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Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
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Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
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The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
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Hepatitis C in Pregnancy.

Pratima Dibba1, Rosann Cholankeril2, Andrew A Li3

  • 1Department of Gastroenterology, Women & Infants Hospital/Warren Alpert School of Medicine, Brown University, Providence, RI 02905, USA. pratima_dibba@brown.edu.

Diseases (Basel, Switzerland)
|April 28, 2018
PubMed
Summary

Hepatitis C in pregnancy, affecting up to 3.6%, poses risks to mothers and infants. Vertical transmission is low, but risks increase with HIV co-infection or high viral load, impacting infant long-term health.

Keywords:
hepatitis C virus infectionpregnancy

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Maternal-Fetal Medicine

Background:

  • Hepatitis C virus (HCV) affects pregnant individuals, with prevalence up to 3.6% in some cohorts.
  • Vertical transmission rates of HCV range from 0.2% to 0.4% in the US and Europe.
  • HCV in pregnancy is linked to adverse maternal and neonatal outcomes, including potential long-term infant complications like cirrhosis and cancer.

Purpose of the Study:

  • To review the implications of Hepatitis C virus (HCV) infection during pregnancy.
  • To understand the risks and outcomes associated with vertical transmission of HCV.
  • To discuss diagnostic methods and infant follow-up for HCV in the context of pregnancy.

Main Methods:

  • Literature review of studies on Hepatitis C prevalence in pregnancy.
  • Analysis of data on vertical transmission rates and risk factors.
  • Summary of diagnostic criteria and infant testing protocols for HCV.

Main Results:

  • HCV screening is not universally recommended but understanding its impact is crucial due to associated adverse outcomes.
  • Increased risk of vertical transmission is observed with Human Immunodeficiency Virus (HIV) co-infection and high maternal HCV viral load.
  • Certain intrapartum events like premature rupture of membranes and invasive procedures may elevate transmission risk, while breastfeeding does not.

Conclusions:

  • Hepatitis C in pregnancy necessitates careful management due to potential adverse maternal and neonatal outcomes.
  • Infants born to HCV-positive mothers require specific testing protocols for HCV RNA.
  • While prevention is challenging, future therapeutic strategies involving direct-acting antivirals may offer improved management options.