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  • 1 Szent Ferenc Kórház Belgyógyászat Miskolc Csabai kapu 42. 3529
  • 2 Zala Megyei Kórház Belgyógyászat Zalaegerszeg
  • 3 Semmelweis Egyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Budapest
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Az antivirális kezelés időzítése nehéz feladat a fogamzóképes korú, hepatitis C-vírus által fertőzött nők esetében. Bár a női nem jobb prognosztikai faktor a betegség lefolyását illetően, az egyes esetek aktivitása és a fertőzöttségi periódus jelentősen különbözhet egymástól, ami befolyásolhatja a reproduktív korúakban a terápia időzítését. Terhesség, szoptatás alatt az antivirális kezelés szigorúan ellenjavallt. Az irodalmi adatok megoszlanak azon a téren, hogy a gyermeket tervezők kezelése a modern kezelési formákkal (peginterferon + ribavirin) a terhesség(ek) előtt vagy azt követően történjen-e meg. A szülés kapcsán a fertőzés anyáról gyermekre való átvitelének valószínűsége mintegy 5% körüli, amit a leginkább az anyai viraemia befolyásol. Nem szült nők és menopauza kapcsán a prognózis a C-vírus-hepatitis lefolyását illetően rosszabb. A magzati fejlettséget, a koraszülések arányát nagy betegszámú vizsgálatokban sem befolyásolta a hepatitis C-vírus-fertőzöttség. A kombinált kezelés több nőgyógyászati és egyéb mellékhatással is járhat (vérzészavarok, libidó csökkenése, depresszió). A leginkább az ajánlható, hogy egyedi mérlegeléssel döntsünk még nem szült hepatitis C-vírus-fertőzött, gyermeket akaró nőbetegeink antivirális kezelésének időpontjáról.

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