임신 여성에서 C형 간염의 유병률과 수직 감염
Prevalence of HCV infection in pregnant women and vertical transmission
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목적 : 한국 임신 여성에서 HCV 유병률 및 수직 감염률에 대한 보고가 미비하였다. 이에 저자들은 임신여성에서의 C형 간염의 유병률과 산모에서 아기로의 수직 감염률을 조사하여, C형 간염에 대한 산전 검사의 필요성과 추후 아기에서의 추적 관찰의 필요성을 알아보고자 본 연구를 시행하였다. 연구 방법 : 2000년 1월부터 2003년 10월까지 본원에서 분만한 산모 총 21,639명을 대상으로 HbsAg, HbsAb, anti-HCV, HIV를 검사하였고, HCV가 양성으로 나오면 RT-PCR을 이용하여 HCV RNA 검사를 시행하였다. Anti-HCV가 양성인 산모에서 태어난 아기들 중 38명이 검사를 하였고, 이중 anti-HCV양성인 아기에서는 PCR로 HCV RNA 검사를 시행하였다. 결과 : 총 21,639건의 분만 중에서 90명 (0.42%)의 산모에서 anti-HCV 양성이었고, 이들 90명의 산모 중 51명 (57%)이 HCV RNA 양성이었다. Anti-HCV가 양성인 산모에서 태어난 아기들 중 검사를 시행한 38명에서 10명 (26.3%)이 anti-HCV 양성이었고, 10명 중 6명에서 시행한 HCV RNA 검사는 모두 음성이었다. 결론 : 본원에서 분만한 산모에서의 anti-HCV 유병률은, 한국의 젊은 성인 남성 유병률 (0.18%)에 비해서는 높은 편이지만, 전세계적인 유병률과는 비슷하다. 모체가 HCV RNA 양성일 때 아기의 anti-HCV 양성률이 증가하였으나, HCV RNA가 양성인 경우는 단 한 경우도 없었으며, 이로써 HCV가 감염되는 경로 중 모체로부터의 감염 경로는 거의 무시해도 될 정도이다. 또한 임신 여성에서 HCV에 대한 산전 검사는 통상적으로 이루어져야 할 것이다.
Abstract
Objective : The HCV seroprevalence rate and the vertical transmission rate in Korean pregnancy women have not been determined until now. The purpose of this study is to estimate the prevalence of anti- HCV in pregnant women and vertical transmission rate to assess the role of antenatal screening of HCV and the necessity of following babies from anti-HCV positive mothers. Methods : We reviewed the medical records of 21,639 patients who delivered at Ilsin Christian hospital from January 2000 to October 2003. The HbsAg, HbsAb, anti-HCV, HIV test were performed in their 1st trimester of pregnancy and the HCV RNA test was performed by RT-PCR in samples positive for anti-HCV. 38 babies born to anti-HCV positive mothers were tested for anti-HCV and those who were positive anti-HCV were also tested for HCV RNA by PCR. Results : The positive rate of anti-HCV in pregnant women was 0.42% (90/21,639) and that of HCV RNA was 57% (51/90). The positive rate of anti-HCV was 26.3% (10/38) and the result of HCV RNA test was all negative in babies whose mothes were positive for anti-HCV. Conclusion : The prevalence of anti-HCV in pregnant women who delivered at our hospital seems to be higher than that in the Korean young adult man and it is similar with the whole world prevalence rate. The prevalence of anti-HCV of babies born to HCV PCR positive mothers was higher than that born to HCV PCR negative mothers. None of anti-HCV positive babies was HCV RNA positive. With this, we conclude that the vertical transmission as the transmission route of HCV infection is negligible but routine screening for HCV is acceptable to pregnant women.
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