When does mother to child transmission of hepatitis C virus occur?
OBJECTIVE
To investigate when hepatitis C virus (HCV) infection from mother to child occurs, and evaluate possible associated factors.


METHODS
Prospective cohort study.


METHODS
Fifty four HCV infected children tested within three days of birth and their mothers.


METHODS
HCV RNA polymerase chain reaction (PCR) results.


RESULTS
Seventeen of the children (31%, 95% confidence interval 19% to 46%) were positive in the first 3 days of life and could be assumed to have acquired infection in utero. Testing PCR positive was not associated with sex (53% v 49% boys; p=0.77) or mode of delivery (29% elective caesarean section in both groups; p=0.98). Children with evidence of intrauterine infection were significantly more likely to be of lower birth weight and infected with genotype 1 (58% v 12%, p=0.01). Although a higher proportion of infants born to HCV/HIV co-infected women were PCR positive in the first 3 days of life, this difference did not reach statistical significance; excluding infants born to co-infected women did not affect the results. Thirty seven of the children (68%) were negative in the first 3 days of life, 27 of whom were positive when tested again at 3 months, and nine were first PCR positive after 3 months (one child had no further tests).


CONCLUSIONS
These results suggest that at least one third and up to a half of infected children acquired infection in utero. Although postpartum transmission cannot be excluded, these data suggest that it is rare. The role of HCV genotypes in the timing and mechanism of infection should be explored further.
Mok
J
J
Paediatric HIV Service, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.
Pembrey
L
L
Tovo
P-A
PA
Newell
M-L
ML
D001942:Breast Feeding; D002675:Child, Preschool; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000821:virology; D005838:Genotype; D015658:HIV Infections / Q000150:complications; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000235:genetics / Q000635:transmission*; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors; D012737:Sex Factors
D012367:RNA, Viral
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