Vertical transmission of hepatitis C virus infection: Usefulness of viremia detection in HIV-seronegative hepatitis C virus–seropositive mothers,☆☆,

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Abstract

Seventy mother-newborn pairs were studied for hepatitis C viremia to evaluate the risk of vertical transmission of hepatitis C virus from human immunodeficiency virus–negative mothers. Forty-five mothers were hepatitis C virus–RNA positive: 4 of 45 children were positive at birth and during follow-up. The level of viremia plays an important role in vertical transmission. (J Pediatr 1998;132:167-9)

Section snippets

Patients and Methods

Screening for anti-HCV antibodies was carried out in pregnant women admitted to three maternity wards over a 3-year period. Results in positive cases were confirmed by second generation recombinant immunoblotting assay and serum samples were stored for HCV-RNA determination. Women positive for hepatitis B virus and HIV infection were excluded from the study. The infants born to anti-HCV–positive women were enrolled in the study. Although maternal milk is known not to be a vehicle for HCV

Results

Seven thousand twenty-three pregnant women were screened for HCV antibodies: 82 were anti-HCV positive, yet HIV and HBV negative. Seventy consenting mother-infant pairs were enrolled in the study. All the newborn infants were anti-HCV positive at delivery and their RIBA antibody pattern was similar to that of their mothers. Ten children were lost at follow-up soon after enrollment, but 60 children were followed up for 12 months. Nine infants, HCV-RNA positive at birth, were followed up longer

Discussion

Vertical transmission of HCV infection from HIV-negative women occurs less frequently than from HIV-positive mothers.3, 4, 5, 6, 7, 8, 10, 12 Higher circulating HCV-RNA titers are closely related to the transmission.5, 6 Our results confirm that maternal viremia and the HCV-RNa titer are prerequisites for vertical transmission.

In our experience HCV transmission occurs in about 5.7% (4/70) of children born to anti-HCV–positive mothers. This risk exists only for children born to mothers showing

Acknowledgements

We are indebted to Dr. Thomas Wiley for carefully reading the manuscript.

References (12)

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From the Department of Infectious Diseases "G. Gaslini" Children's Hospital, the Department of Internal Medicine, University of Genova, the Department of Neonatology, San Martino Hospital, the Department of Pediatrics, Chiavari Hospital, and the Department of Neonatology, Galliera Hospital, Genoa, Italy.

☆☆

Reprint requests: R. Giacchino, MD, Department of Infectious Disease, “G. Gaslini” Children's Hospital, Largo G. Gaslini, 5, 16148 Genoa, Italy.

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