Hepatitis C virus load during pregnancy and puerperium.

Objective: To assess whether pregnancy and delivery influence serum levels of hepatitis C virus (HCV) in carrier mothers.
Design: A prospective study.
Setting: University department of obstetrics and gynaecology.
Participants: Ten pregnant HCV carriers (group A) and 8 nonpregnant HCV carriers (group B).
Methods: Serum samples were collected for group A at first and third trimesters, delivery, postpartum 1, 3, 6, 9 and 12 months, and at every three months for 1 year for group B.
Main Outcome Measures: Each serum sample was tested for serum alanine aminotransferase (ALT), anti-HCV titre and HCV-cDNA concentration by a competitive polymerase chain reaction (PCR) with a sensitivity of 250 copies/mL serum.
Results: In group A, the HCV levels remained unremarkably changed during pregnancy and delivery. However, all women had decreased HCV levels 1 and 3 months after delivery. Two women had undetectable serum HCV level postpartum and thereafter. Serum ALT values in 3 women were sporadically elevated, but did not correlate with decreased serum HCV levels. Anti-HCV titres remained unchanged during the study period. In two women from group B, the serum HCV levels were undetectable during follow up. Other 6 women showed fluctuations in the serum HCV levels but all were above 250 copies/mL. Serum ALT values were normal and anti-HCV titres remained stationary in all 8 nonpregnant carriers.
Conclusion: Serum HCV levels are decreased 1 and 3 months after delivery. This fact might suggest that puerperium is an optimal time for antiviral therapy in HCV carrier mothers.