Protein A coated particles. The mixture migrates upward on the membrane chromatographically by capillary action to react with recombinant HCV antigen on the membrane and generate a alored line. Presence of this colored line indicates a positive just, while its absence indicates a negative result. To serve as a rocedural control, a colored line will always appear at the ontrol line region indicating that proper volume of specimen as been added and membrane wicking has occurred.
The results of the present work showed that the prevalence of HCV-Abs in the studied samples of the pregnant females were 8.1%. In all the HCV-Ab’s positive mothers the fetal outcome was favorable. All the neonates born to HCV-Ab’s positive mothers were negative for HCV-Abs at birth. Certain risk factors positively correlated with increased risk of HCV-infection, namely history of blood transfusion, previous operative interventions, previous dental procedures, unsafe injections using non-disposable syringes and high risk occupations.
In view of the results of the current work, the vertical transmission of HCV is not fully confirmed, further studies together with long term follow up of seropositive mothers and their neonates are recommended. HCV infection doesn’t increase the risk of obstetric complications. National health awareness, guidelines, control are the main items of the prophylactic programs against HCV. Cost benefit analysis of national screening program, for HCV infection must be considered and routine screening for HCV-Ab’s during antenatal care is recommended, we also recommend the implementation of the WHO and CDC guidelines for the prevention of occupational exposure to HCV virus and other blood borne viruses.