Article

When does mother to child transmission of hepatitis C virus occur?

Paediatric HIV Service, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.
Archives of Disease in Childhood - Fetal and Neonatal Edition (Impact Factor: 3.86). 04/2005; 90(2):F156-60. DOI: 10.1136/adc.2004.059436
Source: PubMed

ABSTRACT To investigate when hepatitis C virus (HCV) infection from mother to child occurs, and evaluate possible associated factors.
Prospective cohort study.
Fifty four HCV infected children tested within three days of birth and their mothers.
HCV RNA polymerase chain reaction (PCR) results.
Seventeen of the children (31%, 95% confidence interval 19% to 46%) 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 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).
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.

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Available from: Marie-Louise Newell, Jan 09, 2014
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    • "Currently, there is no effective way to prevent the transmission of HCV from mother to infant. It is not certain when during pregnancy and delivery HCV transmission occurs, however, one study suggested that 1/3 to 1/2 of infants acquiring HCV from their mothers were infected in utero.75 Although HCV RNA is detectable in maternal colostrum, viral transmission via breastfeeding has not been well documented. "
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    • "Maternal viremia represents the most important risk factor [15] even though the possible transmission from HCV-RNA negative mothers has been also reported in the literature [16] [17]. This might be attributed to the typical trend of chronic infections that may alternate blood clearance phases to viremic phases. "
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    ABSTRACT: Women with viral chronic hepatitis generally do quite well during pregnancy, providing that they have not progressed to decompensated cirrhosis. As a general rule, a stable liver equals a safe pregnancy. However, concern is about how pre-existing chronic liver disease may affect the pregnancy and the unborn baby. This review plans to answer some key questions regarding this issue in order to provide to healthcare professionals updated information of the current knowledge in this field. Besides, a synopsis of the following subject matters are reviewed, for instance, the main risk factors associated with vertical transmission of HBV and HCV in pregnant women chronically infected, the influence of pregnancy on HBV and HCV viral load and the effect of pregnancy on the clinical course of chronic hepatitis. Lastly, it is included a list of recommendations to decrease vertical transmission rates of chronic viral hepatitis as well as some information for the reproduction team.
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