ABSTRACT
This study focused on seroprevalence of HCV at ceratin urban [El-Mansoura and Benha cities] and rural [Bilqas and Kafr Shokr] areas, and on assessment of risk factors for HCV infection. The study was conducted on 500 pregnant women [as a study group] at their last trimester and 12[non pregnant women [as a reference group]. The overall seroprevalence rate was 20% with more frequency in rural [24.1%]. The work also demonstrated an increase in the incidence of seropositivity to HCV-Ab in multigravida [28.2%] than in primigravida [15.1%]. The correlation between seropositivity and different risk factors show variable degree of incidence listed in the tables. Ortho HCV ELISA second generation test system was used for all cases and some selected cases with elevated ALT level [45 cases], were subjected to polymerase chain reaction [PCR] for detection of the viral genome in the serum. Although HCV antibody test in pregnant group was high [22%], elevated ALT level was found in only 40% of them, despite its use as a surrogate marker for HCV infection. This finding confirms the superiority of specific HCV antibodies tests in demonstrating HCV infection. PCR was positive in 35.6% of HCV antibodies reactive cases and in 3.2% of all tested pregnant cases. This study demonstrated the significance of the parentral route as a main route of HCV infection and stressed on the importance of surgery [gynecological/obstetrical or general] as a risk factor for HCV infection. Also, the study raised the possibility that multiparity and repeated deliveries carry more risk for HCV infection. Because of the high seroprevalence rate of HCV in the present study [overall 20%], we recommend doing routine screening for HCV infection among the pregnant women and to pay more attention for preventive and control measures especially in rural areas, because risk factors such as blood transfusion and increased parity play a more important role in rural area than that in urban ones. Further studies are needed to clarify the true incidence of materno-fetal transmission as this will affect the clinical management of such cases and their neonates