Vertical transmission of hepatitis C virus infection: Usefulness of viremia detection in HIV-seronegative hepatitis C virus–seropositive mothers☆,☆☆,★
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.
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Cited by (47)
No. 96-The Reproductive Care of Women Living With Hepatitis C Infection
2017, Journal of Obstetrics and Gynaecology CanadaLow mother-to-child-transmission rate of Hepatitis C virus in cART treated HIV-1 infected mothers
2015, Journal of Clinical VirologyCitation Excerpt :The median plasma HCV-RNA was 3.5 × 105 veq/ml (IQR 9.6 × 104, 1.5 × 106 veq/ml). Other studies reporting data on HCV-RNA during pregnancy show that HCV-transmitting mothers have a mean HCV-RNA of >106.2 veq/ml or higher, compared to mean HCV-RNA levels of <106.2 veq/ml in non-transmitting mothers [1,3,5,14]. The one HCV transmitting mother in our cohort only transmitted to her first infant when she had her highest plasma HCV-RNA of 4.6 × 106 veq/ml and lowest CD4+cell count of 160 cells/μl.
HEPATITIS C VIRUS
2009, Feigin and Cherry's Textbook of Pediatric Infectious Diseases, Sixth EditionDiscordant outcome of perinatal transmission of hepatitis C in twin pregnancies
2007, Journal of Clinical VirologyCitation Excerpt :Vertical transmission of hepatitis C virus (HCV) from HCV-only infected mothers to their babies occurs in 4–10% of pregnancies and is associated with high maternal viraemia with levels >106 genome copies/ml more likely to transmit virus (Dal Molin et al., 2002; European Paediatric HCV Network, 2001; Giacchino et al., 1998; Gibb et al., 2000; Granovsky et al., 1998; Lin et al., 1994; Matsubara et al., 1995; Resti et al., 1998; Steininger et al., 2003; Thomas et al., 1998; Tova et al., 1997; Zanetti et al., 1998).
Pregnancy outcome following infections by coxsackie, echo, measles, mumps, hepatitis, polio and encephalitis viruses
2006, Reproductive ToxicologyHepatitis
2006, Infectious Diseases of the Fetus and Newborn Infant
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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.
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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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