Increased risk of mother-to-infant transmission of hepatitis C virus by intrapartum infantile exposure to maternal blood.
Virological and clinical data from 73 hepatitis C virus (HCV)-infected pregnant women who gave birth to 75 children were merged retrospectively, by logistic regression analysis, to investigate risk factors for vertical transmission of HCV. Eighty-two percent of the HCV-infected mothers were HCV-RNA-positive during pregnancy, and 10% were coinfected with human immunodeficiency virus (HIV). Nine children were HCV infected, 1 was HIV infected, but none was HIV-HCV coinfected. Among vaginal deliveries, the mean HCV load of mothers who transmitted HCV to their infants was higher than that of those who did not (8.1 x 10(5) vs. 1.4 x 10(4) copies/mL; P=.056). A reduction in umbilical cord-blood pH (relative risk, 3.9; P=.04) or the occurrence of perineal or vaginal laceration (relative risk, 6.4; P=.028) during vaginal delivery significantly increased the risk of vertical HCV transmission. In conclusion, high maternal viremia, infantile hypoxia, and intrapartum exposure to virus-contaminated maternal blood increased the risk of HCV transmission during vaginal deliveries. Consequently, cesarean section may reduce the risk of vertical HCV transmission in selected cases.
Steininger
Christoph
C
Institute of Virology, University of Vienna, Vienna, Austria.
Kundi
Michael
M
Jatzko
Gerlinde
G
Kiss
Herbert
H
Lischka
Andreas
A
Holzmann
Heidemarie
H
D005260:Female; D005312:Fetal Blood / Q000821:virology; D005500:Follow-Up Studies; D006678:HIV / Q000235:genetics / Q000302:isolation & purification; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000517:prevention & control / Q000635:transmission; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000097:blood* / Q000150:complications / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D016015:Logistic Models; D036801:Parturition / Q000097:blood; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000821:virology; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D019562:Viral Load
D012367:RNA, Viral