Maternal Drug Use Is a Preeminent Risk Factor for Mother‐to‐Child Hepatitis C Virus Transmission: Results from a Multicenter Study of 1372 Mother‐Infant Pairs

Resti, Massimo; Azzari, Chiara; Galli, Luisa; Decorti, Giuliana; Giacchino, Raffaella; Bortolotti, Flavia; Marcellini, Matilde; Moriondo, Maria; Martino, Maurizio de; Vierucci, A

doi:10.1086/339013

Cited by 122 publications

(104 citation statements)

References 30 publications

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“…All but 1 infant were born to women with detectable serum HCV RNA, and in this study maternal injection drug use, not maternal HIV positivity, was most closely associated with HCV transmission. 25 Rate of HCV transmission was not statistically different in women having Cesarean section as opposed to vaginal delivery; however, the rate of elective Cesarean in women not co-infected with HIV was very low.…”

Section: Risk Of Spread Of Hcv Infection From Mother-to-childmentioning

confidence: 82%

Maternal-infant transmission of hepatitis C virus infection

2002

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Mother-to-infant transmission of hepatitis C virus (HCV) is comparatively uncommon. The prevalence of antibody to HCV (anti-HCV) in pregnant women is 0.1% to 2.4%, although in some endemic areas it is much higher. The proportion of women with anti-HCV who have active infection with viremia is 60% to 70%. Transmission of HCV occurs only when serum HCV RNA is detectable and may be related to higher levels (above 10 6 copies per mL). M aternal and child health issues relating to hepatitis C virus (HCV) infection have recently assumed greater importance than ever before. From the pediatric perspective, the availability of effective screening methods for HCV has virtually eliminated new cases of transfusion-associated hepatitis C in children. Consequently, childhood acquisition of HCV infection through maternal-infant transmission has become the most important mode of spread. 1 Vertical, or more precisely, mother-to-infant hepatitis C will likely be the major type of childhood chronic hepatitis C within the next 6 to 8 years. It has been difficult to determine the rate of mother-to-infant transmission, partly because reports of mother-to-infant transmission of HCV have been based on small numbers of patients, with differing disease definitions, followed with different study designs and using different virological assays. These reports tended to be heterogeneous and conflicting. Moreover, factors that promote mother-to-infant transmission and the outcome of chronic HCV infection acquired by this route still require clarification. Likewise, for women of child-bearing age who acquired chronic hepatitis C in childhood or in early adulthood, there are important issues relating to pregnancy itself, such as its effect on the disease course of chronic hepatitis C. Prevalence of Hepatitis C Among Pregnant WomenNumerous studies have examined the prevalence of hepatitis C among pregnant women (Table 1). The studies vary considerably in terms of the size of the study, geographic variables, and adequacy of laboratory testing. In general, the prevalence of detectable antibody to HCV (anti-HCV) is approximately 1% overall (range, 0.1% to 2.4%), based on the studies that included at least 3,000 subjects. The mean Abbreviations: HCV, hepatitis C virus; anti-HCV, antibody to HCV; ALT, alanine aminotransferase; HIV, human immunodeficiency virus.

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Section: Risk Of Spread Of Hcv Infection From Mother-to-childmentioning

confidence: 82%

Maternal-infant transmission of hepatitis C virus infection

2002

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“…In a recent paper published by the European Paediatric Hepatitis C Virus Network on 1479 mother-infant pairs, 3 no significant difference was found in the transmission rate between vaginal and caesarean delivery, and similar results were obtained in an Italian retrospective multi-centre study involving 1372 mother-infant pairs. 18 In the absence of sufficient information on the risk rate of HCV transmission through breastfeeding, in the present study we recommended formula feeding for children whose mothers had a high viraemic load (> 4 × 10 5 IU/ml) before delivery, as discussed elsewhere. 16 This view is not universal; although HCV has been isolated in human milk, a significant association has never been found between the type of infant feeding and the vertical transmission of HCV.…”

Section: Discussionmentioning

confidence: 97%

Longitudinal Long-term Follow-up Study of Children with Vertically Acquired Hepatitis C Virus Infection

et al. 2006

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Seventeen children with vertically acquired hepatitis C virus (HCV) infection were followed from birth for a mean of 104 months. Alanine aminotransferase (ALT) levels were increased significantly at 3 and 6 months of age but were stable thereafter. HCV polymerase chain reaction was positive at 3 months in 16 patients and at 12 months in one patient. Viral load remained stable during followup at a mean value of 5.4 ± 0.4 log 10 . Mild chronic hepatitis was the most common histopathological feature on liver biopsy, occurring in six of the seven children biopsied at a mean age of 4.0 ± 2.4 years. Genotype did not seem to be related to the type of liver involvement. The results of this study suggest that vertically acquired HCV infection has a benign course in children, despite the presence of viraemia and persistent alterations in ALT levels.

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“…The role of factors that are known to influence the vertical transmission of HCV, such as maternal intravenous drug use and HCV viral load [1,3,5,12,13], was impossible to evaluate because only one of 23 mothers reported a history of drug use, and quantification of HCV viraemia during pregnancy and at delivery was unavailable in most cases. Other factors that do not affect vertical transmission, such as HCV genotype, duration of maternal infection, mode of delivery and type of neonatal feeding [2,3,[12][13][14][15], did not seem to influence the development of HCV-specific CD4C-cell reactivity in our children.…”

Section: Discussionmentioning

confidence: 99%