Vertical Transmission of Hepatitis C Virus in a Cohort of 2,447 HIV-Seronegative Pregnant Women: A 24-Month Prospective Study

Ceci, O; Margiotta, M.; Marello, Fiorino; Francavilla, Ruggiero; Loizzi, P; Francavilla, A.; Mautone, A; Impedovo, Luigi; Ierardi, Enzo; Mastroianni, Maria Adele; Bettocchi, Stefano; Selvaggi, Luigi

doi:10.1097/00005176-200111000-00011

Cited by 128 publications

(105 citation statements)

References 35 publications

(54 reference statements)

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“…44,[60][61][62][63] In one study, three fourths of the infants identified with mother-to-infant hepatitis C cleared the HCV RNA by 2 years of age. 23,64 In another study, all 5 infants with mother-to-infant hepatitis C lost detectable serum HCV RNA by 6 months of age. 65 Thus, outcome of mother-to-infant transmission of HCV is usually considered in terms of evolution to chronic hepatitis C, with later spontaneous clearance of HCV infection or progressive chronic liver disease.…”

Section: Outcome Of Mother-to-infant Hepatitis C In Affected Infantsmentioning

confidence: 98%

“…No significant differences were found with spontaneous rupture of membranes, duration of membrane rupture, vaginal delivery or Cesarian section, or evident fetal distress. Infants tended to be small for gestational age, but this could not be attributed solely to maternal chronic hepatitis C. In a study of 2,447 HIVnegative pregnant women from Italy, 23 78 women were identified as anti-HCV positive and these mother-child pairs were monitored for 2 years; 60 women were found to be HCV RNA positive. Eight infants were identified as infected with HCV.…”

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

confidence: 99%

“…Numerous, but by no means all, 27,28 studies indicate that the higher the concentration of serum HCV RNA the more likely mother-to-infant transmission. 23,[29][30][31][32][33] In one study, a high viral level was defined as at least 2.5 ϫ 10 6 viral RNA copies per mL, 33 but in general, studies showing a correlation of HCV transmission with maternal viral load exhibited the effect at 10 5 to 10 6 copies per mL. Differences in when during the course of pregnancy maternal viral levels are tested may explain some of the conflicting observations on this point.…”

Section: Factors Correlating With Mother-to-infant Transmission Of Hcvmentioning

confidence: 99%

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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: Outcome Of Mother-to-infant Hepatitis C In Affected Infantsmentioning

confidence: 98%

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

confidence: 99%

Section: Factors Correlating With Mother-to-infant Transmission Of Hcvmentioning

confidence: 99%

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Maternal-infant transmission of hepatitis C virus infection

2002

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“…15 This clearance is only surpassed by infants with vertically transmitted HCV who demonstrate the highest rate of spontaneous resolution at 75%. 16 A multicenter trial to address the efficacy of current HCV therapy with interferon and ribavirin in this patient population has been initiated. Reports of malaria 17 and West Nile virus [18][19][20][21] in the US blood supply suggests that blood safety cannot be completely ensured and that despite sensitive and specific testing, transfusion-related infections are still a concern.…”

Section: Transfusion-related Infectionsmentioning

confidence: 99%

Complications of β-thalassemia major in North America

Cunningham

Macklin

Neufeld

et al. 2004

Blood

413

309

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Treatment of patients with ␤-thalassemia major has improved dramatically during the past 40 years; however, the current clinical status of these patients remains poorly characterized. We performed a cross-sectional study of 342 patients in the Registry of the National Institutes of Health-sponsored Thalassemia Clinical Research Network. Evidence of hepatitis C exposure was present in 35% of tested patients, was associated with age, and had a rate of spontaneous viral clearance of 33%. Ferritin levels ranged from 147 to 11 010 ng/mL (median, 1696 ng/mL). Median hepatic iron content was 7.8 mg/g dry weight and 23% of patients had values of 15 mg/g dry weight or higher. No patients 15 years or younger and 5% of patients aged 16 to 24 years had heart disease requiring medication. Ten percent had cirrhosis on biopsy. Endocrinologic complications were common among adults. Seventy-four (22%) patients had recent implantable central venous access devices (CVADs) placed. Among 80 episodes of bacteremia in 38 patients, 90%were attributable to the CVAD. Among 330 patients who had received deferoxamine chelation therapy, 224 (68%) reported no complications. We conclude that hepatitis C, iron-related organ dysfunction, and complications of iron chelation therapy are strongly age-dependent in North American patients with ␤-thalassemia.

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“…Thus the influence of timing and mode of infection on the outcome of hepatitis C acquired in childhood remain to be clarified. Data from prospective studies on perinatally transmitted HCV infection are scanty [Tovo et al, 2000;Ceci et al, 2001], and the purpose of this multicenter study is to provide information on the outcome of infection and associated liver disease in a relatively large series of European children.…”

Section: Introductionmentioning

confidence: 99%

Clinical features and progression of perinatally acquired hepatitis C virus infection

Resti

Jara

Hierro

et al. 2003

Journal of Medical Virology

132

113

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The purpose of this prospective-retrospective study was to provide information about the clinical features and progression of hepatitis C virus (HCV) infection transmitted perinatally. Seventy children born to HCV infected woman were enrolled consecutively in five European centers between 1990 and 1999, provided they had HCV RNA in the serum during the first year of life and/or were still anti-HCV positive at 18 months. Sixty-two infants were followed up to 24 months of age or more (range, 24 months-11 years; average, 4.8 +/- 2.3 years). A wide range of ALT elevation was observed in 93% of the infants in the first year of life. During the follow-up, a sustained ALT normalization with loss of HCV RNA was seen in 12/62 (19%) of the children within 30 months of life; 66% of the infants had developed an ALT peak greater than 5x normal at onset (vs. 28% of children with persistent viremia; P < 0.05), and 50% had HCV genotype 3 (vs. 17% of viremic children). Conversely the cumulative probability of chronic progression was 81%. Chronic infection was asymptomatic and liver disease was mild in all 11 children who underwent a biopsy. In conclusion the early stage of acquired perinatally HCV infection is characterized by a wide range of ALT abnormalities, suggesting the interaction of multiple host and virus factors. The chronic progression rate of infection is high, but the associated liver disease is usually mild. High ALT levels at onset seem to offer greater opportunity of biochemical remission and loss of viremia during follow-up.

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Vertical Transmission of Hepatitis C Virus in a Cohort of 2,447 HIV-Seronegative Pregnant Women: A 24-Month Prospective Study

Cited by 128 publications

References 35 publications

Maternal-infant transmission of hepatitis C virus infection

Maternal-infant transmission of hepatitis C virus infection

Complications of β-thalassemia major in North America

Clinical features and progression of perinatally acquired hepatitis C virus infection

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