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Mother to Child HCV Transmission Studied

March 16, 2005

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The article mentions the incidence of mother to child transmission is very low. Of those infected, fully one third contracted the disease in utero. It seems these were mostly genotype 1. Clearly more study is recommended.

When Does Mother-to-Child Transmission of Hepatitis C Virus Occur?

The rate of HCV transmission from mother to child is generally though to be very rare. However, it does occur, however rarely. The aim of the present prospective cohort study was to investigate when hepatitis C virus (HCV) infection from mother to child occurs, and to evaluate possible associated factors.

Fifty-four HCV positive children and their mothers were tested within three days of birth. The main outcome measure of the study was HCV RNA polymerase chain reaction (PCR) results.

Results

Seventeen of the children (31%) were positive in the first 3 days of life and could be assumed to have acquired infection in utero.

Testing PCR positive was not associated with sex (53% v 49% boys; p=0.77) or mode of delivery (29% elective caesarean section in both groups; p=0.98).

Children with evidence of intrauterine infection were significantly more likely to be of lower birth weight and infected with genotype 1 (58% v 12%, p=0.01).

Although a higher proportion of infants born to HCV/HIV co-infected women were HCV PCR positive in the first 3 days of life, this difference did not reach statistical significance.

Excluding infants born to co-infected women did not affect the results.

Thirty seven of the children (68%) were negative in the first 3 days of life, 27 of whom were positive when tested again at 3 months, and nine were first PCR positive after 3 months (one child had no further tests).

Conclusions

The authors conclude, “These results suggest that at least one third and up to a half of infected children acquired infection in utero. Although postpartum transmission cannot be excluded, these data suggest that it is rare. The role of HCV genotypes in the timing and mechanism of infection should be explored further.”

Paediatric HIV Service, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.

03/16/05

References
J Mok and others (for the European Paediatric Hepatitis C Virus Network). When does mother to child transmission of hepatitis C virus occur? Arch Dis Child Fetal Neonatal Ed 90(2): F156-160. March 2005.

Posted by Ralph at March 16, 2005 11:56 AM