Hepatitis C virus infection in the mothers and infants cohort study.
OBJECTIVE
To estimate the hepatitis C virus (HCV) vertical transmission rate, the effect of potential risk factors, and the pattern of HCV antibody response and viremia in HCV-infected infants.


METHODS
The Mothers and Infants Cohort Study enrolled both human immunodeficiency virus (HIV)-seropositive and HIV-seronegative pregnant women at five obstetric clinics in New York City in a prospective cohort study between January 1986 and January 1991. HCV-infected mothers and their 122 offspring were followed-up for a minimum of 12 months for evidence of HCV infection as determined by persistent HCV antibodies or detection of HCV RNA by reverse transcription polymerase chain reaction. Comparisons among groups for categorical variables were performed using the Fisher's exact test.


RESULTS
Seven (6%; 95% confidence interval, 2%-11%) of the 122 infants were HCV-infected. There was a tendency for increased risk of transmission with maternal viral and obstetrical factors, such as coinfection with HIV (7% vs 4%), high HIV viral load (13% vs 6%), HCV viremia (8% vs 3%), vaginal delivery (6% vs 0%), and female gender of offspring (8% vs 3%), although none of the associations reached statistical significance. After loss of maternal antibody, HCV antibody seroconversion occurred at a mean age of 26 months in 3 HIV-coinfected infants compared with 7 months of age in 4 HCV-infected HIV-uninfected infants. Serial samples showed that HCV RNA persisted in 6 infants for at least 18 to 54 months.


CONCLUSIONS
Our study is in accordance with other studies that have shown low overall HCV vertical transmission risk and a trend toward higher risk with maternal risk factors such as HIV-coinfection or HCV viremia. A delay in infant HCV antibody response may be associated with HIV coinfection although larger studies are needed to confirm these findings.
Granovsky
M O
MO
Division of Cancer Epidemiology and Genetics, Viral Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20852, USA.
Minkoff
H L
HL
Tess
B H
BH
Waters
D
D
Hatzakis
A
A
Devoid
D E
DE
Landesman
S H
SH
Rubinstein
A
A
Di Bisceglie
A M
AM
Goedert
J J
JJ
D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000635:transmission; D006526:Hepatitis C / Q000175:diagnosis / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008875:Middle Aged; D009519:New York City; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D014766:Viremia / Q000175:diagnosis
D018937:Hepatitis C Antibodies; D012367:RNA, Viral