Affiliation:
1. Second Institute of Obstetrics and Gynaecology Italy
2. Department of Gastroenterology and Digestive Endoscopy University of Bari Italy
3. Department of Paediatrics University of Bari Italy
Abstract
ABSTRACTBackgroundMother to infant transmission of hepatitis C virus (HCV) has been extensively studied in mothers with human immunodeficiency virus (HIV) infection, whereas fewer data are available on the vertical HCV transmission in HIV‐negative women.MethodsBetween January 1995 and June 1997, 78 consecutive HCV‐positive/HIV‐negative women with their offspring entered this prospective study aimed to define the prevalence of and risk factors for HCV vertical transmission. Risk factors for HCV were carefully sought, and HCV viral load and genotype were determined in all positive mothers. The infants were tested for alanine aminotransferase (ALT) and HCV‐RNA at birth and at 4, 8, 12, 18, and 24 months of age.ResultsEight of 60 (13.3%) infants born to HCV‐RNA positive mothers acquired HCV infection, but only 2 (3,3%) were still infected by the end of follow‐up. Infants' genotypes matched that of the mothers. ALT levels were in the normal range in all study subjects throughout the follow‐up. High maternal viral load (P < 0.05), possession of HCV risk factors (P < 0.004), and history of blood transfusion (P < 0.05) were associated with increased risk of HCV vertical transmission.ConclusionsThis long‐term prospective study shows that, although vertical transmission from HIV‐negative mothers occurs in 13% of cases, there is a high rate of spontaneous viral clearance (75%). High maternal viral load and mothers belonging to HCV risk categories were the only variables predictive of the vertical transmission.