| BMJ 1998 Aug 15;317(7156):437-441
Mother to child transmission of hepatitis C virus:
prospective study of risk factors and timing of infection in children
born to women seronegative for HIV-1.
Resti M, Azzari C, Mannelli F, Moriondo M, Novembre E, de Martino
M, Vierucci A
Department of Paediatrics, University of Florence, 50132 Florence,
Italy.
Objective:
To determine the risk factors for and timing of vertical transmission
of hepatitis C virus in women who are not infected with HIV-1.
Design:
Follow up for a median of 28 (range 24-38) months of babies born
to women with antibodies to hepatitis C virus but not HIV-1. Subjects:
442 mothers and babies, of whom 403 completed the study.
Main outcome measures: Presence of antibodies to hepatitis C virus
and viral RNA and alanine aminotransferase activity in babies. Presence
of viral RNA, method of infection with hepatitis C, method of delivery,
and type of infant feeding in mothers.
Results:
13 of the 403 children had acquired hepatitis C virus infection
at the end of follow up. All these children were born to women positive
for hepatitis C virus RNA; none of the 128 RNA negative mothers
passed on the infection (difference 5%, 95% confidence interval
2% to 7%). 6 children had viral RNA immediately after birth. 111
women had used intravenous drugs and 20 had received blood transfusions.
11 of the infected children were born to these women compared with
2 to the 144 with no known risk factor (difference 7%, 2% to 12%).
Conclusions:
This study suggests that in women not infected with HIV only those
with hepatitis C virus RNA are at risk of infecting their babies.
Transmission does seem to occur in utero, and the rate of transmission
is higher in women who have had blood transfusions or used intravenous
drugs than in women with no known risk factor for infection.
PMID: 9703524
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