[A survey of the current status of research on the diagnosis and treatment of hepatitis C virus antibody-positive pregnant women].

Objective: To analyze the screening, diagnosis, epidemiology, pregnancy outcomes and treatment status in hepatitis C virus antibody-positive pregnant women, in order to provide clinical evidence for further improving prevention and control of maternal and infant safety. Methods: Data of 246 HCV antibody-positive pregnant women admitted to the Second Hospital of Nanjing from January 2014 to December 2019 were analyzed by epidemiological survey research method. Statistical analysis was performed according to different data using t-test, χ2 test, corrected χ2 test or Fisher's exact test. Results: 80 of 246 HCV antibody-positive women had confirmed infection before pregnancy. Of these, 85% were HCV RNA positive, and 16 became pregnant after antiviral therapy. Prenatal examination during pregnancy found that 166 cases were HCV RNA positive, and the HCV RNA positive rate was 81.93%. In the relationship between infection route and birth cohort in HCV antibody-positive pregnant women, there was a statistically significant differences in the proportions of transmission route among birth cohort (χ2=115.6, P＜0.001). With the delay of birth cohort, the proportion of infection through drug use was decreased (P＜0.001), while the proportion of acupuncture-associated infection (P=0.043) and infant hospitalization history were increased (P=0.005). Among pregnancy complications, HCV antibody-positive pregnant women in HCV RNA＜5.0 E+02 IU/ml and ≥5.0 E+02 IU/ml groups had intrahepatic cholestasis of pregnancy (χ2=4.73, P=0.030) and gestational hypertension (χ2=8.65, P=0.003), and the difference in incidence was statistically significant. Postpartum treatment strategy data analysis showed that the treatment rate was highest in the first year of postpartum, and then showed an upward trend year by year, with a statistically significant difference (χ2=17.26,P =0.004). Conclusion: Anti-HCV screening rates are lower among pregnant and reproductive age women. HCV screening should be used as an important supplementary means to strengthen maternal safety and health education management during pregnancy. Active postpartum antiviral therapy, with particularly emphasis on management within the first year after delivery, can significantly improve the treatment rate among women of child bearing age.目的： 通过分析丙型肝炎病毒（HCV）抗体（抗-HCV）阳性孕妇的筛查、诊断、流行病学、妊娠结局和治疗现状，为进一步提升丙型肝炎防控及母婴安全提供临床依据。 方法： 采用流行病学调查研究方法，分析南京市第二医院2014年1月至2019年12月收治的246例抗-HCV阳性孕妇资料。据资料不同采用t检验、χ2检验、校正χ2检验或Fisher确切概率法进行统计学分析。 结果： 246例抗-HCV阳性妇女孕前已明确感染者80例，其中HCV RNA阳性率85%，但进行抗病毒治疗后妊娠者仅16例；通过妊娠期产检发现HCV RNA阳性166例，HCV RNA阳性率为81.93%。感染途径与出生队列的关系中，各段出生队列抗-HCV阳性孕妇传播途径构成比差异有统计学意义（χ2=115.6，P<0.001）；随着出生队列的后延，经吸毒感染构成比降低（P<0.001），针刺感染（P=0.043）、婴幼儿期住院史的构成比升高（P=0.005）。抗-HCV阳性孕妇的妊娠期并发症情况中，HCV RNA＜5.0 E+02 IU/ml与≥5.0 E+02 IU/ml组比较显示妊娠肝内胆汁淤积症（χ2=4.73，P=0.030）、妊娠高血压疾病（χ2=8.65，P=0.003）的发生率差异有统计学意义。产后治疗策略的数据分析显示产后第1年治疗率最高，并逐年呈上升趋势，差异有统计学意义（χ2=17.26，P=0.004）。 结论： 育龄期备孕妇女进行抗-HCV筛查率较低，孕期HCV筛查应作为重要的补充，加强孕产妇的安全管理和健康教育，积极开展产妇产后抗病毒治疗，尤其重视产后1年内的管理，能显著提高育龄女性患者的治疗率。.