Clinical symptoms of liver function disorders in pregnant women with HCV infection
DOI:
https://doi.org/10.15574/HW.2023.167.40Keywords:
viral hepatitis C, liver dysfunction, clinical symptoms, asthenic syndrome, dyspeptic syndromAbstract
Purpose - to analyze the clinical syndromes and symptoms of liver dysfunction in pregnant women with viral hepatitis C (HCV infection).
Materials and methods. A prospective analysis of clinical syndromes and symptoms of liver dysfunction in pregnant women with HCV infection was conducted. Diagnosis of chronic hepatitis C (HCV) in the reactivation phase (with the presence of a positive ELISA result for anti-HCV) - in 120 pregnant women, the main group (MG). The control group (CG) consisted of 40 healthy pregnant women. According to the materials of pregnancy histories of the Kyiv Municipal Center of Reproductive and Perinatal Medicine for the period 2018-2022. Statistical processing of research results was carried out using standard programs “Microsoft Excel 5.0” and “Statistica 8.0”.
Results. In the III trimester of pregnancy, pregnant women with HCV infection had significant differences in the astheno-vegetative syndrome, when compared with the healthy group, due to increased fatigue - 21 (17.5%) cases (p<0.001), sleep disturbances - 20 (16.7%) cases, drowsiness - 47 (39.2%) cases and difficulty falling asleep. Irritability was observed much more often in pregnant women with MG - 14 (11.7%) cases (p=0.033), headache in pregnant women with HCV infection was more often - 11 (9.2%) cases than in healthy pregnant women - 1 (2.5%) case, (p=0.033). Dyspepsia syndrome in the III trimester of pregnancy in MG was characterized by decreased appetite - 5 (4.2%) cases, (р=0.012), pain in the epigastrium and right hypochondrium - 21 (17.5%) cases, (р=0.001), as well as more frequent development of heartburn - 27 (22.5%) cases against 3 (7.55) cases in CG, (p<0.001). Itching of the skin was more typical for pregnant MG - 11 (10.8%) cases (p=0.009) than for healthy 1 (2.5%) cases. Skin rashes and dry skin have been reported.
Conclusions. Despite the absence of specific complaints and symptoms in pregnant women with HCV infection, the frequency of asthenic syndrome, manifested by weakness and increased fatigue, irritability, as well as dyspeptic phenomena represented by nausea, vomiting, heartburn, was significantly higher than in healthy pregnant women. Specific signs of liver damage, such as subicteric sclera, pain in the liver region, tenderness on palpation, skin itching due to intrahepatic cholestasis of pregnancy, were characteristic of pregnant women with HCV infection.
The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was adopted by the Local Moral Committee of the institution indicated in the work. Informed consent was obtained from the women for the study.
No conflict of interests was declared by the author.
References
Abdel-Wahab N, Talathi S, Lopez-Olivo MA, Suarez-Almazor ME. (2018). Risk of developing antiphospholipid antibodies following viral infection: a systematic review and meta-analysis. Lupus. 27 (4): 572-583. https://doi.org/10.1177/0961203317731532; PMid:28945149
Barritt AS, Jhaveri R. (2018). Treatment of Hepatitis C during Pregnancy-Weighing the Risks and Benefi tsin Contrast to HIV. Current HIV/AIDS reports. 15 (2): 155-161. https://doi.org/10.1007/s11904-018-0386-z; PMid:29470782
Chappell CA, Hillier SL, Crowe D, Meyn LA, Bogen DL, Krans EE. (2018). Hepatitis C Virus Screening Among Children Exposed During Pregnancy. Pediatrics. 141 (6): e20173273. https://doi.org/10.1542/peds.2017-3273; PMid:29720535 PMCid:PMC5984711
Chilaka VN, Konje JC. (2021). Viral Hepatitis in pregnancy. European journal of obstetrics, gynecology, and reproductive biology. 256: 287-296. https://doi.org/10.1016/j.ejogrb.2020.11.052; PMid:33259998
Compagnone A, Catenazzi P, Riccardi R, Zuppa AA. (2019). Mother-to-child transmission of hepatitis C virus. Minerva pediatrica. 71 (2): 174-180. https://doi.org/10.23736/S0026-4946.18.04898-3; PMid:29968442
Dibba P, Cholankeril R, Li AA, Patel M et al. (2018). Hepatitis C in Pregnancy. Diseases (Basel, Switzerland). 6 (2): 31. https://doi.org/10.3390/diseases6020031; PMid:29702563 PMCid:PMC6023348
El-Shabrawi M, Kamal NM, Mogahed EA, Elhusseini MA, Aljabri MF. (2019). Perinatal transmission of hepatitis C virus: an update. Archives of medical science: AMS. 16 (6): 1360-1369. https://doi.org/10.5114/aoms.2019.83644; PMid:33224335 PMCid:PMC7667440
Epstein RL, Sabharwal V, Wachman EM, Saia KA, Vellozzi C, Hariri S, Linas BP. (2018). Perinatal Transmission of Hepatitis C Virus: Defining the Cascade of Care. The Journal of pediatrics. 203: 34-40.e1. https://doi.org/10.1016/j.jpeds.2018.07.006; PMid:30170857 PMCid:PMC6252153
Freriksen J, van Seyen M, Judd A, Gibb DM, Collins IJ, Greupink R, Russel F, Drenth J, Colbers, A, Burger DM. (2019). Review article: direct-acting antivirals for the treatment of HCV during pregnancy and lactation - implications for maternal dosing, foetal exposure, and safety for mother and child. Alimentary pharmacology & therapeutics. 50 (7): 738-750. https://doi.org/10.1111/apt.15476; PMid:31448450 PMCid:PMC6773363
García-Romero CS, Guzman C, Cervantes A, Cerbón M. (2019). Liver disease in pregnancy: Medical aspects and their implications for mother and child. Annals of hepatology. 18 (4): 553-562. https://doi.org/10.1016/j.aohep.2019.04.009; PMid:31126882
Gowda C, Smith S, Crim L, Moyer K, Sánchez PJ, Honegger JR. (2021). Nucleic Acid Testing for Diagnosis of Perinatally Acquired Hepatitis C Virus Infection in Early Infancy. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 73 (9): e3340-e3346. https://doi.org/10.1093/cid/ciaa949; PMid:32640018 PMCid:PMC8563185
Huang QT, Hang LL, Zhong M, Gao YF, Luo ML, Yu YH. (2016). Maternal HCV infection is associated with intrauterine fetal growth disturbance: a meta-analysis of observational studies. Medicine. 95: 35. https://doi.org/10.1097/MD.0000000000004777; PMid:27583932 PMCid:PMC5008616
Mintser AP. (2018). Statisticheskie metodyi issledovaniya v klinicheskoy meditsine. Prakticheskaya meditsina. 3: 41-45.
Public Health Center. (2018). Hepatitis C in Ukraine: epidemiological characteristics and severity assessment.
Ragusa R, Corsaro LS, Frazzetto E, Bertino E, Bellia MA, Bertino G. (2020). Hepatitis C Virus Infection in Children and Pregnant Women: An Updated Review of the Literature on Screening and Treatments. AJP reports. 10 (1): e121-e127. https://doi.org/10.1055/s-0040-1709185; PMid:32257593 PMCid:PMC7108952
Rahim MN, Pirani T, Williamson C, Heneghan MA. (2021). Management of pregnancy in women with cirrhosis. United European gastroenterology journal. 9 (1): 110-119. https://doi.org/10.1177/2050640620977034; PMid:33259738 PMCid:PMC8259114
Razavi H. (2020). Global epidemiology of viral hepatitis. Gastroenterology Clinics. 49 (2): 179-189. https://doi.org/10.1016/j.gtc.2020.01.001; PMid:32389357
Roudot-Thoraval F. (2021). Epidemiology of hepatitis C virus infection. Clinics and research in hepatology and gastroenterology. 45 (3): 101596. https://doi.org/10.1016/j.clinre.2020.101596; PMid:33610022
World Health Organization. (2017). Global hepatitis report 2017: World Health Organization.
Zhang Y, Chen J, Liao T, Chen S, Yan J, Lin X. (2020). Maternal HBsAg carriers and pregnancy outcomes: a retrospective cohort analysis of 85,190 pregnancies. BMC Pregnancy and Childbirth. 20: 1-9. https://doi.org/10.1186/s12884-020-03257-4; PMid:33238912 PMCid:PMC7687687
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Ukrainian Journal Health of Woman
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.