Hepatitis
C virus (HCV) infection in children is mainly acquired via mother-to-child
(perinatal) transmission. In a study published in the August 20,2007 issue
of AIDS, French researchers sought to identify risk factors for mother-to-child
HCV transmission, in particular those associated with maternal virological characteristics
or mode of delivery.
The
investigators included 214 HCV positive women and their newborn infants seen at
6 hospitals in southern France between October 1998 and September 2002. About
one-quarter (55%) of the women were HIV-HCV
coinfected. The authors collected data on maternal characteristics, circumstances
of delivery, and laboratory data for the mothers and children. All babies were
followed for 1 year, and those with detectable plasma HCV RNA for 2 years.
Results
•
In total,
12 infants had detectable HCV RNA at 1 year of age, yielding an overall mother-to-child
transmission rate of 5.6%.
•
3
of these children became HCV RNA negative between 12 and 18 months of age and
achieved normal alanine aminotransferase (ALT) levels.
•
137
women (69%) had detectable plasma HCV RNA, including all those whose children
were infected.
•
6
children were born to HIV-HCV coinfected women with detectable HCV RNA, for a
transmission rate of 13.6%.
•
6
were born to HCV monoinfected women with detectable HCV RNA, for a transmission
rate of 6.5%.
•
The
risk of mother-to-child HCV transmission was 3 times higher for HCV-HIV coinfected
women compared to those with HCV alone (P = 0.05).
•
When
maternal HCV RNA levels were below 6 log IU/ml, the rate of transmission was significantly
higher in HIV-HCV coinfected women (odds ratio 8.3; P = 0.01.
•
This
association with HIV status did not exist, however, for women with detectable
HCV RNA levels of 6 log IU/ml or higher.
•
The
rate of HCV transmission did not differ significantly between children born by
vaginal delivery or Caesarean section after membrane rupture and those born by
elective Caesarean section, independent of HIV status.
Conclusion
These
findings confirm results of past studies showing that HIV-HCV coinfected women
are more likely to transmit HCV to their babies than those with HCV alone. The
study also confirmed that HCV viral load plays an important role in mother-to-child
transmission/
Department
of Public Health, France; CHU Nice, France; CHU Toulouse, France; CHU Montpellier,
France; CHG Antibes, France; Virology Laboratory, France; INSERM U379, France.
08/21/07
Reference E
Marine-Barjoan, A Berrebi, V Giordanengo, and others (for the ALHICE study group).
HCV/HIV co-infection, HCV viral load and mode of delivery: risk factors for mother-to-child
transmission of hepatitis C virus? AIDS 21(13): 1811-1815. August 20, 2007.
