title: Variation of transaminases, HCV-RNA levels and Th1/Th2 cytokine production during the post-partum period in pregnant women with chronic hepatitis C.
abstract: This study analyses the evolution of liver disease in women with chronic hepatitis C during the third trimester of pregnancy and the post-partum period, as a natural model of immune modulation and reconstitution. Of the 122 mothers recruited to this study, 89 were HCV-RNA+ve/HIV-ve and 33 were HCV-RNA-ve/HIV-ve/HCVantibody+ve and all were tested during the third trimester of pregnancy, at delivery and post-delivery. The HCV-RNA+ve mothers were categorized as either Type-A (66%), with an increase in ALT levels in the post-partum period (>40 U/L; P<0.001) or as Type-B (34%), with no variation in ALT values. The Type-A mothers also presented a significant decrease in serum HCV-RNA levels in the post-delivery period (P<0.001) and this event was concomitant with an increase in Th1 cytokine levels (INFγ, P = 0.04; IL12, P = 0.01 and IL2, P = 0.01). On the other hand, the Type-B mothers and the HCV-RNA-ve women presented no variations in either of these parameters. However, they did present higher Th1 cytokine levels in the partum period (INFγ and IL2, P<0.05) than both the Type-A and the HCV-RNA-ve women. Cytokine levels at the moment of delivery do not constitute a risk factor associated with HCV vertical transmission. It is concluded that differences in the ALT and HCV-RNA values observed in HCV-RNA+ve women in the postpartum period might be due to different ratios of Th1 cytokine production. In the Type-B women, the high partum levels of Th1 cytokines and the absence of post-partum variation in ALT and HCV-RNA levels may be related to permanent Th1 cytokine stimulation.
authors.affiliation: Paediatric Unit, San Cecilio University Hospital, Granada, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Ciberehd, Granada, Spain ; Paediatric Unit, Granada University, Granada, Spain.
authors.forename: Angeles
authors.initials: A
authors.lastname: Ruiz-Extremera
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Muñoz-Gámez
authors.forename: Ana
authors.initials: A
authors.lastname: Abril-Molina
authors.forename: María Angustias
authors.initials: MA
authors.lastname: Salmerón-Ruiz
authors.forename: Paloma
authors.initials: P
authors.lastname: Muñoz-de-Rueda
authors.forename: Esther José
authors.initials: EJ
authors.lastname: Pavón-Castillero
authors.forename: Rosa
authors.initials: R
authors.lastname: Quiles-Pérez
authors.forename: Angel
authors.initials: A
authors.lastname: Carazo
authors.forename: Ana
authors.initials: A
authors.lastname: Gila
authors.forename: Sergio Manuel
authors.initials: SM
authors.lastname: Jimenez-Ruiz
authors.forename: Jorge
authors.initials: J
authors.lastname: Casado
authors.forename: Ana Belén
authors.initials: AB
authors.lastname: Martín
authors.forename: Laura
authors.initials: L
authors.lastname: Sanjuán-Núñez
authors.forename: Esther
authors.initials: E
authors.lastname: Ocete-Hita
authors.forename: Julián López
authors.initials: JL
authors.lastname: Viota
authors.forename: Josefa
authors.initials: J
authors.lastname: León
authors.forename: Javier
authors.initials: J
authors.lastname: Salmerón
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000235:genetics / Q000378:metabolism*; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000276:immunology / Q000821:virology*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D049590:Postpartum Period; D011247:Pregnancy; D012367:RNA, Viral / Q000235:genetics*; D058408:Th1-Th2 Balance; D000095022:Interferon Lambda
chemical_list: D000410:Alanine Transaminase; D007372:Interferons; D007378:Interleukins; D012367:RNA, Viral; C000624353:interferon-lambda, human; D000095022:Interferon Lambda